CHEMOTHERAPY

My view while getting chemo. Huntsman is Posh!

I sleep with a fanny pack.

If a tumor in the colon is found early enough, they can usually just surgically remove it and call it a day. Regrettably, this was not the case for me. In addition to the fact that cancer cells were already identified in 16 of the 18 tested lymph nodes, because my tumor ruptured, there could essentially be cancer cells spewed all over the interior chamber of my peritoneum. Cancer cells also are likely present in the abdominal wall where the tumor had attached itself.

The good news is that no detectable tumors have formed elsewhere in my body. I know this because I fought 3 different doctors tooth and nail to obtain a PET scan. They all told me that PET scans “are not indicated for this situation.” Translation: “These scans cost $5K and if we doctors order one, your insurance company is going to be super pissed and give us a bad mark.” When I figured this out, I asked them to consider that my life is at stake and to kindly set aside any economic factors (i.e. I’ll pay for the GD thing myself!). They then begrudgingly acquiesced. 

If I remember correctly, the resolution of most PET scan machines is programed such that it's able to detect tumors as small as 5 millimeters in diameter. So if any of these roaming cancer cells in my body have joined forces to create tumors, they’re not big tumors and the hope is that chemotherapy will fuck up their plans.

Gettin' juiced.

Entertainment center at cubicle.

I had my first treatment on November 1^st and will get infusions every 2 weeks for 6 months. The infusions take place at Huntsman Cancer Hospital and take about 5 hours to administer. After these 5 hours I’m then sent home with more chemo for 2 days (read more below). A lot of people ask what the infusion center is like, so I’ve posted some photos. At Huntsman it’s basically a bunch of cubicle-sized personal areas each equipped with a big ol’ recliner chair and a TV and DVD player. They have free snacks and Wi-Fi and 2 people are allowed to accompany you if you so desire. You just sit there while deadly chemicals drip into you. Pretty fascinating, really.

Mom & sister Wendy hangin' for the 5-hour process.

No children are allowed in the infusion center, so my
 3-yr-old nephew sent this to me with his mom.
It's a novo-brachial octopus. 

So far the side effects of my chemo are barely detectable but… they get worse as the treatments continue. The chemo drugs I’m taking don’t generally cause much hair loss. There’s usually a lot of fatigue and some nausea, but the scariest side effects are immune suppression, peripheral neuropathy, and cold sensitivity (read more on this below).

So as not to obliterate vasculature, chemo is usually given through a device called a port- or portacath. It’s like the PICC line I described in the “Surgery” page of my blog only the port is in the chest rather than the arm and is far less likely to leak or get infected because it's surgically implanted under the skin. Take a look here if you’re a curious sort looking for more info. Below are pictures of what one looks like out of the skin and what mine looks like under the skin. Mine protrudes a lot because I’ve lost a lot of weight and it makes me feel like a cyborg.

My poison cocktail is called FOLFOX and consists of three separate drugs:

Oxaliplatin

Leucovorin

Fluorouracil (5-FU)

Leucovorin is not a chemo drug. It just helps the 5-FU to work better.

Oxaliplatin is the one with the worst side effects: hearing loss, peripheral neuropathy, and cold sensitivity- yay for winter!! Most people can only withstand Oxaliplatin for about 7 (of the 12) treatments because the side effects get too bad.

The neuropathy causes pain and numbness in the hands and feet, which is, to some extent, reversible. Nerves in the hand, if they grow back, do so at a rate of about 1 millimeter per month, so if my entire middle finger looses feeling, for example, it would take over 6 years to get it back.

The cold sensitivity can get to the point where you can only eat and drink warm to hot foods and beverages and need to wear gloves when retrieving anything from the fridge or freezer and (obviously) when going outside or touching things outdoors during the winter. No more walking barefoot on my hardwood and tile floors. It’s advised that you always wear a scarf to breathe into when going outside during the winter. Breathing in cold air can cause the esophagus to spasm and make you feel like you can’t breathe. 

Chemo drugs target all rapidly dividing cells such as immune cells and those in the mouth, so the 5-FU can cause a metallic taste in the mouth and mouth sores and can weaken the immune response such that one can get sick or get an infection quite easily. 5-FU can also affect hair, skin, and nails- thinning, dermatitis, and discoloration, respectively. I’m gonna be looking so sexy this winter!

Unlike the Oxaliplatin, which targets cells during the resting phase of their life cycle, 5-FU only affects cells during the division phase. Additionally, it has a short half-life of 20 minutes (vs.16 days for Oxaliplatin), so it has to be administered continuously over 48 hours to be effective. Therefore, I get to take my chemo home with me in the form of an elastomer ball ambulatory pump that I carry around in a fanny pack (and wear to bed). Add that shit to the sexiness factor! You can check it out on this website, but here’s what it looks like:

So that’s that with the chemo. I’ll be blogging as treatments continue to document how things are going.