Sept 2012 chemo

Amy, that is amazing, so happy the chemo is working. 

Hello brave ladies!

Amy, that's fantastic news about your chemo working so well!  Must make the treatments and side effects so much more tolerable when you know it's doing its job.  My chemo is adjuvant, so I just envisage it racing around my body and zapping any nasty stray cancer cells...

Back after 3rd round of FEC this morning with horrible headache, the delightful red pee and metal mouth.  Buzzing off all the steroids and wondering how much sleep I'll get tonight.  At least I have my fantastic Mum here for the next few days to pamper me, make me wholesome healthy meals and help with the kids.  Hooray for caring mothers!

Amy - that's such great news!!!  Must feel like a huge victory.  I'm hoping to hear similar good news in the next week.  I get my first look on Monday when I have an MRI after three treatments under my belt.  

Crossing my fingers for everyone else who's watching those tumors shrink.  

Never underestimate the power of positive thinking, right? So why not have a soundtrack for chemo to get you thinking positive cancer fighting thoughts? Something inspirational, something that speaks to the chemo or to the tumor.  Something to reinforce those pac man/scrubbing bubbles as the magic potion drips into you?

Here's my playlist so far.  Any suggestions?  Anyone else have a list going? 

• Don't you worry about a thing
• Feeling good - Nina Simone
• Don't rain on my parade - Bobby Darren
• Don't stop - Fleetwood Mac
• Don't stop till you get enough - Michael Jackson
• Fill me up - Shawn Colvin
• Fixing a hole - Beatles
• Getting better - Beatles
• I am not my hair - India Arie (right?)
• I choose - India Aria
• One (from a Chorous Line) 
• Personal Jesus - Depeche Mode
• I'm bringing sexy back - Timberlake
• Walk of life - Dire Straits 
• Walk on - U2
• With a little help from my friends - Beatles

Hi ladies!

I am starting my chemo today! Bit scary with unknown drugs, but as you may see from my 'signature' I have had chemo before 5 years ago. Wasn't sick at all then, so maybe I'll be ok!

Because I've had a mixture of drugs before, I have reached my 'lifetime limit' of A/c.

So am having TCH- 3 lots one after the other, 4 hours of sitting! Docetaxol(taxotere), Carboplatin and Herceptin! Every 3 weeksx6 lots. Then have 3 -5 weeks of rads.have to give myself four shots of GCSF (equivalent to your neuroblasta) from days 2-6. Hate doing it, but is easy enough.. Bone pain is horrible from memory.



Am hoping the rads don't stuff my implant. My implant was put in straight away, and then expanded 6 weeks later. We don't tend to do exchanges in NEw Zealand, but if it stays like this tennis ball I have I may ask if it will make a difference. Am lucky in the fact that my PS is a perfectionist when it comes to boobs. He has said that he will lift the other one up to match too. Am all on out public/govt system here. Bit diff to what I hear about the USA. We are fully funded for every part of this through our taxes. Would hate to know what I've cost the country so far!



Anyway, enough rambling.

Hope everyone is going well, remember it is only a temporary bump in the road...

Welcome Leanne - it is great to have you!

Whenlife - great list!

Cindi - listen to Melrose!  She keeps us straight. 

cgesq and all Sept 2012

I had my port insertion today, and start chemo on 9/25.  I am sore but tolerable. My chemo is AC x 4.  I will be getting herceptin the following week.  I am reading that some are getting herceptin shots the next day.  Can anyone clarify?  Also how long does the chemo infusion actually take?  How long are you there for?  Any advice for me? 

@Amy - That is fantastic news! It really is doing its job then and hopefully that makes the hairloss that goes with it a little easier to handle.

Just found this article on this site about my MO. He is the absolute best. Not only is he highly skilled, but he is so sweet and compassionate. He treats every patient like they are his only one. He is a rare jewel and a great example for all doctors to follow.



Nicholas Robert, M.D.



