Tackling Breast Cancer Treatment With Optimism
Her breast surgical oncologist says Hilarys initial symptom was unusual, yet her breast imaging showed a 5.7-centimeter tumor, considered quite large. In addition, Hilary had an aggressive type of breast cancer. Priyanka Sharma, MD, a breast medical oncologist specializing in breast cancer at the cancer center, recommended chemotherapy followed by surgery.
The traditional approach is to go to surgery first and give chemo after, according to Hilarys breast surgical oncologist. However, when people receive chemo first, there is opportunity to downstage the tumor in the breast, making surgery easier, and kill any potential tumor cells in the lymph nodes. This makes it possible to remove fewer lymph nodes at the time of surgery.
On March 2, 2017, Hilary began an 18-treatment chemotherapy course, flooding her body with Adriamycin®, known as the red devil, and Cytoxan®, followed by Taxol. She completed her chemo treatments on July 20. By her 4th treatment, Hilarys discharge stopped, a reassuring sign that the cancer was retreating.
I was tired and bald, but it could have been much worse, Hilary says. Despite her fatigue, she continued working, often tackling her duties from home. An avid runner, she also continued running for the first 2 months of treatment and maintained a rigorous walking regimen when side effects affected her ability to run.
How I Dealt With Permanent Hair Loss And Other Side Effects
When I first lost my hair due to breast cancer treatment, I often heard people say, Dont worry. Its only hair. The implication was that it would grow back eventually. But after a while, I began to notice that it was always the people with a full head of hair who said it. And I am one of the very small percentage of women whose hair didnt grow back after chemotherapy. So, I am still bald to this day.
It doesnt feel like just hair when youre the only one who doesnt have any especially when youre a woman, and you realize that yours is probably never going to grow back. But Im OK with being bald now, three years after my breast cancer diagnosis. Because I am cancer-free, too, and that matters far more to me than having hair.
Most unexpected treatment side effect: permanent hair loss
At first, I couldnt believe I had to give up both my right breast and my hair to be free of cancer. Because here I was, thinking at least I was going to get my hair back, and it turns out the regrowth Id experienced after treatment was only due to the steroids Id been taking. It was totally temporary.
I sat in my dermatologists office and cried when she told me.
It turns out Id developed alopecia areata, a condition that makes hair fall out in patches. It can be caused by chemotherapy, but its usually reversible. Ive tried a few things since then to get my hair to grow back, but nothings really worked. So, Ive accepted the fact that Im probably always going to be bald.
Round One Of Red Devil
My first chemo session went pretty well. I wasn’t sure how I would react to the medications, but I was ready to go.
I felt fine until about an hour after I got home. I had zero appetite, and I felt like if I moved I was going to vomit. So, I ended up not eating and just mostly sleeping that first day.
You May Like: Stage 3 Colon Cancer Survival Rate Without Chemo
Early Stage Or Locally Advanced Breast Cancer
Doctors usually offer chemotherapy to treat early stage breast cancer with a high risk of recurrence or locally advanced breast cancer. Chemotherapy for these stages of breast cancer is generally given as a combination of several drugs because research shows that giving them together is more effective than giving each drug alone.
The following combinations of drugs may be offered. Most of these drugs are given by a needle in a vein :
- AC-T doxorubicin and cyclophosphamide followed by paclitaxel
Angelas Cancer Treatment Checklist
Everything happens quickly after a cancer diagnosis, Angela said. Test results can seem like a foreign language and trying to digest the news and information for making the best decisions for the best outcome can be hard. I recommend creating a cancer checklist.
Heres Angelas checklist from start to finish:
Read Also: Skin Cancer In The Scalp
How Is Adriamycin Given
Adriamycin is given as an infusion into a vein. A healthcare provider will give you this injection.
Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when Adriamycin is injected.
If any of this medication accidentally gets on your skin, wash it thoroughly with soap and warm water.
Adriamycin can lower your blood cell counts. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results.
You May Like: Icd 10 Code For Small Cell Lung Cancer
An Unexpected Breast Cancer Diagnosis
Hilary, who lives in Lawrence, was 39 years old in January 2017 when she noticed blood on her nightshirt. She couldnt imagine what caused the discharge from her nipple, especially since her doctor expressed no concerns during her annual well-woman exam only 3 months earlier. She had never been pregnant, had no family history of breast cancer and was too young for regular screening mammograms.
I assumed it had to be some sort of infection, she says.
When the discharge became more frequent, Hilary made an appointment with her primary care physician in Lawrence. They said theyd get me in to see the doctor the next morning, and thats when I thought maybe this was something to worry about, she says.
Her doctor ordered a mammogram and ultrasound. After suspicious findings on those tests, Hilary had a biopsy at a healthcare facility in Lawrence on Valentines Day. Two days later she learned she had breast cancer.
The doctor who called me with the news seemed concerned but didnt convey an immediate sense of urgency. I was told I could wait from 2 weeks to 3 months before starting treatment. Of course, I wanted to start right away and get the cancer out, she says.
