Starting Herceptin, Zolodex and radiotherapy treatment

I can’t quite believe we’re nearly half way through December already. Here we are with just under two weeks to go until Christmas and I’ve now started the next stage of my treatment. Last Tuesday morning I had the first of my Herceptin (Trastuzumab) injections which will continue for the next year. 

As it was being administered into my thigh, I squeezed hold of Pats’ hand and whilst it did sting a little, luckily it wasn’t too painful. It was quite unlike any injection I’ve had before as it took the nurse a good few minutes to inject it. I wasn’t looking, but Pats told me the nurse was gently and slowly injecting the fluid into my leg. We then had to wait for two hours afterwards to ensure that I didn’t suffer any adverse side effects (which I didn’t).

After applying a local anaesthetic cream onto my tummy, just to the left of my belly button, I was given the second treat of the day. This was an early Christmas present from my oncologist – the Zolodex injection. I’d recently heard from other ladies that this can be a really painful injection (hence the numbing cream) so I was really quite nervous about it. The nurse suggested that I didn’t look at the needle, just as well as Pats said it was rather large! It actually implants a small pellet into the skin area. My eyes diverted to every possible location in the room other than the needle going in. To my surprise it wasn’t as painful as I anticipated!

I’d  discussed hormone treatment with my oncologist the day before and he was still undecided whether to prescribe me Tamoxifen or to use an alternative aromatise inhibitor in conjunction with Zolodex. ‘Let’s switch your ovaries off for Christmas and start the hormone treatment in the New Year,’ he said. And a merry Christmas to you too!

Goserelin, or Zolodex as it is also known, is a hormonal therapy used to treat breast cancer. It works by interfering with the way hormones are made or how they work in the body. The breast cancer I had was strongly oestrogen receptor-positive (ER positive) and therefore relies on this hormone to grow. Zolodex is used to treat women who have ER positive breast cancer who have not yet gone through the menopause. It can be used after surgery to reduce the chance of the cancer coming back (typically over a two-year period). Before menopause, almost all oestrogen is made by the ovaries – Zolodex stops the ovaries from making oestrogen.

I am slightly concerned about what effect this is going to have on me. Because the Zolodex will prevent my body from producing oestrogen it will technically put me into a medically induced menopause. Woo hoo, another lovely side effect to add to the list and cope with. Having said that I am glad that my body won’t be producing the hormone which will reduce the risk of the cancer coming back. But what will this do to me? Will I grow a beard?! Will I become moody? I do hope for my hubby’s sake that neither of these are the case.

After a quick lunch break we returned for the third and triple whammy appointment of the day, my first radiotherapy treatment. There was a delay with the machine so we had a bit of a wait. After an initial meeting to discuss the treatment, side effects and do’s and don’ts, I was given a rather lovely gown to change into that I will keep for the duration of my treatment. We then sat in a smaller sub waiting room until I was called in.

clinacI walked into the room and was greeted by two nurses and could see a very large ‘Clinac’ machine. As I laid out on the bed, the nurses drew on me, lined me up with the machinery and were calling out various numbers around me. There was music playing along in the background. Although whilst this initial part was happening, a particularly dramatic and apocalyptic piece was playing which made it all feel rather intense. Luckily the nurse asked to skip on the song as it was supposed to be festive Christmas music!

I lay there looking up at the ceiling above me which was emblazoned with an image of bright blue sky and the branches of a tree sprinkled with white spring blossom, whilst Christmas songs were playing over the speaker – a very strange and surreal experience indeed.

The team explained what would happen and that they would leave the room whilst the treatment was in progress, but that I would be monitored on a camera at all times. If I needed to alert them at all I just needed to raise my arm. I laid there very still, thinking back to what the nurse had said earlier about trying to relax and to breathe as normally as possible. Quite difficult when you’re laying in a position trying not to make any movements at all!

As I write this now I have completed five radiotherapy treatments so far. I’m pleased to say that it’s not painful at all, but I am very aware of a feeling or sensation of something ‘happening’ in that area. I can’t really explain it, more like a tightness, or almost going back to a period post surgery where I was very aware of that area/my scar. I have definitely started to feel more tired, but they did say this was to be expected, especially following chemotherapy treatment.

I received some recommendations of products to use on the skin from other ladies who have had radiotherapy, so I have an arsenal of creams and gels at my disposal.

