OK-
I now get it- I must really have a disease because i feel sick.
Headaches, nausea, bone pain especially joint pain.- which is the worst
so far. I dislike being useless to do routine things. It is what I hated
about being depressed. This is really not what I had in mind when
wanting to loose weight but I am not really able to eat and some aromas
are horrible for me to smell.
TC
is currently one of the most common types of chemotherapy given to
women with early-stage breast cancer. It’s gradually replacing AC, the
Adriamycin-based “gold standard” of chemo for many years. TC comes with
fewer serious side effects than AC, and studies have shown it’s more
effective for women with node-negative (hasn’t spread to your lymph
nodes) cancer; or cancer where three or fewer nodes are involved.
You’ll
probably be offered Neulasta, which is a drug given by injection 24
hours after each chemo treatment. This “white-cell booster” works to
keep your white-cell counts up. However, it can come with very
debilitating bone pain; some women choose to take their chances with
infection, rather than go through the side effects of Neulasta.
TC
includes two drugs: a taxane, paclitaxel (Taxol) or docetaxel
(Taxotere); and cyclophosphamide (Cytoxan). (Interestingly, taxanes are
one of the few “natural” chemo drugs; they’re made from the bark of the
Pacific yew tree.) Anyway, don’t worry about remembering the names; just
focus on the initials, because anyone who needs to know will recognize
what the letters stand for.
The
"T" part of this chemo combo slows or stops cell division, and keeps
enzymes from making the proteins cells need in order to grow. The “C”
part stops cancer cells from replicating. So between them, you have some
pretty powerful agents working to destroy your cancer.
Q. How long will chemo take?
A.
You’ll probably have four treatments: one every three weeks, so the
whole thing will take about 2 ½ months. Some women have six treatments;
if that’s your schedule, you can add another 6 weeks to that estimate.
Each treatment is given by IV into your hand or arm, and should last
about 2 to 3 hours.
Q. And the side effects?
A.
Thankfully, TC is generally better tolerated than many other types of
breast cancer chemo. Still, there are a range of side effects you may
experience.
•One
immediate (and scary) side effect can be an allergic reaction. You’ll
be monitored closely as you receive your first infusion; and if you
experience this allergic reaction, the IV drip will be slowed down while
you receive drugs to treat it. If it turns out you’re allergic to the
taxane, you’ll be given corticosteroid drugs prior to any succeeding
treatments; these will prevent a reaction.
•Nausea
and vomiting: These can occur – CAN occur – but with the wide array of
anti-nausea medications now available, they aren’t nearly as prevalent a
side effect as they once were. Usually you’ll be given medication to
take directly after your treatment, and this should reduce these nasty
symptoms to general queasiness, if not eliminate them completely.
You
may be one of the unfortunate women who gets sick anyway, but take
heart; you should start feeling better after about 3 days.
•Hair
loss: Sorry. No two ways about it, Cytoxan will see to it that you lose
some or all of your hair. This will probably happen 2 to 4 weeks after
your first injection. Prepare by deciding on a wig, head gear, or if
you’re simply going to “go naked.” It also helps to cut your hair short
before it falls out. Somehow, going from short hair to no hair is easier
than long hair to bald.
•Increased
risk of infection: You’ll be losing white blood cells; the drugs will
destroy some of them, along with the cancer cells. You’ll be at your
most susceptible starting 10 days after treatment, and extending to the
next treatment. In fact, you’ll get a blood test before each treatment
to make sure your white blood cells aren’t TOO depleted, putting you at
too great a risk of infection.
You’ll
probably be offered Neulasta, which is a drug given by injection 24
hours after each chemo treatment. This “white-cell booster” works to
keep your white-cell counts up. However, it can come with very
debilitating bone pain; some women choose to take their chances with
infection, rather than go through the side effects of Neulasta.
How
can you stay infection-free during chemo? Take the usual measures you
would during a flu outbreak: avoid crowds, wash your hands often, stay
away from people who are sick. Remember, an infection you get now will
be more serious than a cold, so use your common sense. Don’t put
yourself at unnecessary risk.
•Fatigue:
As you advance through your 2 to 3 months of treatment, you’ll probably
find yourself feeling more and more tired. This fatigue can range from
mild (increased difficulty climbing stairs) to major (staying in bed all
day).