Read Also: When To Stop Chemo For Colon Cancer
Strategies For Dealing With Chemo Brain Include Making Lists Exercising And Creating A Peaceful Environment For Working And Concentrating
In late 2020, Katie Henry was diagnosed with stage III breast cancer just before her 34th birthday. She started treatment one month later. It started with a combination of Adriamycin and Cytoxan, two powerful chemotherapy drugs. Adriamycin is also known as the red devil because of its distinctive color and toxicity.
She felt the effects of the treatment right away. She explains it this way: It really fogged my brain. I dont know how to describe it other than comparing it to being on a really crazy roller coaster that youre expecting to end at some point, but instead of ending, it just keeps going and going and going.
The Background On Chemo Brain
In the 1990s, women began to report having cognitive problems after having high-dose chemotherapy. Women coined the apt term chemo brain. At the time, doctors didn’t know how chemotherapy affects the brain.
Chemo medicines cross what they call the blood-brain barrier. That means these drugs may cause inflammation or be toxic to the brain.
Now they realize that certain chemo medicines do cross what they call the blood-brain barrier. That means these drugs may cause inflammation or be toxic to the brain. Unfortunately, radiation treatment, surgery and hormone therapy may also cause negative reactions in the brain.
Also Check: Pros And Cons Of Radiation Therapy
What Can My Body Tolerate
Knowing what the Red Devil Chemo drug can do to your body and how it kills the cancer is important to understanding and knowing what you may expect while on treatment. While it is a very scary thought to receive a medication like this, know that in the world of breast cancer it is one of the most potent treatments we have to kill it!
Read Also: Inspirational Quotes For Someone With Cancer
Want To Learn More About Chemotherapy
Attend the ONS/ONCC Chemotherapy Biotherapy Certificate Course today!
A serious but uncommon side effect of doxorubicin can be irreversible heart damage. This includes arrhythmias, EKG changes, angina, myocardial infarction, and cardiomyopathy, which manifests as a reduction in left ventricular ejection fraction and/or symptoms of congestive heart failure. Because of the potential of cardiotoxicity, you can receive only up to a certain amount of doxorubicin during your lifetime. The lifetime maximum dose may be lower if you have heart disease risk factors such as radiation to the chest, advancing age, and use of other heart-toxic drugs .
Every patient should have a multigated acquisition scan or echocardiogram to evaluate a baseline LVEF prior to initiating treatment. Cardiac symptoms should be monitored closely during treatment and after completion because problems can occur as late as seven to eight years after the last dose. In addition, the risk of developing a secondary malignancy, AML, and myelodysplastic syndrome is increased following treatment with doxorubicin. These leukemias generally occur within one to three years of treatment.
Read Also: Metastatic Breast Cancer Access To Care Act
What Does It Look Like
The nurses then change out the bags of fluid on the IV machine in order to put the pre-meds and chemo into your body.
I had several different pre-meds at each chemo treatment including an antacid and steroid. The actual bag of Adriamycin and Cytoxan is red in color and is the reason for the nickname: The Red Devil.
Neulasta And Bone Pain
Neulasta is the medicine that helps your body fight infection since chemo causes your white blood cells count to plummet.
At the end of each AC chemo, the infusion nurse would attach the Neulasta OnPro injector onto my arm. The device would automatically give me an injection the day after chemo.
This way I didnt have to drive back to the doctor, and I could get the medicine at home. Neulasta can cause bone and joint pain, which some allergy medicines are supposed to help with.
You can ask your doctor about recommendations if you suffer from joint pain. I did get flu-like body aches after the first round of AC chemo.
You May Like: How Long Does Pancreatic Cancer Take To Develop
Adriamycin And Cytoxan: Rounds 2
The first round of AC chemo was the worst for me. Once the nurse changed my nausea medicine, I didnt get sick to my stomach any more. I did get sleepier DURING the chemo sessions though and just kind of laid there with the TV on.
Looking at my phone or a magazine made me feel nauseouskind of like reading in the car. I also didnt really want food while I was there. If I did eat, it had to be something bland like french fries or crackers, but that was about it.
After each session, I continued to mostly sleep for the first 5-7 days. I also never really remembered this first week after an infusion.
I watched TV shows and had conversations with people that I would have absolutely no recollection of the next day. A lot of that may have been due to the nausea medicine I was taking and not the actual chemo though.
Outpatient Oncology Drug Series: Doxorubicin Is The Infamous Red Devil
Editor’s note: This article was first published on April 10, 2015, and updated on May 29, 2018.
Learn even more about the red devil on Episode 92 of the Oncology Nursing Podcast.
Doxorubicin is a cytotoxic chemotherapy drug and an antitumor antibiotic in the anthracycline group. Isolated from cultures of Streptomyces peucetius var. caesius , doxorubicin is semi-synthetically produced and is indicated for the treatment of a multitude of cancers, including breast and ovarian, leukemia , Hodgkin lymphoma, non-Hodgkin lymphoma, Wilms tumor, neuoroblastoma, and sarcoma. As you can imagine, with all of those indications, youll be seeing this drug quite a lot. Most commonly, youll use it to treat patients with breast cancer.