Have you had any of these treatments described in this post? Have you suffered any side effects? If so, do you have any tips you can share to help  deal with these?

Final chemo, CT and heart scan

I had so many mixed feelings from my appointments at the hospital last week. I was feeling so, so relieved that the final chemotherapy infusion was going in. I sure was glad to be climbing that last hurdle of a very long and tiring race. When I started my chemo back at the beginning of August, this time in November seemed like such a long time away and actually the latter part of my treatment did seem to go by much more quickly.

chemo
At last, the final chemo!

I also had my first radiotherapy appointment where I had a CT scan and was measured for my forthcoming treatments. Pats and I both went into the scanning room and the radiologist explained to us everything that was going to happen. There was a male student in the room as well and she asked if I would mind him being part of the planning session or to just observe. To be honest I didn’t feel particularly comfortable with him being there, but I didn’t want to hamper his learning opportunity either so very shyly agreed for him to be present. Pats then left the room and I went into the cubicle to get undressed.

I knew the scan wasn’t going to be painful but I began to get upset standing there with my blue bit of paper covering my modesty (not a large piece I might add!).  I climbed onto the bed and they placed both my arms in stirrups either side of me. This in itself was a strange experience and I felt like I was about to be tortured. As hard as I tried, I just couldn’t stop the tears from rolling and both the nurses could see I was upset so went and got Pats who was waiting for me outside. He came and held my hand whilst they took their measurements of me. I felt rather silly crying, but I can’t imagine I’m the only one who has. It just brings such an enormity to the whole thing and magnifies and intensifies everything that’s going on.

After the radiographers and Pats left the room, I lay there on my own splayed out on the bed as it began to move in and out of the big ‘polo mint’ machine. It’s over pretty quickly and I was desperately trying to take my mind off the whole experience by thinking of all the good times I’ve had in my life.

CTplanner

After a few minutes I was rejoined by both nurses and Pats and then had small permanent tattoo ink markers placed on three places – one in the middle of my chest and another one on each side. It was done with a small needle and wasn’t too painful at all and they are actually smaller than I thought they would be.

We left the radio department and went straight to the chemo day unit for my very last treatment. I was given the choice of being in the open area or in a separate room. I figured it would be nice to have a separate room, a) to compose myself after the previous appointment and b) well, just because we could!

The final part of the day was to have my Picc line removed. As I hadn’t had any infections or stints in hospital with the chemo, my oncologist said I would be okay to have it out after the last treatment. Wow – getting my arm back at last! They’d said that I wouldn’t feel it coming out but naturally I was apprehensive about them tugging a plastic tube out of my vein! I felt a slight tugging sensation and was amazed to see the line coming out, but had to look away as it was actually quite gross to see. Then it stopped and wouldn’t come out any further. The muscle in my arm had gone into spasm so was effectively clenching onto the line so it wouldn’t come out. The nurse put a heat pad on for 15 minutes and luckily this relaxed the muscle and the rest of it came out. Yey, a little bit of me back. I had to to wear a plaster on it for the following two days but have now had the pleasure of standing under a shower instead of having daily baths waving my hand in the air trying not get it wet! Oh it’s the little things in life : )

Our third and final trip to the hospital that week was to have my echocardiogram (heart scan). Because I am HER2+ I need to have Herceptin® (trastuzumab), an adjuvent targeted therapy which will reduce the risk of the cancer coming back and will comprise of three-weekly injections for a period of a year.

Because there is a low risk that Herceptin can cause heart damage they take a scan to check how well the heart is functioning. An echocardiogram uses sound waves to take detailed pictures of the heart as it pumps blood. I didn’t feel anything and no radiation is involved for this test. I layed on my side whilst the nurse moved a device over my chest, ribs and neck. She said that everything looked normal which was good to hear! They will continue to take regular scans of my heart throughout the treatment to detect any sign of heart damage.

My first Herceptin injection and radiotherapy appointment is on 8th December. I need to have 19 radio sessions all together, 15 to the whole breast area and four booster ones to the tumour/scar site. I do get Christmas Day off and a couple of days afterwards so a breather from going back and forwards to the hospital. It’s not quite the Christmas I had imagined, but hey ho I will make the best of it!

I’ve heard mixed stories from ladies who have had radiotherapy, some have not felt many side effects, some have been severely fatigued and also suffered bad burning.  I’d be lying if I said I wasn’t nervous about being nuked, but I sincerely hope it will be as kind to me as possible.