Bald 'n Sassy

Life is for the living. Live simply. Expect less.

Archive for the category “Chronicles of Chemotherapy”

The question is to Oral Chemo or not Oral Chemo

I know, I know.  It has been a long, long while since I updated my blog.  I am not going to give any excuses either. Since my last chemo in October 2011, I have kept myself busy looking for work.  Plus I took another short break to visit my homeland of Australia.

Anyway, coming back on to chemo or not chemo.  I have gone for a regular check up – 6 weeks to be exact.  In the last blood test just before Christmas, my liver was good.  I always look out for the red numbers in the report.  They show if I am below or above the normal range for various elements.  The December blood test was a little more colorful this time.  There were at least half-dozen indicators glowing in red.  But my oncologist reviewed that the key elements are my liver, my haemoglobin, white and red blood count cells.  Not forgetting the cancer (CEA) markers.  Liver was good but the haemoglobin, white and red blood count cells are still below the normal range.  The doctor mentioned that my white blood cells may not recover to the normal range for the pure simple reason of past radiation treatment coupled with chemo.  Basically my body has taken a good beating.

My CEA marker for Dec crept up to 30.  I was a little alarmed but I stayed calm. The doctor did ask if I was feeling under the weather in the week leading up to the appointment.  I didn’t have any major symptoms like cramps or flu. I did have diarrhoea but nothing serious.  Believe it or not having the tummy runs does spike up the CEA markers.  l learnt something new. Even though my markers increased again, it was still too soon for any next steps in terms of treatment.

Last Friday, 3 February it was my second follow-up post chemo. This follow-up was a little unconventional.  The nurse from the pathology lab took an extra vial of blood.  My oncologist rushed into the treatment room explaining that the extra vial will be tested on a separate machine.  The lab introduced a new machine and the readings for CEA Markers plus Cancer Antigens 19.9 is vastly different.  This is a major concern for my oncologist because she is not able to decide if her patients need further or not.  The “discrepancy” was discovered through another patient. I am so happy that she found out about this soon enough.  I hate to think that patient’s having to continue chemo unnecessarily.

The blood tests took longer this time round. I zoomed in on how my cancer markers were performing.  I got a real shock when the CEA doubled from 6 weeks ago.  The doctor asked the same question if I had any symptoms.  She reminded me again not to focus on the number.  If the trend is going up, then it  just indicates that the embryonic cancer cells are active once again.  Since that I pose no symptoms, she would not recommend any treatment.  I did ask about oral chemo.  I recall from earlier consultation that there was an oral chemotherapy yet to be introduced in Singapore.  She shared the oral chemo drug is now available. From the trial, the drug has 40% to 50% success of keeping the cancer cells from producing.  That is not too bad of success rate.  Of course with oral chemo, you would need to take several tablets per day everyday for up to 4 weeks.  Then a 2 week break and then you resume.  The beauty of the oral chemo is side effects are much less severe in comparison to traditional intravenous chemo.  diarrhoea and low white cell blood counts are the reported side effects.

So the question now is to whether switch to oral chemo. I am trying alternative treatment via diet and exercise to bring down the markers.  At this stage it is good to know that I have the oral chemo available.  Furthermore, at least I don’t have to spend hours at the clinic and not be sick for 1 week.  I am going to do my own research on this oral chemo.

Time to wrap up this post.  Till next post.

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No more chemotherapy

All of this week, I was feeling a little anxious leading up to my next round of check up with my oncologist.  It is the routine 3 week visit.  The appointment is scheduled for 11.11.11.  Whether it was deliberately scheduled or sheer coincidence, this date would be forever remembered.

On the way to the clinic, I kept repeating the mantra in mind that “I don’t want to do any more chemo.  My blood test results will be good.”  From my last post, I made the decision to stop chemo on the basis the cancer markers are stabilized.  My oncologist did not object to that idea but she did say that I could stop only if the levels were within plus or minus 10% from the previous level.  Once the nurse from the pathology lab drew my blood, the next 2 hours was going to be the longest 2 hours I had to endure.  I distracted myself with some breakfast followed by sipping a large mug of tea to kill time.  I kept looking at my phone to make sure that I had a strong signal to receive calls and that my phone wasn’t set to silent.