Email to a friend Print Page last modified on: February 11, 2012

Dr. Nicholas Robert is a co-chair of the Breast Committee of the U.S. Oncology Research Network and also chairs the Cancer Committee and Research Committee of the Inova Fairfax Hospital's Cancer Center. He is a graduate of the McGill Medical School and completed an internship and residency in medicine at the Royal Victoria Hospital in Montreal. Following a residency in Anatomic Pathology at Massachusetts General Hospital, he continued his training in Boston in hematology at Brigham and Women's Hospital and in Medical Oncology at Dana Farber Cancer Institute. He was a fellow at Harvard Medical School.



After serving as the clinical director of medical oncology at New England Medical Center (Tufts University), Dr. Robert joined Fairfax Northern Virginia Hematology Oncology Practice. He is a member of several organizations, including the American Society of Clinical Oncology and member of the Eastern Cooperative Oncology Group (a past chairman of the breast committee) and National Surgical Adjuvant Breast and Bowel Project. The author of more than 100 publications, Dr. Robert is a reviewer for several medical publications as well as the recipient of numerous research grants. He is certified in internal medicine, anatomic pathology, medical oncology, and hematology.



Dr. Robert takes great pleasure in developing close relationships with his patients and discussing the most cutting-edge breast cancer therapies with them so that they can understand all their options.

Dear Waiting, 

Last Wed. my first A/C took four and a half hours.  I ate a big hearty breakfast before reporting at ll.  I learned afterwards that I should have taken the first nausea pill of the three pack beforehand, but I took it afterwards.  I did remember to put the numbing stuff on the port an hour beforehand.  A caring nurse cleaned the port area and said that next time I should spread the cream around the port as well as on top.  Then she stuck in the needle, but I felt no pail--like pushing a pencil against my collarbone lightly.  First she cleaned the system with saline, and then she put in several chemicals, one by one slowly, first telling me possible side effects, and watching for any allergic reaction.  Fortunately I had none.  I once went to the toilet pulling the stand that supports the infusions.  I especially appreciated that I had brought shawl, lap robe, fluffy houseshoes for the lab room was icy, and I am very cold natured.  I watched a video on my computer with earphones, and checked email and read.  I had crackers, water, sugarfree mints with me.  Left, ate a big bowl of soup when I got home and took the 6 hour nausea pill that makes you sleep when I got home.  Next morning took second pill of pack for nausea took Claridin and a tylanol and had the Neustra shot.  Never had pain or nausea, but from day 4 to day 7--extreme fatigue.

I understand that everyone is different and your reactions may be different.  The worst thing about my first A/C day was the fear and anxiety leading up to it.  I hope you have a pleasant day and no side effects.

Hi Ladies!

I have only had access to this site from my phone for awhile so I've been trying to keep up.  I hope everyone is doing well.  I've been feeling great for the past few days - seems my side effects went away after 10 days or so and since then I feel pretty normal.  Just tire out a bit more easily.  I've been still working full-time and taking care of my 4-year-old son without any difficulty. 

Hair starting coming out a bit a couple days ago... now I can pull big hunks out.  I scheduled the shave for tomorrow with the hairdresser that cut it short for me right before treatment.  It's driving me nuts but I'm still a little nervous since I don't have many things to use for headwear yet!

Went to Look Good Feel Better this week - it was fun and informative and I recommend it to everyone if you can find one in your area.  The other ladies in my group all took a nice wig home... there weren't really any there suited for me.  We all got nice makeup.

For those starting soon - I have never been such a nervous wreck.  I had to take two Ativan just to not leave!  The not knowing how you will react is the worst, and kind of the feeling of no turning back.  I went by myself.  Once I was relaxed it was fine.  I talked with another lady there and learned a lot from her.  The side effects were very managable.  I just took the medications as recommended, and I wasn't offered a Neulasta shot - not sure why!  I'll have to ask my doctor when I see him next week.  But if I could do it, anyone can do it!!!!  I just remembered that I want to survive for my son - I'm his only legal parent and he needs me!!  And I want to see him grow up and have kids of his own.  I kept thinking of the reasons I wanted to survive and it helped so much.

Take care everyone!  I hope for minimal side effects for you all.

