Dealing with Cancer #3, Chemotherapy

Lesson #3

Chemotherapy is not fun, and its effects are cumulative.  Don’t be lulled after the first or second infusion into thinking, “This isn’t that bad.”  Be prepared for the physical, mental, and spiritual challenge that will grow more intense with each session.  Regimens and side effects are different from one person to the next, but it ain’t easy.

When my urologist initially broke the news that I have prostate cancer, I asked if I should see an oncologist.  “No,” he replied, “An oncologist won’t tell you anything I won’t tell you.”  That changed several weeks later when an MRI and cat scan revealed the cancer had metastasized into my bones and liver.  At that point, my urologist referred me to an oncologist.

My situation was further complicated when I had a bicycle accident on December 1, 2022 that resulted in a broken femur and a damaged artificial hip that needed replacement.  That required a 10-day stay in a specialty hospital to repair, and chemo makes the leg recovery slow.  Vice versa, the broken leg makes the chemo more difficult because exercise is encouraged but the broken leg limits what I can do. It is my Catch-22.

An Aggressive Approach

Based on the available information, my oncologist recommended an aggressive treatment that would include chemotherapy.  “It will not be easy,” he explained, “but you are in good shape despite the broken leg.  If I didn’t think you could handle it, I wouldn’t recommend it.”

Mrs. tVM and I agreed to the chemo protocol he proposed that included a series of 12 infusions, one every three weeks.  The first infusion was on January 23 which required me to sit in a lazy boy in the clinic while the staff dripped the chemical into me for two hours.  I am a lucky one; the room is occupied by other patients, and some require an 8-hour infusion.  “I had the blues ‘cause I had no shoes…”  Each infusion was followed by an injection the next day. 

In addition to the chemo I receive at the oncology clinic, I receive monthly injections from the urologist, and another injection every three months.  I was also taking a ‘wonder drug’ daily that was prescribed by the urologist.  I suddenly found myself a stranger in a strange land; until this experience, I’d taken no pills other than vitamins.

Good News and Bad News

The Martians have landed in Maine and they are headed West and South.

As I’ve verbalized it to my doctors to ensure that I understand the process, the injections and medications I receive from the urologist are intended to keep the cancer in check so that it spreads no further; the chemotherapy I receive from the oncologist is intended to ‘kill’ the cancer that has moved from my prostate into my bones and liver.  They both concur with that simplistic explanation, so I’m comfortable passing it on.

On the most positive of sides, after the first chemo infusion, my PSA plummeted from 415 to 4.1.  After four sessions, my PSA is down to 0.4, probably lower than that of most men reading this post.  Remember, normal PSA is 0 – 4.0.  Given the way my body has reacted to the protocol, my oncologist has reduced the program from 12 infusions to 6. 

Getting there, however, has been a challenge. My side effects include:

• FATIGUE
• Neuropathy in hands and feet.
• Watery eyes 24/7
• Bloody mucus
• Hair loss
• Weight gain
• Peeling skin on hands

I can write off my displeasure with the hair loss – virtually all of it – and the 20 pounds I’ve gained over the four months of treatment to personal vanity.  I don’t like it, but I can live with it.  I eat much less than I did before I began the treatment, but I also exercise far less and burn far fewer calories because I can’t ride my bike with the broken leg, and I get winded after 50 yards or so of simple walking.

I write the watery eyes 24/7 and bloody mucus to inconvenience.  I like neither condition, but I can live with it.

Fatigue and neuropathy are different.  After the initial chemo infusion, I experienced minor ‘tingling’ in my feet.  The tingling has progressed to pain in my feet and hands and fingers.  After three sessions, my hands were so painful that I purchased an external microphone for my computer so that I could dictate text and operate my computer with speech recognition and fewer inputs with my fingers.  My hands peeled like snakeskin, and my fingernails turned black, then white.  I will lose them all.

The fatigue factor is worse.  The simple act of dressing in the morning leaves me winded and out of breath.  An old classmate and teammate from USAFA who battled cancer a dozen years ago advised me from the start to nap every day.  Excellent advice.  On a good day, I take an hour-long nap at midday; on bad days, I can take three or more naps throughout the day.

The heavy burdens of chemotherapy tempt me to pull out and let happen what happens; that option was offered from day 1: if it gets too bad, we can always stop.  Still, I heed the writings of Francis de Sales.  God has not shielded me from suffering, but he continues to give me the strength to bear it. I do not like what I see in the mirror, and I do not like the way chemo affects me, but a final session confronts me this week, and I am certain it will get better.

Chemo Is Different

As a young athlete, I pushed myself to my physical limits and was quickly and visibly rewarded for the effort; I was an All-American in 1969.  As an adult, I’ve continued to engage in physical activity like hiking, biking, snowshoeing, kayaking, swimming, etc., and have enjoyed the feeling of physical exhaustion followed by the joy of a cool glass of water.  Chemo is different.  I’m not doing the pushing; I’m on the receiving end, and the results are not immediately apparent, and the procedure leaves the body wiped out for days and weeks.  A digital exam and PSA test last seconds; chemotherapy lasts months, sometimes even years.  There is no comparison.

Accept and embrace the fact that you are apt to age decades in a few short months.

Lesson #3

Chemotherapy is not fun, and its effects are cumulative.  Don’t be lulled after the first or second infusion into thinking, “This isn’t that bad.”  Be prepared for the physical, mental, and spiritual challenge that will grow more intense with each session.  Regimens and side effects are different from one person to the next, but it ain’t easy.  Get a PSA test and digital exam annually when you turn 40 so you can minimize the possibility of having to experience chemotherapy for prostate cancer.

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Coming Soon: Lesson #4: A reliable support system is mandatory.

Ringo Starr, “It Don’t Come Easy”