11.55am, my phone rang and it was my oncologist’s office.  The nurse told me the results are back.  Luckily I was at the shopping mall across the road from my doctor’s office.  Walked back with a brisk pace and constantly thinking about results.  As soon as I walked through the clinic doors, I was ushered into the doctor’s office.  I sat down and my eyes were scrambling to see what the results were.  I zoomed in and saw that the cancer markers level decreased to 19.9 from 26.  I let out a huge sigh of relief and couldn’t stopped smiling.  I was ecstatic!  My doctor was also very pleased.  We ran through the blood test results and other components were looking great as well.

My oncologist did the usual physical examination to make sure there were no other symptoms on the body.  I was given the all clear.  Mind you, my oncologist’s slip in the question “Are you sure you don’t want to do another round just to make sure?”.  I instantaneously replied, “no, thank you”.  There is no guarantee that undergoing another round of chemo would “foolproof” from the cancer cells coming back.  Completing  8 rounds of chemotherapy is more than enough for me. It doesn’t mean that I cancer free or in remission.  For now, the CEA (Carcinoembryonic Antigen) levels are low.  “When CEA levels decrease after therapy, it means that most or all of the CEA-producing tumor has been removed.” (extracted from Lab tests online)

Now, it is up to me to focus on what I eat and keep up a healthy lifestyle incorporating exercise.

I will post more on the alternative treatment I am trying.

Ciao for now!

Ding ding, round 8 of chemotherapy

Oh boy, it has been a while since my last post.  Oct was a very busy month for me. It was mostly spending time with my family.  For the first time in over 10 years, all my siblings and their kids plus my mum were in the same city.  I must say it was great to have everyone together once again albeit for a few weeks.  As you can imagine, my sister’s apartment was rather crowded.  Anyway, I am digressing from the main subject about my last chemo.

Round 8 of my chemo was on 21 October.  I decided this round to be the last chemo I would want to do.  I am looking to alternative medicine as my choice of treatment.  My reason for stopping chemo is to give my body a chance to be back to normal.  The chemo drugs literally “kills” all the good cells in the body.  While I am under treatment, my white cells are low and producing minimal red blood cells.  The former is expected but having low white blood cells can be dangerous.  It means that I am more susceptible to catching any sickness and have a harder time to recover from the ailment.  I am learning that now with the ongoing cough that has prolonged for almost 2 weeks. With low red blood cells, my haemoglobin levels are low and classified as anaemic.

On the Friday morning of treatment, the usual routine of drawing blood but it was done by my favourite nurse.  I was rather anxious about the results this time. After seeing a decrease in the previous round, I was hoping the downward trend will continue.  When the results were back, there were 2 other patients ahead of me.  When it was my turn, I sat down and my oncologist smiled.  She showed me the results and the cancer markers dropped by 50%.  I was so deliriously happy. I shared with my oncologist that I wanted to stop treatment after this round and try alternative treatment.  She had no violent objections to that idea.  I need not do any more chemo on the premise that my cancer markers are around the same levels.  My oncologist and I are crossing our fingers and toes that it stays the same.  With the usual physical check up over, it was time to start the chemo session.

The nurse placed the hot pack on my right hand to help my veins come alive so the hunt and inserting the needle is much easier.  I took a good look at my hand and the needle marks from previous sessions are still there.  You could literally join the dots and form some sort of shape.  My poor veins has used and abused. I soldiered on for the next 4.5 hours.

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Time to hide under the covers.  Wish me luck for the next blood test! I will post another blog about the results.

Lucky number 7

Well not sure it is lucky or not but it was round 7 of chemo a fortnight ago.  Oh boy, the side effects post chemo was tough at times.  The worst side effects was the body aches and the bad headaches. The body aches I felt was right through the bones.  It made it difficult for me to fall asleep and sit up right for too long.  I laid in bed for most of the day trying to get some rest.  Even falling asleep at night was a challenge.  The aches prolonged that falling asleep was hard.  Once I do, I would be tossing and turning throughout the night and wake up feeling more tired in the morning.  Cat naps was indeed in my recovery plan.  Having headaches didn’t help either.  I felt that I was supporting a bowling ball with my neck coupled with the slight nausea was not a great mix. Taking strong Panadol didn’t make it go away.

Coming back to my treatment day.  When I walked into the clinic, my favourite nurse from the pathology lab was sitting in the waiting area.  Whether it was coincidence that she was there or she just finished taking blood from another patient.  I like to think she was there for me.  Like previous experience, it was a painless experience when she poked the needle for the blood test.  A good start to that day.

