Chemotherapy

On 20 May 2010, almost a month after my major surgery, I walked into Johns Hopkins Clinic (“JHC”) for my 1st cycle of chemotherapy. Chemotherapy is medicine that will kills the cancer cells in my body. The only setback is that chemotherapy effects both cancerous cells and normal cells. Chemotherapy is systemic. That is, it delivers medicine throughout the body. Regardless, the chemo drugs will kill the cancer cells by traveling through my bloodstream.

The Onocologist from JHC that was assigned to me was Dr. Gilberto Lopes. Dr. Lopes is a Brazilian. During our first meeting, we spoke about the cancer treatment and also about the coming World Cup 2010 and the Brazilian team.

Dr. Lopes advised that I would need to go for 8 cycles of chemotherapy. Each cycle will last for 3 weeks. For my chemotherapy treatment, during the 1st day of each new cycle I would be given intravenously (an injection via the vein) of chemo drugs in which I would need to be at JHC for 3 to 5 hours for the drip to be administrated. This will be followed by 2 weeks of oral pill form treatment whereby I need not be at JHC. The pill form treatment will comprise of 3 pills to be taken twice a day during those 2 weeks. The 3rd week of each cycle will not have any chemo drugs introduced into my body. Basically the 3rd week of each cycle is meant for my body to recover a bit before the start of a new cycle.

The chemo drugs prescribed for me by Dr. Lopes includes Oxaliplatin (Eloxatin). This drug is administered to me intravenously. Oxaliplatin is an alkylating agent, that works directly on DNA during all phases of the cell cycle to prevent the cancer cell from reproducing.

The other drug prescribed is called Capecitabine (Xeloda). Capecitabine is an oral form of the antimetabolite 5-fluorouracil that is usually used to treat colorectal cancers that have metastasized.

Prior to my 1st cycle of Chemo treatment, Dr. Lopes also took the time to advised and alert me on the potential side effects of the chemotherapy treatment. Chemotherapy drugs are used to prevent cancer cells from dividing and growing, but they also affect normal cells to a lesser degree. When these normal cells are killed, side effects result.

According to Dr. Lopes. the side effects can be divided into two categories: short-term and long-term (or late) effects. The short term effects occur during and shortly after treatment and tend to be reversible. Late effects may occur months or even years after treatment. However, all patients responds to chemotherapy medicines differently.

The most common short-term symptoms due to chemotherapy include:

  • Fatigue
  • Nausea, vomiting and loss of appetite
  • Diarrhea
  • Hair Loss ( rarely for the chemo drugs I been prescribed)
  • Swelling in the extremities
  • Low blood counts
    • Low white blood cells – results in increased chance of infection
    • Reduced number of platelets – bleeding or bruising after minor injuries
    • Low red blood cells – fatigue
  • Changes to skin & nails, rashes and mouth sores

These side effects are generally short term and reversible.

The most common long-term symptoms due to chemotherapy include:

  • Nervous system:This is characterized by numbness and tingling in the hands and feet. This effect may not improve for weeks or months after the chemotherapy is discontinued.
  • Organs: if the severity of the side effect potentially results in permanent organ damage, such as damage to the liver or lings, the chemotherapy will be closely monitored and discontinued if damage is detected.

Before the start of each chemo cycle, the nurses at JHC will extract my blood to do some blood tests. The purpose of the blood tests are to analyse my red & white blood counts and also my platelets count. If any of these counts are too low, the onocologist could decide to cancel chemo treatment that day until the counts increases.

I remember when I had my 1st cycle of chemotherapy, my red blood cells count was low. Dr. Lopes decided to prescribe a course of Iron pills for me to take to boost up my count and he encourage me to take more beef and liver to help get my red cells count increased.

From young, I had always had a phobia with needles and injections. So I really hate it whenever the nurses need to draw my blood. But for the sake of my chemo treatments, I had no choice but to bear with it. The 1st day of each cycle when the needle is inserted into my vein to inject the Oxaliplatin into my body is something I fear and it is so painful. How I wish all the chemo drugs can be applied orally.

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