Taxotere/Cytoxan starting July 2011

Hello everyone,   I've been busy reading all of your posts.     I start my first round of chemo on 9/15,  and am very nervous.    I will be getting Taxotere and Cyclophosomide,  4 treatments 3 weeks apart.   I was fitted for a wig yesterday and am hoping to continue working through my treatments.   My final infusion will be Nov. 17th,   cannot wait for that day to get here.     I am 45 yrs old,  and I have 2 sons ages 12 & 14.     I am writing everyone's advice down and going to get everything together so I am prepared for Thursday.    I sure hope it's not going to be as bad as I expect it to be! 

peachy-pie: For me the fear was worse than the treatment. I have had almost no side effects except fatigue and hair-loss. I bought my wig prior to my first chemo because it made me feel more secure. I did not start losing my hair until day 18 after my first chemo. My wig is beautiful, and I feel beautiful in it.

Like you, I do chemo on Thursdays. I take Friday off, rest all weekend, and am back on work on Monday. Last night (8 days after 3rd chemo) I broke out in hives. I popped a steroid pill, a benadryl, and applied some Hydrocortizone dream. All is good today.

Since diagnosis I have been taking an herbal supplement called Essiac. I truly believes it helps, and after reading up on it, I will take it for the rest of my life. It is kind of pricy, so I make my own. In fact, that is what I am doing today.

Good luck, and please talk to the ladies here if you have any questions that are not Dr. related.   

Painting - When it comes to radiation, the the key things are the quality of the equipment - the linear accelerators - and the caliber and experience of the radiation physicist, who will work with your radiation oncologist to get the radiation plan calculated properly.  This is why you want to stick with a major medical center site with top quality machines and people.  Here in Philadelphia, we have a number of such excellent facilities.  You're near Boston, so if I were you, I would go to MGH or one of the other top places in Boston.  Don't screw around with something so critical as this, even if it means some extra commuting time.

Peachy - As the others note, chemo (especially TC) is totally do-able and manageable and you will have all of us cheering you on.

Thank you so much,  it makes things so much better to have people to talk to who have been there or who are also going through it.   

Phillybird - very well summarised, a good piece of advice for first timers. Peachy- my good friend also made an essential oil blend of chamomile, geranium and lavender for me to sniff away when I got nervous. I was freaking out during my first chemo and first port access and that made matters worst and caused onco nurses to freak out as well and we all had a rough time. Well it's easy now for me to advise you to keep cool and stay calm but I know what you must be going through now.

Theatercat - wear a comfortable beanie when you sleep. It catches your hair so you dont have to deal with cleaning your bed in the morning.

Thank you PhillyBird and Frances C,  I have a notebook and I am taking all of this down.    Do they usually have ice at the doctors office?  Or should I bring some in a cooler from home?     I can always call and ask,  so maybe I should do that tomorrow.   I will try not to be nervous,  even though I am terrified.   I am watching the ceremony for the 911 victims and think i'll offer up my fear for them.   I think about how horrified they had to be going through what they did,  so I can make it through something like this and be thankful I am still here.  My heart is heavy today for all who were lost,  so I will get through this with a smile on my face for them.  

Thank you Rossileo18,  I will keep that in mind.   My doctor told me to expect the Taxotere to take about 90 mins and the Cytoxan about an hour.    Maybe the first infusion will be slower for me?   I heard they make the next few quicker.    Do they put an IV in your hand for this?  or in your arm?    I will not be getting a port.   

My doctor said that too,  no port needed for only 4 cycles.    Hopefully they can find a vein easily for me.    I am going to the Pharmacy today to pick up my Meds, and going to try to get the other list of things like Claritan, and Aleve, a probiotic and some L-Glutamine, B6, Mylanta, Biotene and a good moisturizer.    Anything else I should get? 

Peachy - I don't know where you are being treated, but I'll bet it is going pretty much like this:

Day before chemo you take 16 mg of dexamethasone.

Day of chemo - forgot to mention, wear a fun tee shirt, bring a hoodie, put your "affected" arm in the sleeve, and leave the unaffected arm (the one for the IV) out.  As others have mentioned - ask for a blanket and a pillow too.