Time for the review the blood test.  It was a rather a busy Friday at the clinic.  I had to wait for my turn to see the oncologist.  The doctor had a smile on her face when she opened her door greeting me to enter her office.  As soon as I sat down, the first news she shared was the cancer markers has decreased to 56.5 from 66.3 – FINALLY!  What a relief!  I could say it is definitely lucky number 7. The other components in the blood test indicated that I am still slightly anemic and white blood cells to be low.  Even though it is low, it was acceptable to go ahead with the next round of chemo.

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It has been a while since I had the company of other patients in the treatment rooms. Sharon, a young nurse working at the clinic shared that one woman was rejected treatment by another oncologist for the simple reason that her cancer has advanced cancer that chemo would be futile.  However, she didn’t give up hope and sought a second opinion my oncologist.  Our oncologist took her case and prescribed a treatment schedule buying her more time.  There are two school of thoughts here.  One doctors’ are taught to save lives and convince patient’s to consider all possible medical solutions.  This would mean more financial impact for the patient. On the side of the spectrum some doctor’s may tell you the prognosis and enjoy whatever time that you have left.  Of course some person would not accept the news and look towards alternative medicines to prolong their life. What would you do if you are placed in this situation?

Round 6 chemotherapy

Oh my!  Where did the time go?  I have neglected to update on my latest chemo.  Bad girl I am.  It is almost 2.5 weeks ago that I completed my 6th round of chemo or the 2nd session with the carboplatin/taxol drugs.  Three days before chemo, I had the case of déjà vu.  Late Sunday evening, my tummy was experiencing cramps.  The pain was mild and tolerable.  Nonetheless I took some Buscopan to relieve the discomfort and hoped the cramps to disappear by the following morning. When I woke up the next morning, the cramps were gone and happily had my breakfast.  The cramps returned an hour later after having the morning meal.  From the past experience, I knew that I had to let my stomach rest by not having any solid foods and just let hydrate myself throughout the day and continued to medicate myself with Buscopan.  I did just that.

By the second day, my tummy was slightly bloated.  I continued to fast and hydrate my body.  I was a little sad because on Tuesday, 30 August was my nephews 13th birthday.  My sister and the family went out for lunch at local hamburger joint, The Fat Boys.  I sat there drinking cranberry juice while the rest of the family members was tucking into juicy burgers.  It is not the first time where I had to watch others eat.  Last year when I was hospital, I could not consume any solid food or drink any water for 1 month because of the same reason of cramps.  The surgeon prescribed liquid food delivered intravenously.

On the day of chemo, I continued to fast in the morning even though I didn’t feel any cramps.  I shared with the oncologist of the cramps.  She shared the cramps could be a due to the combination of radiation and surgery plus possibility of cancer cells working into my guts.  She reviewed the blood test results with me.  My cancer markers indicated an increase by 10% to 66.2 from 62.1 from the previous round.  I was taken aback.  She did explain that the “new” set of drugs theoretically takes 3 rounds to become effective.  I am crossing my fingers that the downward trend holds true.  The next round which takes place this coming Friday will be the 3rd round.

When it was time to start the chemo, I told the nurse that I wanted to use my left hand for a change and let my right hand rest.  The nurse placed the hot pack on my hand to help to wake up and easier for her to poke me.  My hand was red from the hot pack.  The good thing was that she was able to find a good vein to use.  After almost a year of undergoing chemo I am still scared each time the nurse inserts the needle.  The first poke was bearable but as she continues to push the needle a little further into the vein I let out a little yelp.  It didn’t stop there, the needle was only 70% in. One more push and the needle was in.  Yes, I did cringe one more time. Then it was time to hook up the tube to the chemo drugs and test to make sure the flow is smooth. It was good to go ahead.

It wasn’t too long after the chemo started that I felt uneasy in my chest area.  I felt really warm and some tightness.  I had to raise the alarm with the nurse.  My oncologist also stepped in to check on me.  The doctor ordered to slow the flow of the drug to minimise the discomfort.  It made such a big difference immediately.  The doctor did say that because the drugs are derived from plants that it is not uncommon for patients to feel uneasy.  With having to slow down the flow, it took over 5 hours to complete the treatment.

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Over the next few days, the fatigue was the main side effect.  By the 2nd day post chemo my entire body aching.  The ache even spread to my bones.  I took some strong Panadol to help.  It was a temporary relieve. I was so lethargic that I slept for most of the day.

Only 4 days before the next round of chemo.