Waitingforthenextstep- I am sure you are filled with mixed emotions while you are waiting to start chemo.  It is an anxious time since part of you wants to start and part of you would just rather not.  Glad you have joined these gals on the September 2012 chemo thread; hopefully you will find the support and comraderie that others have found here.  Just remember you are not alone ever!!!  I know this post is long but hope it helps you.

STARTING POINT:  The best place to start is to go the BCO Forum link that has several links to help you figure out what you might want to take with you to your chemo sessions and also some great tips about the chemo and head coverings.  I know it is a lot to digest but always feel free to ask questions here.  Here is that starting point link:

Topic: Important Chemotherapy Threads for Newbies

http://community.breastcancer.org/forum/69/topic/785189?page=1#idx_1

• Tips for getting through chemotherapy
• More Tips (and a Shopping List) for Getting Through Chemo
• PORT PLACEMENT: Detailed description of process
• Head Covering Options for Hair Loss
• wig advice
• Cold Cap Users Past and Present, to Save Hair

PORT Info:  I posted info earlier about the port  and preparation for the port before you leave home for your chemo round. 

As for the port, if you get one placed right before you start chemo, you will not be able to use any lidocaine cream (EMLA cream) for that first round.  EMLA cream cannot be applied to any newly sutured areas.  Ask the nurse to numb the area with some ice or ask for a lidocaine spray.  If you don't have a prescription for the EMLA cream, ask your onco for one. 

When applying the EMLA cream, make sure you put on enough.  Resist the temptation to spread it around with your finger.  You will have a numb finger if you do!!!!  If your prescription did not come with Tegaderm coverings (those clear plastic squares they put over an IV placement), you can use a 4 X 4 inch of plastic wrap or Press N Seal wrap.  The Tegaderm coverings are a little expensive-- they come in a pack of 8 for $9-$10 at CVS.

Whether you get a port or not, make sure you start to hydrate a few days before your chemo day.  It helps make the IV's easier to insert in arm veins if you don't have a port and it makes it easier to access the port.  I know each will hear and read, the importance of plenty of fluids during the actual chemo treatment and the days to follow to help flush the chemo through your body.

ICING NAILS:  At the suggestion of my onco, I iced my nailsI(fingers/thumb and toes) during the Taxotere infusion and used clear nail polish to help keep my nails strong.  She had suggested Sally Hansen Hard as Nails clear polish but I found that Essie All in One Base/Top Coat on my nails worked better for.   I have also been very careful about my finger nails to prevent damage by using rubber gloves to wash dishes or to do house cleaning (cleaning shower/sinks, etc) and also stop using my finger nails as "tools" to open boxes/containers/ plastic packages or remove staples.  So far so good.   I don't know if you will be receiving Taxol later which is when you may decide to ice your nails.  The nail damage is a side effect of Taxotere and Taxol.   If so, make sure you talk to your onco about icing before you do it. 

FIRST CHEMO ROUND:  Make sure you hydrate the day before and the morning of your chemo.  It helps with the port access.  Also, make sure you eat breakfast and take snacks/sandwich with you.  Don't go on an empty stomach since you will be receiving meds in your IV/port before you actually receive the chemo.

As you probably have already read here, the first chemo round may last longer than the ones to follow.  A lot of time is spent explaining the actual process to you.  The chemo drugs may be run slower so that you can be carefully monitored for any allergic reactions.  Just remember you aren't left alone to administer the chemo yourself; the infusion nurses/staff will be constantly checking on you.  The first Herceptin infusion may run over 1 1/2 hours; again so that you can be carefully monitored for any reactions.  After the first time, the infusion may be run over a 1/2 to an hour time frame.  I've already completed my chemo rounds and now have Herceptin only infusions every 3 weeks.  Those are run over an hour's time which works for me. 