In THE CHAIR, they will put an IV line in a good vein in your unaffected arm.  I suggest you watch the nurse do it because it takes the mystery out and actually will calm you down.  It is a tiny bore needle with a plastic sheath (tiny catheter) over it.  The needle goes in the vein (it will hardly hurt) and then the nurse pulls the needle out, leaving the flexible catheter behind.  This will be taped up nicely so you can't accidently yank it out on your trips to the bathroom or while you're typing on your computer or whatever you're doing in THE CHAIR.  No need to fear that it will get loose.

They will run some saline in the line, and then pump you with more steroids (more dexamethasone) and an anti-nausea drug - I get Aloxi.  This could take 30 min or more.  The regular speed is 30 min, but they may well go more slowly to watch for adverse reactions.  You may feel funny or hot or itchy in your privates or butt when the dex goes in.  Maybe not - just be aware - nothing to worry about.  It goes away quickly.

After that, they start the Taxotere, which is a 60 min infusion at regular speed.  They will ramp you up to regular speed VERY SLOWLY the first time and, usually, the second time.  This is, again, to be sure that you do not have an allergic reaction to the Taxotere.  This means, it could be 90 min or more to get the Taxotere into you.  Typically, they ramp up the speed every 10 min or so. 

Bear in mind that at any point during the infusions, you can always unplug the IV pumping machine (it runs on a battery), and go to the bathroom.

After the Taxotere, they rinse the line again with saline and start the Cytoxan.  Usually, Cytoxan is infused over 30 min, but they will probably go a bit more slowly at first and then ramp it up when they see you are okay with it.  This is the time that you should have that Styrofoam cup with ice chips.  My facility has an ice machine, by the coffee machine and the water dispenser.  My hubby goes over there and fills a cup up for me when it is time for the Cytoxan.  Ask your oncology nurse whether the chemo facility has some ice.  If they don't, sure, try to bring some in your cooler.

When it is all done, they will remove the catheter, apply a piece of gauze over the tiny hole with a bit of pressure, and place some tape over the gauze to hold it to your arm.  If you are the least bit allergic to such medical tape, ask if they can use a hypoallergenic tape or bring some with you.  I am not really allergic to anything, but darned if I didn't get a red welt from the stupid piece of tape they used the first time.  I bring my own tape with me!

Once your chemo is done, go home and relax, but try to use the high that you will feel from the steroids to tire yourself out a bit; otherwise you may have trouble falling asleep in the evening.

The next day, you are probably going to take another 16 mg of dexamethasone.  Note that I did that the first two chemo cycles, but we changed that to a tapering off - 12, 8, 4 over three days - that I would not feel like a truck hit me by three days post chemo.  If you feel like every muscle in your body aches three days after chemo, make sure to mention it to your oncologist.  This is due to an abrupt drop in the steroids.  It is not the Neulasta.

I understand you will be getting the Neulasta shot the day after chemo (same as me).  The "Neulasta pain" that you have probably heard everyone talking about comes about a week after you receive the injection and is in the lower back for me mostly.  If you work out at the gym at all, you will think it feels a bit like you over worked your lower back muscles.  I guess some people suffer more than others with this, but I find it to be relatively mild and easy to deal with - take Tylenol or Motrin.

Here are the rest of my general tips:

Keep on drinking lots of water.  Stay away from sugary drinks and high salt foods.  Hey - that is good advice in general.  Since you'll be drinking a lot, you'll be peeing a lot.  For the first few days up to a week or so after each infusion, you may feel numb (or it might burn) in the area as the urine exits your body.  To cleanse away any chemo-laden urine (or anything else), try Playtex flushable, personal wipes.  They come in a plastic box - keep it next to the toilet, just in case.  My oncologist told me that some women mistakenly think they have a UTI, when it is only the chemo in their urine burning or numbing the skin on the way out.

For the first two cycles of chemo (by day 3 or 4 post chemo infusion) my tongue
turned white and felt like it was raked (this lasted about a day or so, then went away rather quickly).  Also the inside of my mouth gets kind of puffy and mushy (that lasts from about day 3 post chemo to about day 11 or 12 - it depends on what you're eating and drinking and how well/often you rinse your mouth).  This might have been from tasting wine (alcohol of any kind), or eating a hot pepper or other spicy food. If you do want some tastes of wine, chase them well with water. My experience has been that it is during the first couple of days after chemo (and it is the cyclophosphamide that causes this) when the inside of your mouth is particularly sensitive to the drying effects of alcohol and spices.  By week three of the cycle (maybe even starting as early as day 11 or so), your taste buds will be back and mouth tolerance to alcohol and hot spices will return, and you will feel like a normal eater.