Slight change of plans for round 5

Number 5 must be my lucky number.  It is exactly 5 days ago that I had another round of chemo treatment.  However there is a slight change of plans. The morning of the treatment started like any chemo session – a blood test.  I was hoping to have my favourite nurse to draw my precious blood but wasn’t my day.  I am not sure if she was rushed for time.  It was rather painful when she poked me with the needle. I could feel the blood flowing into the tube.  My arm was sore and weak for several hours – this is the first time I have felt any discomfort post a blood test.

So what is the change of plan you might ask.  The cancer marker level in my blood test showed a northward trend – about 10% increase from 56 to 62. This is not what I wanted to see.  My oncologist did not hesitate to advise me that we need to change the chemo drugs.  The plan is to go back using the set of chemo drugs administered last year.  The combo drugs are Carboplatin and Taxotere.  Before we proceeded with the treatment, she gave me an option of changing Taxotere to another drug called Taxol. From what she explained to me, Taxol is within the same class of Taxotere and used to various cancers such as breast and ovarian.  Taxol can be administered either on a weekly basis or every 3 weeks. I just can imagine not having a rest in between each session.  Plus my veins would not be able to recover in time.  I could have opted to insert a catheter but I can’t bring myself to go under the knife once again even if it is for very short duration.  I would be silly enough not to take up the 3 week plan. Mind you it takes around 4 to 4.5 hours to fully administer.   At least I have a longer period to recuperate in between each session.

Now that treatment plan took a detour, the next question I had to ask the doctor is how many rounds would I need to complete.  The answer I received is “Until the cancer markers has stabilized”.

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I am happy to say that the side effects for the new drugs are much easier to manage than the Japanese Campto drug.  No nausea, a slight headache and body aches for a day or two.  Mind you I am still very cautious about my immunity in the first post chemo.  My white blood cells has crept up a little higher but I am not completely out of the woods.

I am looking forward to walking out of the house for some natural Vitamin D tomorrow.  The other happy news is that I can fit in more swimming days in between treatments.

What will the results show today?

It’s Friday and today is round 5 of my chemo treatment. My body is starting to ache from the 2 consecutive days of swimming.  I am proud to that I can swim 40 laps each time. This is my personal best thus far and my minimum number of laps each time I swim.

Ok, swimming aside.  I am little anxious what my blood test results will be later this morning. The results will decide what course of action I will take.  Should there be minimal decrease in the cancer markers, then I may have to revert to using the Carboplatin and Taxotere combination used in my first chemo treatment last year.  If my memory serves me right, my oncologist mentioned that she will change to Taxol instead of Taxotere.  The white blood cells count will be the other indicator closely monitored. Although I feel physically fine, I am susceptible to catching any cold or virus’ very easily plus my body would have a tougher time to fight should I fall ill.  It doesn’t help that my sister and her daughter have not been well over the past week.  I just keep a good distance away when possible.  My brother in law has a sore ankle to add to the woes. So I have been helping out with the cooking and housework. Not a fun household to be in right now.

I am crossing my fingers and toes for a better blood test results.  It is a short post today.  I’ll be leaving shortly to head to the doctor’s.

Round number 4 – checked

Is it me or is timing flying past much faster.  It is exactly one week ago that I successfully completed my 4th chemo treatment.  Phew!  Overall the treatment well but there is a possibility a change in plans.

So here is the story.  As you may have learnt from my earlier posts, there is a blood test that is carried out prior to start of each session to decide how I am responding to the treatment plus the results will raise any concerns in my blood.  For me the key indicators are the cancer markers and white blood cells that I am most worried about.  I like to see a downward trend for the cancer markers and for the white blood cells level increased to a higher level.  As soon as my oncologist sat down with me to review the results for round 4, I was taken aback to see cancer markers increased by 10% from 49.9 to 56.3.  She was just as surprised as I am.  There are two possibilities that could see the markers spike up.

  • Fighting a viral infection.
  • The cancer cells has learnt to adapt to resist drug and mutate to generate new cancer cells.

I have been physically fine and not fallen ill in between treatments. As for the second point, cancer cells are incredibly intelligent to regenerate new cells in a matter of days.  In round 3, I postponed the treatment by 5 days simply because my white blood cells were too low and anemic.  In that short space of time, it is an opportunistic time for the cancer cells to adapt and learn to be resistant. I haven’t researched into this myself nor can I prove it.   Moreover the chemo drugs has  “expiry” date in terms of effectiveness.  In my case, the drug, Campto last for about 17 days or so. Delaying any further could pose further risk and lower the effectiveness.

