How sick are you after the first round of TC?

tshire

My MO (1st opinion) has recommended that I do chemo, 4 rounds of TC. This is mainly because of my very young age and Ki67 (34%), even though ALL my other stats are very favorable. She told me that I should double my risk from 13% on Oncotype (20) to 25% based on my age. I am still in the process of harvesting eggs to make embryos with my fiance, and getting other opinions, including one from MD Anderson, but just to mentally prepare for the worst:

My entire family was going on a cruise to Alaska for my 32nd birthday in mid-September. If I end up starting chemo before then, say the first week of September which is what she recommends, will I still be able to enjoy the cruise? We were going to do things like hike on glaciers and bike down mountains. Will I be nauseous and miserable the entire time? Will I be able to eat at the sumptuous buffets? Will I be incredibly motion sick from the boat on top of the chemo nausea? (I tend to get very motion sick).

I asked about starting Tamoxifen now and doing chemo after the cruise but she said she will not start Tamoxifen before then because she said it will make any cancer cells go to sleep and then chemo/rads won't be able to kill them.

Thoughts?

ladyboss1997

I never got sick on TC. I took my nausea pills every 4 - 6 hours for 24 hours after each chemo, and I never got sick. The fatigue is what might get you on the cruise. But you can do whatever you feel up to. The bad thing is that you are going to start losing your hair about the time you go on the cruise - so plan ahead for that.

MsPharoah

tshire, I started losing my hair (shedding) about 3 days before my 2nd infusion. That is normal and if you want to avoid hairs all over the place and you are not cold-capping, you want to address the hair issue on about day 14. I noticed that my hair was dried out and really ugly by day 14, and I was actually happy to take it off.

Everyone is different, but in my case, I had no issues with my first infusion, except I felt "funny" (foggy) on the 3rd and 4th day after the infusion and I got an itchy skin rash on my chest, nothing serious though and benedryl helped. I had medication before and after the infusion to control nausea and I took Claritin before and after my Neulasta injection which helped. Once I was a week out from the first infusion and for the next two weeks, I felt fine. I did not experience intense fatigue until my 3rd infusion and it does get progressively worse. (I had 6 cycles of TC). Your taste buds will likely not be affected as much by your first infusion and generally if you have taste issues, they will last only the first week in the cycle. Ask your doctor what he/she thinks about taking a trip. Most likely, if this is a doctor who manages side effects well, she will tell you to go for it.

Good luck MsP

pebee

I had to go on two work trips while on TC. I think hiking glaciers would be pushing it - maybe ride a bike around town? I was tired, would get sleepy pretty quickly during these trips.

Go, have fun, take lots of pictures.

DaisyQ

tshire,

I had 6 rounds of TCHP (every 3 weeks) starting 9/9/2014. Like ladyboss I relied on the anti-nausea meds every 6 hours and never got sick. Honestly, the first round didn't knock me on my butt that much. I felt pretty normal by about the 5th day post chemo. The big taste changes and food aversion came with subsequent treatments. Everyone is different, but you might find that you can still enjoy the food. I agree with asking your MO. Mine would have encouraged me to go.

Good luck with your second opinion at MD Anderson!

Amy

Jackbirdie

my experience was very similar to MsP. 6 rounds of TC, never had nausea, but fatigue and bone pain got worse with each round. Had some rashes, got pneumonia after #4, but I'm prone to it. The first one wasn't that bad.

I shaved the day after my first chemo so I wouldn't have that awful moment in the shower when it starts to come out in clumps. That decision put me in control and I never regretted it. Bought lots of cute hats on ETSY.

But, and this is a big but. Everyone reacts differently. No guarantees. If you are one of the less fortunate who suffers more SEs, yes, there are meds, but if you got really sick it might be tough to be so far from home. A woman in my chemo group had promised her 6 year old son a trip to LegoLand. She got a fever on the drive there and when you are on chemo and get a fever over 100.4 you usually are advised to go to the ER. She spent several days in a hospital hours from home while her husband and son went on. Not pretty.