So lets start with the most talked about and memorable characteristic of this drugit’s color. Doxorubicin is bright redseriously red. In fact, it will likely get the attention not only of the patient receiving it but also of the other patients in the room, particularly if theyre not receiving the same drug. Upon first glance, most nurses think, Well, its pretty. And it is. It is a pretty color and a pretty nasty little chemotherapy agent. As such, it deservedly has been nicknamed the red devil.
Don’t Miss: Treatment For Stage 4 Cancer
Kidney And Bladder Effects
Certain chemotherapy medications, such as cisplatin, can cause damage to the kidneys and bladder. This can result in a decreased ability of your kidneys to filter your blood.
Damage to the bladder can also occur and may be temporary or permanent. Symptoms of bladder irritation may include pain or urgency with urination, or blood in your urine.
Chemical: Gemcitabine / Brand: Gemzar
How it works: Gemzar is a type of antimetabolite, which gets absorbed into cancer cells because it can mimic other components of the cell. Once its in, it prevents the cell from dividing and causes cell death. It can be given on its own, but is usually given along with another chemotherapy drug, either carboplatin or Taxol.
Types of breast cancer treated: -Locally advanced: cancer has spread to lymph nodes and other tissues in the chest or neck-Metastatic: cancer has spread to other organs
Pill or IV:Taken intravenously.
Most common side effects:Hair loss sore mouth and taste changes nausea and vomiting fatigue fertility menopausal symptoms sore eyes and runny nose skin problems flu-like symptoms breathlessness liver and kidney problems.
Chemical: Cisplatin / Brand: PlatinolHow it works: Paraplatin and Platinol actually contain platinum, and damage the DNA of cells to the point where they cannot repair themselves, causing cell death. They are typically given in combination with other chemo types after surgery, but can also be given prior. They may also be used in clinical trials for those with Triple Negative Breast Cancer or those have a BRCA gene mutation.
Types of breast cancer treated:-Early stage: cancer hasnt spread-Locally advanced: cancer has spread to lymph nodes and other tissues in the chest or neck-Metastatic: cancer has spread to other organs
Pill or IV:
Nausea and vomiting fatigue chemo brain fertility menopausal symptoms.
Recommended Reading: Best Cancer Treatment Centers In The World
Women On The Brutal Reality Of Undergoing Chemotherapy In Their 20s And 30s
I was terrified of people finding my hair on them.
Everything about cancer sucks, but perhaps the only thing that comes close to the awfulness of the disease is the treatment for it. Chemotherapy is life-saving medicine, no doubt, but it can take a severe toll on your life in the meantime. Here, seven young cancer survivors open up about the surprising, devastating, and sometimes even hilarious aspects of nearly killing your body in order to save it.
It was utterly terrifying to go in and start my first treatment because everything was unknown at that point, says Jessica Rowley, 35, of Nibley, Utah. Will it hurt? What will the side effects be? Will it even work? Who knows! Its a leap of faith.
How To Take Doxorubicin
You May Like: Do Genital Warts Cause Cancer
Chemical: Vinorelbine / Brand: Navelbine
How it works: Navelbine is a type of vinca alkaloid, which stops cell reproduction and destroys cancer cells altogether by interfering with DNA. Its derived from the periwinkle plant, and is often used alone.
Types of breast cancer treated:-Locally advanced: cancer has spread to lymph nodes and other tissues in the chest or neck-Metastatic: cancer has spread to other organs
Pill or IV:Taken orally or intravenously.
Most common side effects:Nausea and vomiting sore mouth fatigue bowel issues numbness and tingling in hands and feet skin changes at infusion site liver changes.
Chemical: Doxorubicin / Brand: Adriamycin Chemical: Epirubicin / Brand: Ellence Chemical: Pegylated liposomal doxorubicin / Brand: Doxil
How it works:Anthracyclines damage the DNA of cancer cells, making them unable to divide and causing cell death. They can be either neoadjuvant or adjuvant and are typically used in combination with other chemo types, especially Cytoxan . Adriamycin is called the red devil because of its bright red color.
Use of anthracyclines has decreased over the years. High usage can result in cardiac damage and they have severe side effects. Now anthracyclines are paired with other drugs and given at a much lower dose to reduce toxicity.
The combination of Herceptin with anthracyclines can cause severe cardiac dysfunction and is not recommended.
Pill or IV:Taken intravenously.
Surviving The Red Devil Chemo
Overall, Adriamycin and Cytoxan were the hardest things I have ever been through. It was nice that I had 21 days between each round so that I could recover and then have a couple weeks of normalcy.
Once AC chemo is over, you feel so much better! You really realize that you are stronger than you think you are and that you can handle anything!
For more inspiration, you can check out my post on positive breast cancer quotes.
You May Like: Radiation Is Targeted Cancer Therapy That Works By