Thursday, September 27, 2012

Four Myths about Chemo

I am at the halfway point of my chemo cycle. Two weeks from last one and two weeks til next one -- time flies when you're having drugs infused into you. 

No, that's not me... see Myth #4
The two-week mark is also when they take blood and vitals and see how you're tolerating chemo. (For my blood draw today, I had the same lab tech that I've had before and he may be one of the all-time best blood drawers. Seriously. Having found my vein earlier, he basically picked up the needle from his table and stuck me with one fast fluid motion. If phlebotomy had a nightly recap show, this would have made the highlight reel.  But I digress.) 

So how am I tolerating chemo? The short answer is: well. My vitals are all normal and my blood counts are all stable/steady/normal. But I didn't really need any check-up to tell me that.  I feel fine - energetic, healthy, alert. I feel like myself and have pretty much since about last Friday/Saturday - one full week after the chemo ended. 

I met with Nadia, Dr. LaCasce's nurse practitioner and did the usual doctor things, including feeling my lymph nodes, including the one that started this whole thing. I forgot to mention to her, but that one node -- the one that I've always been able to feel with my fingers seems to be definitely smaller, which is what we want to happen. I also asked Nadia some questions about chemo side effects and lifestyle limitations -- and between her answers and what Dr. L already told me, I'm ready to dispel a few myths (or at least over generalizations) about chemotherapy. 

Myth #1:  Chemo gets worse over time
For some treatment regimens this is true. And for some people undergoing the same 4-6 cycle treatment that I'm doing, there may be mean progressively more pronounced side effects -- both in duration and in severity. However, many patients who tolerate the first cycle well (as I did) will continue to tolerate all the cycles well. Many times the progressive side effects are in patients who aren't in such good health as I am. (I've never been told more times how healthy I am than I have since I've been diagnosed with cancer. Go figure.) I'm still bracing for tough first weeks but am optimistic that I can contain it to that.

Myth #2:  Chemo means you have to take it easy 
False. You have to listen to your body, but that doesn't mean you spend the whole treatment time on the couch. In fact, exercise has been shown to help both physically and mentally during treatment. I'm not planning on running any half-marathons, but as long as I don't succumb to man-up mentality, I'll be fine. I'll rest when my body says rest; I'll be active when my body says it's okay.

Myth #3: Avoid crowds, kids, and public restrooms 
Nope. Not necessary. Only stem-cell transplant patients have strict immune system protection safeguards to follow. As Nadia said, I wouldn't put myself in a room full of sick people, but there are no other immune system precautions. One side effect is a possible drop in white blood cells, which often responds well to a booster shot (forgot what that was called, something like imboost or some other clever pharma marketing name) but otherwise, only avoid crowds if you're agoraphobic, kids if you want peace and quiet, and public restrooms if you're fresh out of hand sanitizers.

Myth #4: All your hair falls out
Although this does happen in many cases, it's not always the case. And it's certainly not happening to me, which means any comments about apparent hair loss should be duly attributed to genetics and aging, not chemo.

I'm not trying to make light of chemo. It involves some serious pharmaceuticals that can knock people on their ass. But cancer is a disease of more than 400 different types; and among those 400 types, there are sub-types; and among those sub-types there are different stages of disease; and for each of these there are often different courses of therapy, including different variations of chemotherapy. And then those different variations of chemotherapy are applied to people who fall on vastly different points of the healthiness spectrum. It makes generalization problematic.