Not trying to scare you but there is no way to predict. Have a good plan in place of what you would do if you got sick. Good luck! I hope you get to go and have a great time

MsPharoah

tshire, I just wanted to encourage you to expect the best during your treatment and don't assume you can't travel, work, have fun. I remember when I was going through radiation, my grandson's 1st birthday party was scheduled at the end of my treatment and I would have to take a plane to attend the party. At the beginning of treatment, I thought....no way, I will not be able to travel, but as treatment wore on, I found it to be very tolerable and with my RO's blessing, I surprised everyone by showing up with my husband and we had a great time. Just remember to put your health and well being first. Ask for help in very specific ways and save your energy for important things....like being with your family on a wonderful vacation or in my case, hugging a sweet 1 year old.

Love and Hugs, MsP

AmyQ

I would agree with the others, live your life, enjoy your trip and make great memories. Hard to say if hiking glaciers is doable, your body will tell you that. I kept a diary of my treatments and side-effects and consistently found the 4th day after infusion was the most tiring but since you will have had just 1 infusion, I would think you would be in a better physical condition to enjoy the cruise. Chemo tends to have cumulative effects, so you ought to be okay. Do take your anti-nausea meds and enjoy the food.

Amy

tshire

Thanks ladies.

octogirl

Just wanted to jump in to say that I have an important work trip planned a bit less half way through my TC chemo and my MO has told me to feel free to go for it. So, continuing to do all of of the planning and work to prepare for the trip on the assumption it is a go, and treatments are scheduled around it. At this point, my biggest fear is diarrhea on the plane (it will be a cross-country trip), but that's what Imodium is for (or so I hope, anyway, and so glad TMI isn't an issue with the bco sisters). In any case, I really appreciate the responses on this thread as they give me every reason to believe that it will work out. If fatigue hits I will need to plan to hole up in my hotel room part of the time.

Part of the trip will be a visit to the National Cancer Institute at NIH. That could be interesting.

By the way, Tiffany, I am going to start a September chemo thread. Hope you will join us there.

Octogirl

Carolyn62

I had my first treatment today, so I will let you know. I already have issues requiring immodium due to the removal of a large part of my rectum in 2013 due to stage 1 cancer. I needed no chemo or rads with that one, but when I gotta go, I gotta go. I carry immodium with me everywhere already. I'm prepared with Two scripts for nausea, too.

Good luck! I think you can make it from what I've read and heard.

Lila-claire66

I had my first round of dose-dense AT chemo yesterday and did pretty well. I was very tired when I came home so slept for 3 hours. I feel funcky but not bad. A little light headed, headache with very minor waves of nausea. I took a walk which felt great. I usually do at least 10K steps a day so I want to get back up to that.

My pre-meds included anti-nausea drug and a steroid. I knew the side effect would be insomnia and yep, I haven't slept a wink! What have others tried to solve this issue beside they typical methods, l.e. quiet dark room, don't read in bed.? Going in for my Nuelasta shot today so will ask my MO too.

First day not so bad at all!!

Sjacobs146

I hate to rain on everyone's parade here, but based on my experience, I would not go on a cruise during chemo treatment. If you develop an infection, you will need to be treated right away. I did have the Neulasta shot, but I developed an infection anyway. My DH has to bring me to the ER in the middle of the night when I spiked a fever of 102.5, where they ran a battery of tests including a chest x ray to determine the source of the infection. Luckily, it was just a UTI, but they did warn us that I could be admitted when we called in. I should add that I was 48 and other than BC,in good health. I do not believe that they are equipped to treat cancer patients on a cruise ship, and it costs tens of thousands of dollars to be evacuated off of a ship. Go on the cruise before you start chemo.

Land based trips are another story, while not ideal, I'm sure any hospital in the states would be equipped to deal with a possible infection.