What happens at a chemo session?

Now that I’m nearing the end of the chemotherapy phase of my treatment I thought I’d try and demystify what actually happens in chemo week. It might help others who are about to go through it, or for family and friends it shows what happens to their loved ones. I didn’t really have a clue, and a post like this would have really helped prepare me.

Here is where the magic happens, at Queen Alexandra Hospital, near Portsmouth (QA for short). It can take between 40 minutes and an hour for me to drive there, depending on traffic.

Chemotherapy Cycles

Every cancer patient is different, and although I’m following a well-trodden path for breast cancer treatment I’m keen to point out that others may not have the same amount of sessions that I’ve had. Some are treated with chemo tablets rather than infusions (via a vein) and some will have a different ‘cycle’

For my treatment I was recommended to have six cycles, three weeks apart. I received a schedule where the appointments were like clockwork, every three weeks on a Thursday. My drug combination was called FEC-T, and the first three sessions were using FEC, and the final three were using Docetaxel (or ‘T’ for short!). I won’t try and explain how they work, but the Breast Cancer Care site has plenty of info here.

Stop!
In case you don’t read to the end, please can you take a moment and check yourself over. Ladies, the Coppafeel website explains how to check your boobs and if you’re a guy then It’s In The Bag has a great page for checking your balls. Catching it early gives you the best chance to be cured, so DO IT NOW!

While I have your attention, make sure you don’t miss a mammogram appointment, or a cervical smear. Screenings like these will find anything nasty which is lurking around and potentially save your life…

Pre-Chemo Appointment

Before each chemo cycle, usually on a Tuesday, I see an oncologist and have a blood test.

Before I see the oncologist the oncology nurse Mandy weighs me. This is always disappointing as I’ve put on such a lot of weight during my treatment, an average of 2 kilos (4-5lb) every three weeks, the best part of two stone! Mandy always assures me this isn’t a bad thing, as I need my strength in case I get poorly, but it’s horrible for me as I was previously relatively slim and healthy!

When I say ‘an oncologist’ I mean that I don’t see the same one every time. In fact I’ve seen three doctors, one of whom is the consultant, who is always there in case the others need to refer any questions to her. They are all very nice and the aim of the appointment is for them to check how I was after the previous chemo and tweak the drugs I’m given for the next one. Depending how bad my side effects have been, I may need more anti-sickness tablets, or stronger pain relief. Once I had a kidney infection so was prescribed antibiotics to clear that up.

They always ask how I am, and it’s weird because I’m usually feeling really well as it’s nearly three weeks since the last cycle and so I’m pretty much back to normal with barely any side effects. I do keep a diary though, which is really important as you sometimes forget how bad some days are, and exactly how long each side effect lasted.

No matter what, I’m always tired though. Even when I’m feeling relatively well, there’s always an underlying fatigue, no matter how much I’ve slept.

Although this appointment is usually fairly routine, sometimes you can be delivered a curveball, as happened to me before my final cycle. I had been told previously that I’d have radiotherapy next, followed by a mastectomy and reconstruction (at the same time). However, that won’t be the case now. They need to do the mastectomy next to remove any remaining cancer in my breast, and then radiotherapy to zap anything which is lingering in my chest wall.

I will only be able to have a reconstruction once the danger period for the cancer recurring is passed, which is around 18 months to two years. This is because I need to be able to spot any new lumps or bumps, and they won’t really show up on a reconstructed breast as they will be under the ‘filling’ (which could be fat and muscle from elsewhere in my body or could be an implant). I’m disappointed about this, but obviously want to do the best for my long term health so my cosmetic appearance is less important than survival!

As well as seeing the oncologist, I have blood taken through my PICC line, which needs to be tested to check that I’m fit for chemo. The chemo drugs strip me of my immunity, so my red and white blood cell levels need to be high enough, otherwise you can’t have the next cycle. Luckily I’ve always been OK, as it would be annoying to delay the treatment.

After the blood is taken the nurse changes my PICC dressing, which has to be done weekly. Luckily my sister, who is a nurse, has been trained to change it so that, in between the hospital sessions, she can do it in the comfort of my kitchen.

