The luck of the draw

Day 88 

General status update

Jaw: still twinging sporadically – or should it be twingeing, I can’t quite decide – but seemingly quiescent

Nose: almost back to normal

Hair: its disheveledness is reaching positively Boris Johnsonian levels – it will start quoting Pliny the Elder soon.

Nausea demon: He’s not feeling too well – he seems to have eaten something which disagreed with him. As Oscar Wilde said about the death of Little Nell, you’d have to have a heart of stone not to laugh. I’m sure he’ll be perfectly fine and able to resume his duties by the time FEC5 happens a week from now.

Chemo Muse: Keeps making disparaging remarks about the Anti-Tooth Fairy and her frou-frou outfits, which is a bit rich coming from a woman whose hair is made of snakes.

Anti-Tooth Fairy: she’s been playing poker all day with the Despair Demon – they seem very tight.

Chemo Brian: a little bit confused, what with all the new people milling around recently – he called me over to the sofa a little while ago and whispered into my ear ‘Who the HELL is that b*tch in the tutu?’

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Anxiety level (1-10): So, I started coughing on the phone to my sister today, and she said ‘that sounds promising’ and I said ‘No, no, it’s just because I’m lying down on the sofa and trying to speak at the same time’, but then it occurred to me how hideous it would be if I went down with a viral respiratory infection now AS WELL AS the bacterial tooth infection, because then it would be like the Nazi-Soviet pact in 1940 when the Forces of Evil JOINED UP, and I’d really rather not have Hitler AND Stalin rampaging around my immune system together – I mean, who would?

Fatigue/weakness: mental, as much as anything – there’s just too much to think about: the chemo, the tooth infection, the upcoming root canal work, trying to remember what happened AFTER the Nazi-Soviet pact and how it ended up with the Siege of Leningrad.

State of mind: busily replaying all the major battles of WWII in my head. Expecting Rommel and the Afrika Korps to appear on the horizon at any moment.

News from North Yorkshire: poor old Hank took his humongous balls off to the boarding kennels today, as BigSisFo and the MC are off to Marrakech for a long weekend at one of those amazing riads with courtyards and fountains and a rooftop view of the Atlas Mountains. The MC is apparently being dragged there kicking and screaming, as there are no salmon rivers, low-flying pheasant or vineyards producing Premier Cru wines in downtown Marrakesh.; he doesn’t really understand what Marrakesh is FOR.

I had the most extraordinary conversation on Twitter yesterday, with a woman who’s also had breast cancer, and finished treatment in 2011, and the extraordinary thing was that she had two sorts of chemotherapy treatment, not only FEC, but also its much, much nastier twin Taxotere –

this is one of the taxane type drugs that were originally developed from the yew tree; now a man-made drug, it was first made from yew tree needles, which are, of course, very, very poisonous. Taxotere has a quite prodigious range of side effects, many of which are currently being suffered by some of my cyber chemo-buddies, and include agonising joint pain, extensive itchy skin rashes, finger and toe nails going black, and the skin on the fingers and toes burning and blistering. One of my friends reports that all the skin on her fingertips has essentially fallen off, so for the moment she is fingerprint-less, and in a position to commit the perfect murder: she didn’t say who she had in mind, but I wouldn’t be at all surprised to hear it was her oncologist…

-  and suffered virtually no side effects: no nausea, no hair loss, no toxic stomach, NOTHING. She just ate up the poison and thrived:

‘I did get a skin rash on Taxotere. But didn't bother with anti-sickness or steroids. I was as fit as a butcher’s dog. With cancer.’

I had heard that there were a few people who undergo chemotherapy with little in the way of side effects, but in my mind they had the status of urban legend, given the severity of the side effects I have been experiencing, as have all the other people I know who are undergoing chemo; it was quite startling actually to come across one. As mentioned in an earlier post, I’m taking part in a doctor’s PhD research study, which is trying to find a way of identifying those patients who are likely to suffer most from chemo side effects by looking for metabolic markers in the blood.  

It seems that how you will respond to chemo is entirely individual and idiosyncratic, according to your genetic makeup, and at this stage of medical knowledge it is impossible to predict which patients will suffer badly, and which will get off lightly – expect that if you have a known tendency to nausea, and suffer from travel sickness, or experienced bad morning sickness in pregnancy, then you can be pretty sure that you will be as sick as a dog on FEC, which is a particularly nausea-inducing combination of chemotherapy drugs.

I mention these issues to highlight to anyone reading this blog that not only is there a huge range of variation both in types of breast cancer, and in types of tumour, but also in individual responses to the various forms of treatment: my experience of the FEC chemo regimen has been horrible, but yours, should you ever experience it, might be quite different. I have suffered from extreme nausea, as do many women being treated with FEC, but there is a significant minority who experience only mild nausea, or do not experience it at all.

I discussed this with the Matron for Chemotherapy when we met last week, as I always feel that I am somehow ‘failing’ chemo by being so floored by the side effects. She reassured me that it was simply the luck of the genetic draw, and mentioned that she currently had two male patients of a similar age and with a similar disease who were currently undergoing an identical chemotherapy regimen: one of them is going through hell; the other is barely affected by it.

It’s all in the luck of the draw…