Another man's poison

I had a call from my excellent GP yesterday. He wanted to decode the medical speak in the letter from the consultant and re-assured me that I will cope well with the chemo and not to be too concerned by the astounding list of side effects.

I'm going to have a adjuvant chemotherapy using a combination of Oxaliplatin and 5FU every two weeks for 6 months. Both drugs will be delivered into a main vein close to my heart. On Monday, I will be in RUH to have a Hickman line inserted into my chest to allow this to happen. I get to keep this for the whole 6 months - what a treat! this would be a real boon for drug addicts! The Oxaliplatin is infused during a hospital visit whilst the 5FU is infused over a 48 hours via a portable infusion pump. I really don't relish this level of intervention, but the potential complications are the biggest challenge to come to terms with...

The common side effects include:

• Sore mouth and ulcers ("get a soft toothbrush")
• Taste changes
• Diarrhoea
• (5FU) Gritty eyes and blurred vision
• (5FU) Skin discolouration
• Lowered resistance to infection (it hammers the bone marrow - and therefore reduces white cells)
• Bruising and bleeding (platelet count is reduced)
• Anaemia (red cells are also reduced - all in all not good for the blood)
• Tiredness and feeling weak
• (Oxaliplatin) Numbness and tingling in hands, feet, neck and or throat (often triggered by cold)
• Nausea and vomiting (controlled by anti-emetics)

Less common side effects:

• Hair loss (I'm already follically challenged -  so I quite like to trade this one for, say... susceptibility to infection)
• (5FU) Nail damage
• Increased skin sensitivity to sun
• Itchy rashes (controlled by drugs)
• Soreness of palms and soles of feet
• Increased production of tears (I think this happens as soon as you read the list of side effects!)
• (Oxaliplatin) Difficulty swallowing and breathing
• (Oxaliplatin) Allergic reaction

Nasty stuff. It's a shame that this treatment only reduces your chances of re-occurrence of the cancer by a mere 15%. If it was more like 40% - I could put up with crying a lot and not being able to breathe for a bit! So far as I can tell the treatment hasn't changed significantly in 15 years (when my father was diagnosed with colon cancer) and I have to say, it feels about as advanced as blood letting or leaches!

Yet... I don't have much choice. I also learnt from the oncology consultation that my histology results are a little worse than I had been given to believe previously:

• 1/11 lymph nodes (previously heard 1/18) tested positive for cancer -- indicates spreading
• Cancer cells in tumor are 'poorly differentiated'. Well differentiated cells look more like normally developing cells (ie. cell specific function is clearly identified -- liver cells look different to colon cells). Cancer cells are not fully differentiated - and this indicates a more advanced/aggressive cancer.

The advice from two consultants and the GP is - throw everything at it now.

Better do that then!