Chemotherapy After Colon Cancer Surgery
So why am I taking chemotherapy? The surgeon believes he got all of the cancer. The seven lymph nodes harvested were negative. Physical examinations, blood tests, x-rays and CT scans all are negative. For all intents and purposes, I am a cancer survivor. So why am I taking chemotherapy?
In any cancer surgery, there is always the possibility that one or more cancer cells got away. Unfortunately, even one is enough to cause a problem. Now, if I were 100 years old, it would be difficult to increase my life expectancy with chemo, so the decision not to would be fairly easy. If I were 50 years old, significant improvement in life expectancy could be realized, so the decision to do it would be fairly easy. At 71 years old, the decision isn't quite as easy.
Statistics indicate that a person with my profile has an 82% chance of survival for 5 years without chemo and chemo improves that chance to 87%. Granted these are just statistics and statistics don't apply to an individual. So it boils down to a tradeoff just like everything else in life. Six months of side effects to buy a better CHANCE for survival. I must admit I took a middle ground. I agreed to START chemo, knowing that if the side effects are too much for me, I can stop. So far, so good!
The oncologist scheduled me for a six-month regimen. The regimen is known as FOLFOX 6. The recipe includes oxaliplatin, leucovorin, and fluorouracil. Quantities are determined by a formula using the patient's height and weight. According to that formula I have 1.98 square meters of skin.
I have a blood test on Saturday. I go in to the oncologist office on Monday, have an IV plugged into the implanted port, and then sit for two or three hours as the majority of the chemicals are input.
The IV is left attached and reconnected to a portable pump about the size of a paperback book or a VHS cassette. The balance of the fluorouracil is input over the next 46 hours. The pump becomes my friend and constant companion for that period.
On Wednesday, I return to the oncologist office for removal of the IV. Then I have 12 days free before the next "hammer". My instructions are to walk "about two hours per day" and drink "LOTS of fluids", try not to lose weight, report side effects, and hang in there.
At this writing, I'm nearing the end of the second two-week period (of 12). Perhaps a little early to make generalizations, but enough to report some experiences.
The first period, I felt quite normal from Monday through Wednesday. Then Thursday through about Sunday I had a bit of nausea and fatigue. The nausea was easily taken care of with a pill (prochlorperazine). The fatigue resulted in lots of sleeping. The second week I felt a little stronger each day and was just about back to "normal" by the following Monday.
The second period was very similar day to day, with a couple new things. On Wednesday after the IV removal, my legs and arms developed little red spots. I had blood work for platelet count and saw the doctors. The oncologist said the platelets looked OK and decided to wait and watch. The spots subsided and (in my professional opinion) are now gone.
Nausea remained low-level but fatigue was a little more pronounced. Sensitivity to cold in the mouth, throat and fingertips was noticeable (I think this is called neuropathy). Grapes taken from the refrigerator had to be allowed to warm up a bit before I could touch them. Bottles and dishes taken from the frige required a towel for comfortable handling. As I near the end of the period, this effect is diminishing.
One effect that nothing I read ever predicted has been developing. I have a sensitivity to smells. The smells of laundry detergent, fabric softener, and even the bath soap I use have become obnoxious to me. I am experimenting with solutions but some sprays intended to mask smells are worse than the smells themselves. I have odor free fabric softener and I'm shopping for "free" detergents and soaps.
A suspicion I harbor is that the smell is me! I am very careful about hygiene, but I wonder if the chemicals are just oozing out of me?
The oncologist thinks that it is a side effect on the olfactory nerves. He suggests chewing gum or mints or something to mask the effect. I think he is right. I took an experimental tour through our biggest shopping mall to expose myself to lots of smells. I found that about half of them are obnoxious, another quarter or so are just barely tolerable, and only a small number are pleasing. It wasn't like that before chemo.
I think basically I'm doing OK with the chemo so far, but there are 10 more hammers to come. Stay tuned.