Try
some gentle exercise, no matter how bad you feel; even walking helps.
And eat enough to keep your strength up. Not eating and not exercising
make you feel tired even when you’re not undergoing chemo; so going
hungry and being inactive exacerbate chemo’s fatigue even more.
•Loss
of appetite/metallic taste in your mouth: Many women report having a
metallic taste in the mouth after treatment. This can certainly cut back
on your appetite! Not much you can do about this one. Try to eat small
meals if that's what you can manage, enough to keep you going. Don't eat
spicy foods in an attempt to "drown out" the metallic taste; it won't
work, and may give you mouth sores. And now that we mention it...
•Sores
in your mouth, on your lips, or in your throat: Imagine cold sores
inside your mouth –OUCH! These may crop up within a few days of
treatment. Try to prevent them by chewing on ice chips during the first 5
minutes or so of your injection; this works for some women.
Avoid
spicy foods, or anything that might irritate your mouth – including
strong mouthwash. If you do get these sores, don’t figure you have to
just live with them; ask for some medication. It’s best to try to knock
them out before they become well established.
•Infertility/stopping
your period: Your ovaries will probably stop producing eggs while
you’re being treated. Depending on how old you are, among other factors,
this infertility may be temporary or permanent.
Broadly
speaking, a woman of 45 has an 80% chance of going into permanent
menopause, while a woman of 35 has only a 20% chance; you can place
yourself on this continuum to get an idea of whether you might be done
with your periods for good. “Chemical menopause” has all the possible
range of symptoms of normal menopause, but condensed into a smaller
timeframe.
•Nail
loss. This is a less common reaction to a taxane, and actually happens
after chemo is finished, usually within a month or so. You may find your
fingernails and/or toenails are very weak and prone to damage. Your
nails may become ridged and loose; they may detach about halfway down;
or you may even lose them entirely. But don’t worry; this generally
isn’t painful, and you’ll find new nails growing in underneath.
•Eye
irritation: You may find you can’t wear contacts during chemo. Or you
may find your eyes are sore and watery. Wear sunglasses if you’ll be
outdoors in bright weather; and try “artificial tears” eye drops to
reduce the soreness.
•Susceptibility
to sunburn: You may be more likely than usual to get a sunburn, so wear
a hat, slather on the sunblock, and just plain stay out of the sun as
much as possible.
•Bladder
irritation: Cytoxan may cause some bladder irritation, which may feel
like a mild bladder infection. Drink plenty of fluids; this will help
allay the discomfort. And mention to your doctor that you're feeling
uncomfortable; he or she may want to check to make sure you don't in
fact have a bladder infection.
•Pain:
You may have pretty significant joint pain that (hopefully) lasts just a
couple of days, but may stretch beyond that. Ibuprofen, taken at fairly
high doses, usually helps with this. Ask your doctor how much to take.
•Tingling:
Some women experience tingling (neuropathy) in their hands and feet.
Not much you can do about that; it's annoying, and can affect your
balance if it's in your feet (since it feels like your feet are asleep);
but it should go away once you're done. Some women experience lasting
neuropathy, finding it takes many months for it to subside; hopefully
you’ll avoid this outcome!
•Chemo
brain: This rather disheartening side effect is experienced by many
women as they go through chemo. And in about 15 percent of women, it
lingers for years. Short-term memory loss and difficulty concentrating
are its main characteristics. You may forget your best friend's name,
your own phone number, or which way to turn a doorknob... any number of
heretofore simple tasks are made more difficult, simply because you've
(temporarily, hopefully) lost some short-term memory.
Until
recently, this side effect wasn't officially recognized, nor taken
seriously. But now, as more and more women experience it, researchers
are trying to figure out just what's going on, and how to provide
relief. If you do run up against chemo brain, try not to stress; if it
doesn't disappear pretty quickly once you finish chemo, it should lessen
over time.
These
are the most common side effects attached to TC chemo. You may have
your very own; but whatever you experience, if it irritates you, be sure
to ask your doctor for something to treat it. Suffering in silence,
keeping a stiff upper lip (choose your favorite axiom) are NOT words to
live by during chemo!