When your mouth is out of whack and you really can't taste food, try Trader Joe's organic low sodium tomato and red pepper soup (comes in a box), microwaved in a bowl or cup, then add a big spoonful of non-fat Greek yogurt and sprinkle with tarragon. Good flavor and mouth-feel.

So, I would recommend that with each round of chemo, drink lots of water (of course) and then have unsweetened iced tea as a "drink" when out with friends or at meals for the first week and a half.

The other thing to do, and that I have been doing regularly throughout all my treatment, is to brush your teeth after every meal (floss frequently too) and then rinse your mouth with Biotene dry mouth oral rinse (you can get a big bottle of it, as well as a purse-sized spray bottle at Rite Aid). This is excellent for adding back moisture, since your saliva production goes down with the chemo. It also will help you avoid mouth sores.

Biotene also makes a chewing gum, which I use when I don't get a chance to brush, or when I am on the run, out of water, and need to add moisture to my mouth. About food not tasting right, you may find in the beginning of each cycle that food loses its flavor. I ignore that and just keep eating all my good vegetables, etc. I use more fresh ginger and tarragon in my cooking at these times - since I can taste those things.  If you stick to a high fiber, decent protein, low glycemic index, healthy fruit and vegetable-focused diet (hot stone ground oatmeal for breakfast, quinoa, brown rice (in moderation), yams and sweet potatoes (not regular potatoes or fries), salads with olive oil dressing, non-fat yogurt, fresh fruits (not fruit juice), salmon, sardines, mackerel, no-salt almonds, cashews and walnuts, kale, Swiss chard, spinach), you will be able to stay regular, energized and won't need to worry about gaining all sorts of weight.  Of course, chemo is not the time to think about going on a diet, if you needed to lose weight before.  I have heard many people complain about getting fat due to all the crazy eating they do during chemo.  Just don't eat junk food and candy, have lots of healthy snacks on the ready instead, and try to get some sort of exercise every day - even if it is just a walk around the block.  Since the dexamethasone (and chemo in general) can tend to plug you up, high fiber and lots of water is the way to go.  If you start to get a bit loose and think you are tending toward diarrhea, I would tend to stay away from too many Imodium, since they'll just end up overdoing it and plugging you up.  It is better to try a bit of the BRAT diet good to slow things down a bit - bananas, rice, apple juice and toast.

Ginger - Many people have recommended ginger tea - I just started drinking Tazo organic spicy ginger tea (got it at Whole Foods), and I must say it is great, especially right after each chemo infusion and the subsequent days.  The ginger is supposed to combat any hint of nausea.

Your oncologist will also probably prescribe anti-nausea drugs for you (I have two such prescription bottles at home).  I have resisted taking them.  I was only queasy one time, the evening after chemo #2, and I did a little mind over body thing and calmed my way out of it.  I took two Tylenol and some spoonfuls of liquid Maalox. The prescription anti-nausea drugs can give you killer headaches and other nasty side effects.  You might get some serious heartburn - feels like your rib cage is crushing inwards.  Keep Maalox liquid and chewables on the ready.

Dry crackers - I keep a box of Wasa crackers by my bedside (along with bottles of water), and nibble on a piece of cracker when I get up.  This is really just in case I might be dizzy or nauseated. It was recommended by the nutritionist at my chemo facility (she also raved about the use of ginger and ginger tea). I don't really find I need those crackers to combat nausea, and have taken to making peanut butter snacks out of them as a supplement to my usual oatmeal breakfast!

Moisturizers (I found all of this stuff at Rite Aid): Udderly Smooth for your hands; Burt's Bees cuticle creme and/or Nature's Bounty Tea Tree Oil to dab on your cuticles (fingers and toes); Neutrogena Moisture products without alcohol for sensitive skin to apply to your face day and night; Neutrogena also makes make up removers and facial washes that are alcohol-free; Vaseline Intensive Rescue Moisture Locking Lotion (although it does have alcohol in it) for the rest of your body to moisturize. The chemo will slow renewal of new skin cells and you will find your skin starts to look very dry and papery if you don't keep it slathered up. I wouldn't do any exfoliating or hard rubbing drying with towels.

