To Chemo or not to Chemo? (That is the question)

(Celebrating Halloween while getting my CT scan, 31st Oct. 2023)

It never occurred to me before that the amount of people who refused chemotherapy to treat their cancer was far higher than I expected, at least in my experience since my diagnosis (Aug. 1st, 2021). Many patients opt for no treatment at all for different reasons but for many, it comes from fear and fear alone. I hope this blog post might help allay these fears because without chemotherapy, I wouldn't be here writing this.
When I talk to patients who have opted out of treatment (two of these were family members), they believed that 1) the chemo side effects would kill them faster or 2) that the life they had left would be utterly miserable because of side effects.

The Assassin and the Misery-Maker

(Free image by"https://pixabay.com/users/berzin-4893239/Владимир Берзин)

If you base your understanding on experience, usually with a loved-one who had suffered while on chemo, then I really do not blame you. It would be weird if you were optimistic about chemo. But, even if your past experiences are as recent as a year or two ago, then you may be surprised to hear that cancer-related medical advances in treatments as well as side effects management have moved way beyond what was available even 6 to 12 months ago. For example, there is a new anti-sick medication called Olanzapine which was not available to me 6 months ago but is now and it is a game changer for me. I vomited so much at the start of my treatment that I have permanent damage to my vocal cords. I cannot sing and my speaking voice is hoarse but much improved thanks to a voice surgeon. I could not speak at all for over three months at one point, which was really depressing. However, this was less to do with my chemotherapy but more to do with the position and size of one of a cancerous cyst on my ovary which was impacting on my oesophagus. Anyway, enough about me, me and me! Let’s look at some ways we can help ourselves with side effects and even reduce tumour growth by 20% at the same time. Let’s live longer with Cancer, feel the fear and do it anyway… or not. The choice is really yours and no matter what should be respected.

#1: Vomiting, Nausea.

(Image by <a href="https://pixabay.com/users/darksouls1)

You need anti-sick medication for a start, and you may need a combination of meds to reduce or eliminate it entirely. At home, my fellow cancer patients and I found nibbling on a cream cracker helpful or eating small pieces of plain white toast helpful. This is because when we are nauseous, we don’t tend to eat much if at all and this can cause us to feel sick in our stomach. This is because our stomach has toxins in it and these need to be absorbed by carbohydrates and expelled the natural way, if you know what I mean! So, a little bit of dry carbs, the white starchy kind, mop up these toxins and we feel better- yay! Also, watching your favourite TV programme while smelling the rind of a lemon is great too.

#2: Fatigue.

(Image by Jupi Lu from Pixabay)

Please don’t kill me! Exercise in the form of a bit of resistance training reduces this dramatically. If you can afford it, hire a personal trainer, and liaise with your physiotherapist first to learn how you should begin your training. It can be anything, weights, resistance training, yoga, pilates or anything you enjoy. If you don’t enjoy it, it is going to be impossible to get yourself out of bed and into the gym/ class when you are experiencing fatigue. Many is the day that I am cursing my 3-minute walk to yoga, but I skip with joy on my way home. Interesting fact which you can Google- look for articles from *ASCO or *ESMO- 150 minutes a week of exercise that makes you sweat, reduces cancer tumour growth by up to 20%. An oncologist from a webinar with DICE told me that if there were a chemo that would reduce tumour growth by 5%, they would give it to you, side effects and all. Exercise also reduces side effects like restless legs, joint aches too. Exercise has been proven to be medicine. Isn’t that amazing?

# 3: Neuropathy

(https://pixabay.com/photos/iceberg-antarctica-polar-ice-sea-404966/)

A painful condition where the nerves in our hands, feet and legs tingle and soar in pain, when exposed to cold. You can also experience throat spasms if we drink/eat something cold, like choking. Scary, right? Based on the principles of the cold cap which helps prevent hair loss in breast cancer patients, the icing protocol I followed prevents the infusion from reaching the hands, feet and throat. The result meant that I have zero neuropathy despite having completed a 3-month cycle of *Oxaliplatin. It involves icing your mouth, hands and feet 20 minutes b4 starting the infusion. These three areas need to be numb and kept numb throughout the session. You will also need to ‘OK’ it with your consultant and day ward beforehand. My hospital had heard of it, but I was the first patient to try it and they watched me like a hawk the first time in case anything happened. You can find instructions for the icing protocol on Colontown or on our Bowel Cancer Ireland Private FB group for patients and carers.

Finally…

(A good day in hospital, dreaming about home...- April, 2024)

Having to start chemotherapy is one of the most horrendous experiences of my life but the antidote to this was the incredible support from medical team, the cancer ward staff including cleaners, caterers, the TV guy, my fellow patients as well as the doctors and nurses. Every one of these and more helped me relax and feel kinda like I was in my local pub enjoying a drink among friends.

Footnotes:
*ASCO = American Society of Clinical Oncology.
*ESMO = European Society of Clinical Oncology.
*Oxaliplatin is one of the ‘gold standard’ chemotherapies for Colorectal/Bowel Cancer patients. There are other chemotherapies that can trigger neuropathy also.