Chemotherapy from the perspective of a brain tumor patient
Half a year ago, I only had a vague understanding of chemotherapy. I knew it was associated with cancer treatments, that it can be hard to go through... and that’s about it. How it’s administered, what it does to the body, who has to take it, what are the side effects? I had no idea. Today my understanding is informed by my experiences with chemo over the past five months, as well as a fair amount of research and conversations with doctors, nurses, and dietitians. Given that at least two friends are also currently in or about to start active treatment, I thought that it’d be useful to share a few of my own thoughts on chemo. I’m by no means an expert and do not intend this as medical advice, but I hope the post below may prove informative for others.
What is it? Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in the body. There are many different chemo drugs, which can be used alone or in combination with one another (source: May Clinic).
Who is it for? Chemotherapy is used to treat individuals affected by many different types of cancer.
Why is it used? Chemotherapy is used to kill off cancer cells in individuals with cancer. It can be used in different ways - as a primary or sole treatment, as a treatment after surgery for a specific period of time, to prepare an individual for other treatments, or to ease signs and symptoms. Some chemo drugs are also used for other conditions, such as bone marrow diseases or immune system disorders (source: Mayo Clinic).
When is it used? This is tied to the ‘why’ question above and is different for individuals with different types of cancer. In my case, I started a 6-week daily chemo regime one month after my brain surgery. I then took a month off before starting my current ‘5 days on, 23 days off’ regime of ‘maintenance chemo.’ For individuals with my type of brain tumor, this is part of the standard of care, and usually lasts from 6-12 months. My dosage at this time is twice the amount as when I was on the daily regime.
How is it used? Chemotherapy can be administered in different ways - for example, intravenously, through a device such as a port or a catheter. I don’t have firsthand experience with this. It can also be administered orally. In my case, I receive the pills once a month in a well-wrapped and sealed box. I use gloves to touch the pills as I take them with a large glass of water, and then wash my hands and the glass thoroughly, dispose of the gloves, and put the pills away carefully. During my daily treatments, I took chemo timed to radiation treatments during the day. Now, during maintenance sessions, I take it right before going to bed.
The good news: Chemotherapy can work to keep cancer cells from growing, dividing and making more cells.
The not-so-good news: While chemo kills off cancer cells, it doesn’t discriminate between healthy and cancerous cells - meaning, it also kills some healthy cells as well. Chemo can reduce the number of white blood cells produced by the blood marrow. This can reduce the body's defenses during and after treatment. There are also many side effects to chemo treatments - some short and some long-term. These can be difficult to manage, even with medication. Chemo can cause severe constipation and severe nausea. As it weakens the immune system, chemo can also cause infections, easy bruising and bleeding, hair loss, and tiredness and fatigue.
How has chemo affected me? Each round of treatment is a bit different. I have felt nausea come on most during treatment days 4 and 5, and then post-treatment for two or three days. It’s a sensation of needing to throw up, but not being able to because you’re taking anti-nausea medication. On and around treatment days, I experience a sharp aversion to the smell of most food and spices, as well as a noticeable lack of appetite. Physical activity becomes harder during those days as well, though I get my strength (and appetite) back within a few days post-treatment. The constipation is awful, and the only thing I can do to help it is to take pills, despite my best efforts with prunes and prune juice. I’ve needed a nap nearly every day for the last six months, even with 8-9 hours of sleep at night. To be fair, chemo's not the only culprit here - it's also the other treatments, medication, and post-op recovery that have brought on this need. This is all at the physical level.
How do I deal with all of this? I strive to maintain an extremely healthy diet that includes smoothies, green vegetables, protein, tons of water and herbal tea, and virtually no desserts other than fresh or dried fruit. While my physical yoga practice has changed, I’m building it back up, and supplementing it with daily walks (often around the block and/or just back and forth in the living room given the East Coast storms as of late). I’ve ramped up prayer, meditation, music, and conversations with family and friends. On chemo weekends, I allow myself to take a break from online classes and activities I’d otherwise normally engage in, and just rest or sleep as needed. I realize how fortunate I am to be able to do that.
So - that’s my own "chemotherapy 101" for you. I’m still experiencing chemo, and will remain in active treatment for awhile. I know every individual’s experience with chemo is different, but I hope that this gives you a small window into this part of my current world.
I welcome comments and questions. Thank you!
September 18, 2021
Picture: Leaves in Arlington, Virginia, September 2021
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