Tuesday, 4 May 2010

Chemotherapy Marks you for Life!

I went to see my doctor last week because I have an unusual spot which is not going away. He has referred me to a Dermatologue and I am waiting for the appointment in June.

During the consultation he was looking at my records on his computer (for a French doctor he is unusually up to date with technology) and he asked me if I was still having follow ups after the chemotherapy that I had twenty years ago for a seminoma. I said no, my oncologist had said that after ten years it was my choice and I decided not to continue with them. I added that there was no risk of metastases after twenty years. He then asked me what my profession used to be and it was only later that I realised that I had used a medical term that the general public would not know.

Chemotherapy is such a salient experience it marks you for life! If you are like me, you learn words that you never forget. I can still remember the names of all the cytotoxic drugs, which are poisons really, that were used to treat me. Cisplatin, Methotrexate, Bleomycin, Vincristine, Adriamycin, Cyclophosphamide, Etoposide. All of them make you ill in one way or another. Because their function is to kill rapidly dividing cells they also interrupt the production of blood cells so anaemia and neutrapenia (a lack of production of white blood cells) are common. The latter was worse than normal in my case because I had had radiotherapy on my abdomen before the chemotherapy, and the treatment killed a large proportion of my bone marrow. Luckily I was able to continue being treated even with very low white cell counts without catching infections. Nobody knew why this was and other patients at the Charing Cross Hospital on ward 6W were always having their treatments delayed. There, you see, I can still remember the number of the ward, and actually I can see it in my mind, together with some of the people I met there.

Some drugs have other side effects; Vincristine kills the extremities of the nerves so that after a few months you finish chemotherapy with feet that feel numb and it’s difficult to walk confidently. That takes about a year to go away completely! You lose all your hair and in those days you were always as sick as a dog after a treatment. Loss of appetite could last for days. When I was having chemotherapy various anti-emetics were given and one of the most effective was Lorazepam combined with Dexamethasone. The problem I had with it was that once it has really kicked in, the Lorazepam wipes your memory as well. Some of my fellow patients appreciated that, but I found it profoundly disturbing and refused it after a couple of occasions.

I volunteered to be part of a clinical trial of 5HT3 inhibitors, which are now used regularly, in conjunction with other drugs, to control nausea. They work very well and before he retired Professor Edward Newlands, my oncologist, said that since their introduction the experience of chemotherapy has been transformed. It certainly needed to be! By the end of five months of chemotherapy I was desperate for the treatments to finish so that I could begin to feel well again and get on with my life! I started working again about three weeks after I finished the last treatment. In spite of a short holiday in Morocco I still looked like a ghost, extremely pale, thin and with a few millimetres of soft grey hair. My appearance shocked some of my colleagues but I soon recovered!

So here’s hoping that the spot is nothing serious!

I went to the Dermatologue on 9th June and the tiny spot on the bridge of my nose is a cancer but fortunately it is very slow growing type and not one that spreads.  When I go to have it removed in Early September I will ask for the correct name.  Interestingly he would not have used the word cancer if I hadn't asked a direct question.  Perhaps he doesn't want to worry people unnecessarily!
I wonder what the statistics are for having two types of cancer in your life?


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