chemotherapy

The word chemotherapy is composed of two segments: Chemo- and therapy. Chemo-something is something which has to do with chemical(s). Therapy is a word on its own. It is pronounced: kí*mó*thè*ruh*pí

It is a method of treating cancer. The idea is that you give the patient enough poison to kill the tumor but not the person. This tends to have very serious side effects. The most outwardly visible, but probably the least important, is hair loss.

I think that I used to wonder what was so terrible about chemotherapy. So I thought I'd briefly describe it.

The first problem is the needle. Though I'm more needle-tolerant now than I was before I went through chemo, it becomes painful to receive a needle in the same place every day for several weeks. It becomes very tender in that area. Not to mention that they have to stick you in the hand or the wrist, as opposed to the inside of your elbow, which is less sensitive. Sometimes they would leave a tube in, so that they wouldn't have to stick me again the next day. Sometimes the tube would get plugged, and the next day when the nurse would try to put saline through it it would put intense pressure on the inside of my vein, which would cause intense pain. I would realize at that point that leaving the tube in overnight and dealing with the slight, constant stinging had done me no good, and that I was going to have to get stuck again anyway.

Even before the needle, however, comes the rubbing alchohol. Though it's almost a pleasant smell the first few times, once your body associates it with the impending needle, and the drugs to follow, it quickly becomes an intolerable smell that makes you sick to your stomach. I began having to plug my nose whenever the nurse would apply it.. Then there's the yellow stuff they rub on, which is equally repulsive, but has the added disadvantage of having a rather sickly appearence as well.

So once the needle is in, they run saline (salt water) through to wash it out. At first, the only sensation is coldness, but after a while that too becomes a foreboding sensation.

And then they hang the big chemical bag from the metal stand, hook the tube to your IV, power up the machine, and let it go. And there that bag hangs, perhaps a few liters full, I don't know, and you know you'll have to endure what is to come until that bag is completely empty. My treatments were, I think, 3 or so hours long. And the liquid starts flowing.

At first, it's just cold again, like the saline. In fact, that's all it's like for the first week or so, you get out each day thinking "wow, this isn't so bad after all." It's long and tedious, but doable. You still have all your hair as well, at this point.

But then, after a week or so, you start to notice this taste in your mouth. Little do you know you won't be able to rid yourself of this taste/smell until your chemo is done. It's not altogether unpleasant at first, it's metallic, but that's its only similarity to anything else I can imagine.

As more time goes by, this taste is more and more disturbing. It's especially noticable when you're actually getting the chemo done (and some kind of strongly-flavored food is required to help ease it), but it's noticable all the time. It makes you feel sick. Whenever you visit the restroom (which you do often, and in great quantities), your piss smells like it too. No matter how much you eat or drink, that taste is ever-present.

The coldness of the IV becomes more of a problem as well, in conjuction with the taste of the chemo, it makes you feel especially sick. You'll find yourself wrapping your IV'd arm with a warm, damp towel to help alleviate the coldness, in conjuction with eating.

Then, of course, one morning you find a lock of hair on your pillow. At this point, I shaved it all, rather than sentence myself to watching it fall out gradually. I'm sure this was easier for me than it is for women. It was an interesting change of pace, and friends gave me some cool hats too.

Even when one day is finally over, you know you'll be back again tomorrow. But I can't imagine the feeling that terminal patients have, that they'll be doing this until they die. What a terrible sentence.

Did I mention that I'm happy to be alive? Truly happy.

Chemotherapy Broadly refers to one of the two classes of Drug Therapy. It refers to the use of drugs to kill or prevent the growth of organisms alien to the to the patient. We include cancer cells as foreign organisms along with bacteria, fungi, viruses, protozoans, and metazoans.

Chemotherapy doesn't always make your hair fall out. It depends on the individual drug used.

Mine fell out, though. One day while at work I realized I could just pull little clumps out. This was fun for a while, because it freaked out the guy sitting in front of me, but then it became alarming. My wife picked up a big-ass electric razor on the way home and I became a bald guy for eight months (with a good-looking head I might add).

My chemotherapy would make me extremely sick to my stomach. I needed to take a very expensive drug called Zofran before every treatment. I tried going without it once and it wasn't pretty. I quickly realized that marijuana had the same anti-nauseant properties, and started having a toke before every chemo session. Worked a charm.