Your hair will probably start shedding around day 13 post chemo #1.  So far, my eyebrows and lashes seem intact.  Perhaps a bit of thinning to brows.  I try not to rub them. I am very careful about applying and removing eye make-up.  Everyone is different though, and I am amazed that I am still not completely bald.

If you decide to wait to see how the hair loss progresses, rather than cut it off or shave it, you can sleep in a Slumbercap (http://www.slumbercap.com/index.html), and it will catch all the
falling hair to avoid a mess in the bed.  I comb/brush it each morning and toss it in the trash. I have five different colors of Slumbercaps, since I also wear them during the day sometimes; I think they will be neat in the Fall and cooler weather. Note, as well that the cap is very helpful for sleeping since the scalp is rather sensitive as it goes bald. I have been shampooing very gently with Eucerin's Aquaphor Gentle Wash and Shampoo - for babies. Make sure to put some sort of stopper or catch over your shower drain, because (especially in the beginning as your hair falls out in larger clumps) all that hair is going to try to go down the drain. I guess you can see why many women just shave it all off - too much trouble to chase after hair all over the house and bathroom.

I'll say again, keep on exercising.  Even if the chemo makes you tired, some exercise (even a long walk in town) will tend to boost your energy and actually make you feel better.  I am a gym rat and continue lifting weighs and doing my cardio workouts.

I am exhausted!  You are probably exhausted reading this.  I wish you the best and an SE-free or SE-minimal experience!!

Peachy,

My hospital does it slightly differently. I take dexamethasone pills the day before, the day of and the day after. But at the hospital, I get it and the anti-nausea (zofran) as pills, not through the IV. Then I take the zofran for two more days afterwards. My first time there was a bit of a confusion about which pills to take. Maybe that's why phillys place just throws it all in with the chemo drugs. On the other hand, it means less time in the chair. Just wanted to make you aware that procedures can differ slightly,

A good friend sent this link to me. I find it so useful.



http://m.youtube.com/index?desktop_uri=/&gl=US#/watch?v=XaDt3AJQ98c





If can't access, go YouTube and search for these words:Natural Defenses in Preventing and Treating Cancer

Phillybird,  thank you for taking the time to write all of that for me.   I think the worst part is not knowing what to expect,  and reading your posts along with others posts really helps me out a lot.    My notebook is full of things to get before I start on Thursday and full of do's and don'ts during chemo.   I can't thank you all enough for being here for me and helping me through all of this.   From time to time I have anxiety and panic attacks,  I hope knowing all of this ahead of time calms me and prevents them from happening.    I picked up my scripts tonight,  I will take the Dexamethasone 8mg with breakfast & 8mg with dinner the day before, during and after treatment.   Then I have Prochlorperazine 10mg to take every 6 hrs as needed for nausea.  But My doctor told me not to take it,  that he would help me along with it?   I didn't know what he meant by that,  guess i'll find out.    Going tomorrow to get the rest of my list,  the Claritan etc...   I sure hope all goes ok.    I have a food allergy to tree nuts,  and I get anaphalaxia if I mistakingly eat them in something.   So I know what it is like to have your throat and nose close off on you,  I sure hope these treatments won't do that to me.   It's things like this I worry about.    Also with trouble swallowing or my tongue swelling.....so I am going to make sure I have that Biotene and some ice chips in hand!     You are all so wonderful,  I can't thank you enough!   2 more days left until my adventure with chemo begins.        

I have found that lemonade cuts through that nasty taste in the mouth. I also put a little lemon juice in my water. I am with everyone else - drinking lots of fluid is the key. You need to avoid carbonated and caffeinated stuff. These two things will dehydrate you. I will treat myself to a Diet Doke only after I have drank my 64 oz of water.  

   I haven't had any nausea but I take my daytime nausea pill for the three days after chemo - just to make sure. The night-time nausea med makes me loopy.  

All the best theatercat, I understand the anxiety and I still get the butterflies in my tummy whenever it's my turn and I have done this 5 times! But once I am in the chair and the drip starts, I feel ok again.

My eyebrows have thinned out a lot already and looks like I need to whip out the brow pencil LOL! My eyelids itch a bit and I guess eyelashes are coming off too. So eyeliner is the answer One more chemo to go only.... I heard they do come back fast.