Tuesday, August 12, 2008

What's up with chemo?

Hello, I thought that it would be interesting to explain how I receive chemotherapy. Of course there are variations in each case but I will describe my own situation below. I received my first chemotherapy treatment on Tuesday the 5th. It went well. I had no side effects except being a little bit tired 48 hours after the start of the treatment.
Let me explain treatments: Every two weeks I go to the hospital Sacré-Coeur where I intravenously receive a series of cytotoxic products (which kills the cells, yes, good and bad). The perfusion is done through a catheter installed on the inside of my left arm near the armpit. The catheter is installed for at least 6 months (it is called the Piccline). It consists of a tube of a few millimetres in diameter and about 20 cm long. So it enters my arm and goes through a deep vein almost up to the heart. That is so treatments are distributed to the rest of the body in the most direct and quickest possible way. Back to treatments, the first product injected into the catheter is an anti-nausea drug with a 24 hours effect. It seems to work very well because I did not experience any nausea after the first treatment. Then comes the chemo, the cocktail that I receive is called Folfox-6. It is a mix of three drugs which are regarded as the best of the best for colon cancer today. To this mix will be added another agent, Avastin, in the second round of treatment. Let me explain why later. Folfox is started at the hospital. Two of the three drugs are given to me over a period of about three hours. Then a nurse attaches on my catheter a bottle, they call it the "Biberon" in french (Biberon means a baby bottle in english), it contains the rest of the 5FU agent which must "infused" on a 46 additional hours schedule. I therefore leave the hospital around 13:00 (having begun treatment at 9:00) and for two days I have my bottle in a bag tied around the waist. I look like a tourist with my banana bag but at least I'm mobile. When the bottle is empty, a CLSC nurse comes to my house to unplug it. Why? The catheter installed on my arm is very convenient but it is also a direct opening to the inside of my body that does not offer any protection. Therefore the manipulation of the bottle must be done with a lot of safety and precaution (sterile conditions). Especially since chemotherapy treatments can possibly reduce the effectiveness of my immune system, therefore I must avoid infections at all cost. Once the bottle is removed there is nothing special. I take drugs to control the pain every day but nothing more. This cycle is repeated every two weeks for about 6 months, after which my oncologist will compare the new images of my abdomen to check if my tumors have reduced in size. As far as Avastin goes, one effect of this product is that it prevents scar healing. As I have a big scar on the stomach there needs to be at least a month between any operation and the start of Avastin.

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