And that’s it for the pre-chemo appointments.

Chemo day

On the day of chemo I pack a bag which is almost the same as if I was going on a plane journey! No other patients seem to have anything like as much as I do! My bag includes :

• Snuggly blanket
• Food and drinks
• Phone, iPad and headphones
• Book or magazine
• Sucky sweets
• Power bank to charge my phone

I’ve been known to take comfy slippers too! I’m probably over-prepared but I’d rather have everything ‘just in case’. I have to say that having an electric faux fur throw was a godsend when I was using the cold cap, but I didn’t need it at my last appointment, when I didn’t use scalp cooling.

The last three sessions have started with a Herceptin injection, which I need because my cancer is HER2 positive. I need to have these every three weeks for a year, and luckily once chemo is over I’ll be able to have them at a more local hospital, saving me some of the journey time.

Before anything happens you are given anti-sickness tablets to take. I’ve had trouble taking them in the past, even though they are tiny, so if I’m feeling feeble on the day then they will give them to me intravenously which is great!

Next they ask whether you want to use the cold cap. If you do then the machine is wheeled in, plugged in and given 10-15 minutes to cool down. It’s a portable fridge with cables leading to a hat which is like a highlighting cap, which is then covered by a pink dome. Your hair is dampened with water and then slathered in conditioner, which will make it easier to take off afterwards, when your head is frozen!

The cables are attached to the machine and your head starts to cool down, for 30-40 minutes.

A saline drip is then hooked up using a machine which delivers it at a prescribed speed, just to flush through your body.

After that, the main chemo drugs are injected into the PICC line. Some of them are done manually by a nurse, using a syringe, but most of them are plugged into a machine which does it automatically, at a programmed rate.

This tends to take an hour or so, after which there’s another flush. If you’re using the cold cap then that will need to be kept on for a while, depending on the chemo drugs. For my FEC cycles I had to keep it on for another 90 minutes! But for the Docetaxel it was only 30 minutes.

Finally, before you leave you’re given a goody bag. It’s full of drugs to take home, and I write down what I need to take, on which days and what time, otherwise I’d lose track. There’s also some injections that I have to give myself, so those need to be kept in the fridge to keep them cool.

You’re also given a car parking ticket so that you only pay for an hour, which is the only time when I get any kind of discount. It’s good because chemo tends to take 5-6 hours in total, which would cost a fortune. For all of my other appointments I pay the full fee, which really mounts up as I’ve lost track of how many hospital visits I’ve had to make.

When you go home from chemo you generally don’t feel too bad, except maybe a funny taste in your mouth. After one session I felt quite sick, and had a bowl with me for the journey just in case, but luckily I didn’t need it. It’s only after a day or so that the side effects really kick in, and then the fun starts!

I hope you’ve found this interesting! I’ve been really lucky and avoided infections, and hospital stays, so far (fingers crossed). I will be glad when this phase is over, but am very nervous of the next stage, the mastectomy.

HAVE YOU GOT LIFE OR CRITICAL ILLNESS INSURANCE?
If the answer is no, then maybe it’s time to sort it out. Unfortunately I didn’t have critical illness cover which would have given me a handy payout and taken the pressure off, financially. I do have good life insurance cover though as I think it’s vital to protect my family if the worst were to happen. You can always speak to the really helpful people at LifeSearch, the UK’s biggest life and protection insurance broker, and loved by Martin ‘MoneySavingExpert’ Lewis. Use this link to get in touch with them and they’ll help guide you through the process – and will also know that you’re from the Diary Of A Detour website.

Read More

Read more about my cancer journey :
– My cancer diagnosis
– My first breast cancer surgery
– What happens at a chemo session?
– My chemo half time analysis
– My chemo side effects
– Making a breast cast
– My mastectomy
– My radiotherapy treatment
– 10 Ways to help someone with cancer
– Am I in remission?
– What is Scar Work?
– My breast reconstruction surgery
– Find travel insurance after cancer