Getting the pot was easy because I live in Vancouver, British Columbia, Canada, and there is a legally-grey place called the Compassion Club that will sell you small amounts if you have a doctor's note recommending it. The police know about the Club but leave it alone because it is a community service (despite the people I saw in there, often with notes from their doctors diagnosing the sniffles, acne, etc.)

The theory behind most forms of chemotherapy is this: Since cancer cells replicate faster than normal cells, a poison that affects quickly-replicating cells will kill off cancer cells. From this theory, we can quickly draw two more conclusions:

1. Other quickly-replicating cells, such as those found in hair follicles, gastrointestinal tract linings and the immune system will also be affected.
2. If the tumor is indolent (that is to say, slow-growing), it will not be so easily affected by chemo. It is an ironic fact of oncology that the least aggressive tumors are usually also the least responsive to common treatments.

I underwent CHOP chemotherapy, one of the oldest known regimens, for Non-Hodgkin's Lymphoma, and experienced the following side effects:

1. Hair loss. I was expecting all of my hair to fall out, but what actually happened was something stranger: Most of my hair fell out, but about 10% of my hair remained, and this 10% was, on average, much blonder than the rest of my head. Of that 10%, maybe 1% kept growing out, giving me a kind of freakish appearance if I didn't shave the strands down every few weeks. My facial hair acted the same way. In fact, the only hair that fell out completely turned out to be the pubic hair around my testes.
2. Digestion. Unlike what I've heard about chemotherapy, I was fortunate enough to have no nausea problems, and no loss of appetite. Somewhat to my chagrin, my weight managed to remain constant throughout the 6 cycles of treatment I received. However, I developed a kind of hiccup-ing spasm that would manifest itself while eating, and disturb the rest of my family. They eventually mentioned it during a trip to the doctor's office, and he prescribed Ranitidine, aka generic Zantac, which got rid of the problem handily.

   I would also develop problems with bloody stool about 10 days after an infusion, which really freaked me out, because my immune system was supposed to be whacked, and I didn't want an opening to my blood stream in my anus. I took collase to try and get rid of this, but usally all I could do was wait it out for a few days.

3. Immune System: I found myself prone to getting mouth sores, as well as sores on my feet and around my penis. My oncologist prescribed Acyclovir, the herpes medication, and these sores quickly went away.

   Also, on the night after a couple of cycles, at about 7 PM, I experienced a snap fever, sending my temperature over 100. Two extra-strength tylonol were enough to make me feel normal again by midnight.

4. Psychosomatic reactions: Although I too was afraid of needles, by the time I got past all the surgery and around to starting chemotherapy, I was a lot more inured to an IV placement than klash seems to have been. However, I did find myself experiencing some of the immediate side effects of chemotherapy drugs before they were even given to me as I was in the clinic. For instance, cytoxin will make you sneeze, but while I was still hooked up to the saline solution, I was sneezing harder than I would be when the drug was actually administered 15 minutes later. As I add my writeup to this node, I can, if I will it, still call up some of the strange sensation I had from the drugs.

   I mentioned this to some of the nurses in the infusion clinic, and they told me that my reaction was not uncommon; some cancer survivors can be made sick by the mere mention of chemotherapy.

To avoid the pain of the needle in the same place every time, ask for a central line AKA catheter. In this context, a catheter is a tube threaded through a major blood vessel all the way to just outside the heart, making the constant problem of finding a vein for injection or drawing blood trivial. A port-a-cath is especially convenient.

With a regular central line, you end up with a tube sticking out of your skin which requires special care to prevent a serious infection. Showering for instance becomes a ritualistic ordeal.

A port-a-cath once installed is simply a small button-like structure under your skin. A nurse pokes the button-like port whenever you need a IV or a shot. You can even get a double-ported port-a-cath, which can be convenient if you need to receive chemotherapy and IV fluids at the same time.It is important when injections are being given that the injection site is kept sterile, but the rest of the time you can live like everybody else.

Some forms of chemotherapy are so harsh they require a catheter since the chemicals will destroy small blood vessels if injected into them directly. Also since the chemicals are first introduced in the heart they will be distributed evenly throughout the body.

While the insertion of a catheter is one of the most routine procedures performed by a surgeon, it is not without risk. Damage to the blood vessel during insertion or removal of the device can lead to scar tissue, which can further lead to blood clots or closure of the vessel altogether. Bacteria can be introduced through the catheter directly into the blood stream and can lead to a massive (even fatal) infection.