At the every round, you will be weighed, blood pressure & temperature taken and blood lab work.  You are weighed since the dosage amount is by body weight.  Then, you will probably go to where your chair/lounger will be so that your blood pressure and temperature can be taken.  The next thing is that your port will be flushed with saline.  It doesn't have the most unpleasant or pleasant taste; some suck on mints/candy because of the taste.  (I just always tell the infusion nurse that it is cherry flavored even though it really isn't.)  The blood lab work is important so your onco knows if your white blood count is high enough to have chemo and also to check to see how your red blood count is.  Once it is determined that your counts are good, your chemo is ordered and you get to wait. You will probably receive your pre-chemo anti-nausea IV meds and saline.   Make sure you drink water during the chemo and eat ice to help prevent mouth sores.  If you need to go to the restroom, ask the infusion nurse to unplug your IV pole from the wall.  You can walk around while you receive your chemo if want.  A word of caution about sucking on too many candies during chemo--- try not to do that non-stop.  One of my chemo buddies sucked on too many lemonheads and now hates them. 

When you get home, make sure you eat 5-6 small meals a day if you can.  Your anti-nausea meds probably need to be taken with food to avoid have nausea from just taking the meds.  A tummy with food is a happy tummy after chemo-- food helps keep the stomach acid down and helps you to avoid nausea.

GETTING A NEULASTA SHOT AFTER YOUR ROUND OF CHEMO:  You may want to try taking regular 24 hour Claritin to help with the bone pain that may accompany the Neulasta shot.  There is an ongoing clinical trial evaluating Claritin to prevent the bone pain.  Here is the link:  (clinicaltrials.gov/ct2/show/NC...). According to the clinical trial, one takes the Claritin (10 mg) once a day for 7 days beginning the day of the Neulasta treatment.

I had my first Neulasta shot with my 3rd round of Cytoxan/Taxotere and took the Claritin.  I did not experience any bone pain.  The Claritin doesn't help everyone but it is worth a try since from my understanding the bone pain may be intense.    I took the Claritin for 9 days starting the day I had the Neulasta shot.  I would take the Claritin in the morning and would get my Neulasta shot in the afternoon.  Just remember to ask your onco about trying the Claritin before you take it.

I get my Neulasta shot in the tummy where there is some tummy fat.  In fact, I ask the nurse to give it to me there rather than in my arm.  It hurts less going in and I don't seem to have any post injection pain.  The nurse gives the shot to hold in my hand to warm it up before I receive the injection.  She then, slowly injects the shot which to help with injection pain.

I've also read on the boards that you can take one Tylenol and one Motrin combo every 4-6 hours to help with the bone pain.  I do not take any Tylenol or Motrin or Advil after I get my chemo but I am cleared to take Tylenol or Advil by my onco.  Again, always ask your onco about what OTC pain meds you can take before you take any.

Wishing you the best!!!!  If you have more questions, please post them!!!!  We all want you to be ready for next week!!!!

Another question...

I haven't heard my MO say anything about Neulasta yet but was wondering if the Claritan can be substituted with Zyrtec and/or Singulair. I ask, only because I take two doses of Zyrtec and one dose of Singulair daily and am not sure if adding another allergy med would be helpful or smart. 

 Any thoughts?

twinplus1- I've read on other chemo threads that some women who are already taking Zyrtec do not take any additional Claritin for the Neulasta bone pain and just take the Zyrtec only.  I'm with you that it probably wouldn't be a good idea to take Claritin in addition to the Zyrtec.  FYI: Not all oncos know about the Claritin and how it may help with the bone pain that can occur after a Neulasta shot or Neupogen shots.

Yes, you don't have to get everything for your chemo today!!!  It is okay.....     You may want to investigate using the caringbridge website so your friends can keep up with you and so you don't have to tell your story multiple times.  You may want to call upon a few of your best gal pals and ask them to help you organize some help for you with errands, meal cooking, etc.  I know there are things that you want to do for your kids and things you can get help with, you may consider getting some help.  Just remember that during the weeks that follow your chemo, you need to rest, eat well and stay well and active (but not to the point of exhaustion).  There is a time period (nadir period) when your white blood counts are at their lowest even with the Neulasta shot and you will need to be aware of the possibility of infection.  Your body will let you know that you have done too much. 

Good luck today!!!  Wishing you an easy time in the chair today and minimal side effects!!!!