So what does the above mean for me.  My doctor explained the options available.  First option is to change the chemo drug to the Carboplatin/Taxotere combo used in my first volume of chemo last year.  This means back to one round every 3 weeks and I would need to completed at most 4 rounds.  My white blood cells levels with this drug didn’t drop below the normal range.  Second choice is to use a complete new drug that is prescribed on a weekly dosage.  I am not too keen on this option because my veins would not be able to cope with the weekly poking.  As it is now my veins are under so much stress each time I have chemo plus I only have less than 2 weeks to rest before it all happens again.  In the event I choose to have his intense program, she strongly recommended for me to insert a catheter near my collarbone for much smoother and painless administration.  Oh boy!  Decisions decisions.

If I had to compare the choices, I would opt for number 1. And from past treatments, my white blood cells did not take a huge beating from the drugs.  There is a fine balancing act right now of making sure the drugs are working and still be somewhat strong enough to fight off a cold.

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I am just wondering with the modern medicine today, how come pharmaceutical companies haven’t thought of a wonder pill for white blood cells.

TGIF.  Have a good weekend everyone!

Numero Quattro – a milestone

An active morning for me today. With a sunny day outside I was looking forward heading to the pool to swim some laps.  Each time I swim, I make it a point to swim 30 laps.  This magic number has been my minimum laps for the past 2 months.  I decided to challenge myself and increase to 40 laps.  I am so proud of myself that I did manage to squeeze in the extra 10 laps.  I could see dark clouds looming  each time I lift my head to take a breath. Moments later, the clouds starting to cry. The rain didn’t stop me from continuing with my swim.  I love swimming in the rain.  The rain drops has a soothing effect on the back.  Some may think I am little crazy in the rain.  There were 2 other swimmers who also didn’t let the rain stop them from swimming.  My arms and legs starting to ache now.

Tomorrow will be my 4th round of chemo.  This marks as milestone for me.  I would cross the quarter mark checkpoint.  When I first started this second chapter of chemo, the number 12 is a high number and that it will take 6 months to complete which sounds pretty daunting. As each day treatment passes, I can happily cross each session.

I must admit that I haven’t been doing my stress ball exercise in the last few days.  I hope tomorrow the nurses will not have a major challenge to hunt for a suitable vein.  I like to see this hunting exercise as “game” for the nurses.  I say I make it interesting each time I visit the clinic.

Ok, time to head under the covers and get some shut-eye.  I hope there is some improvement in my white blood cell count in the blood test.  Fingers and toes crossed.

Round 3 – this time it’s for real

Gosh where has the time gone.  One week has zoomed at a blink of an eye. After the wait and see approach and taking iron tablets to address my anemia, it was time to get another blood test done to decide if I am  medically fit to go ahead with round 3.  Aside from the haemoglobin the other key indicator the oncologist is hoping to see some improvements is my white blood cell count.  I kept my fingers crossed while I waited patiently for the results.  In the meantime, I fed my tummy with a nutella and banana sandwich for breakfast.

An hour and half later, the results are back.  There was good and bad news.  First, the good news is that in 5 days, my haemoglobin level increased and fall within the “normal” category.  I was no longer anemic.  The bad news is that my white blood cell count specifically the polymorph level has not changed from last week – this is also known as leukopenia. With low white blood cell count it means that my body is not as strong to fight off any infections. So what does this mean?  My doctor said that I have 2 options.

Option 1:  go ahead with the chemo session with the same dosage but I would have to inject myself with Neupogen, is a man-made form of a protein that stimulates the growth of white blood cells in your body.

Option 2: Wait for another week with the hope that the white blood cells improve.  I did ask if I could eat or do something to help.  Unfortunately, there is very little I can do in this case.  Should I wait a little longer to do chemo, there is a possibility that I may encounter some cramps in my stomach because the cancer cells are working their way into my guts.  Not a pretty picture and nor do I want to wait and see if the pain comes back.

With no other obvious symptoms such as pain or discomfort, there wasn’t anything to prevent me from continuing with the treatment.  Since I am not keen to have any stomach cramps, I chose the first option.  I would rather have the injections.

By now my body is attuned to receive the chemo and most of the common side effects are manageable.  One of my least side effects is the nauseous feeling.  Despite the anti-nauseous medications I am given prior to each chemo session, it still lingers around for 4 to 5 days.  I hate it!  It is having the hangover feelings without the alcohol.  Somehow, I fought the feeling and survived it.

I have officially completed a quarter of my treatment.  Hooray!

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