Not that anyone I don’t personally know will ever see this blog, but just in case, Dear Reader, I am not a healthcare professional. I am simply writing about my experience in hopes that it helps someone else who may be going through something similar. I am not advocating for any particular treatment plan. I am happy to answer questions and give my opinion based on my personal experience, but I’ll leave the medical advice to the pros.

Why did you have chemotherapy?

I was diagnosed with early-stage, estrogen-receptor positive, HER2 negative breast cancer, which made me a candidate for the Oncotype DX ® test, which takes into consideration a number of factors to determine risk of recurrence. While I did not have the BRCA gene mutation, I did have a high Ki-67 number, which gave me a higher risk of recurrence. The Ki-67 is an index that measures how quickly the cancer cells within a tumor are growing and dividing (how aggressively it’s growing). Because my “oncoscore” was high, my oncologist added chemotherapy to my treatment to reduce the risk of recurrence.

What is chemo like?

This won’t come as a shock to anyone, but chemo sucks. I was so incredibly fortunate that I did not have a terrible reaction to the chemo, but it’s still a real drag. I did not opt for a port because I am easily grossed out (understatement) and I only had to do 6* infusions. Actually, at my initial appointment with my oncologist, I nodded along as she explained things because I had (of course) read the materials the clinic provided before my appointment. She asked me “are you in healthcare?” to which I laughed and said “God no, I’m a lawyer. I am super squeamish.” She is an angel on earth and said that she wouldn’t do a port because I was squeamish. I love her.

Because I did not opt for a port, I had to go to the lab before each infusion and have a line inserted into a vein in my arm for the infusion. Not to be dramatic, but this was probably the worst part of it all. I told you I was a wimp about things that gross me out. The first time, it was in my hand. I did not like that at ALL, and that was the last time that happened. The lab techs also drew blood to check and see how things were going. More on that later. Most of the time, the techs were absolute pros. I did have one gal get a little too confident and try to go in on a vein that she couldn’t see but “felt bouncy and good” and she immediately blew that vein and it bruised for weeks. Not cool. My skin is practically translucent, fam. Let’s stick to the ones we can see, okay?

After labs, I typically met with my oncologist or nurse practitioner to go over the labs, and then head up to the infusion suite. Suite is a bit of a stretch. It was a tiny space with a recliner and a small chair, surrounded by a curtain. When you added the cold cap machine and my chemo bag, you could barely move in the space. A nurse came in and gave me my pre-meds, which consisted of a steroid and an anti-nausea medicine.

Next came the infusions. I had a combination of Taxotere and Cytoxan, and they were administered one right after the other. The first day, they had to titrate the medicine to see how I handled it, so we were there FOR-EV-ER. Seriously. They administered the Taxotere first and gave it to me over a 2 1/2 hour period. The Cytoxan was quicker, and as I continued treatment and tolerated it well, they sped it up so that the whole infusion only took an hour and a half (not including the cold capping time).

How did you feel?

The day of chemo infusions, I felt fine. The first day I had chemo, I went straight to the baseball field for 8th grade recognition night for my oldest son. I just slicked my hair back into a bun and called it good. Typically, I felt completely normal until Friday, when I almost always had a terrible headache. Mostly, I was just tired for a couple of days. Like I’ve said many times, I was so lucky not to have had a worse reaction to the poison running through my body. I don’t know what to attribute that success to, but I drank a TON of water, especially the day before and the day of infusions. I ate healthy, and I also fasted.

Fasting

I feel like this may seem a little “woo woo,” but I read about fasting and the benefits of fasting during chemo treatment and decided to give it a try. One of its touted benefits was that fasting before and after chemo helped reduce side effects. I am not sure if that is why I tolerated chemo so well, but it was worth a try and I did not mess with a good thing once it seemed to work. My infusions were on Tuesdays so my last meal before chemo would be dinner Sunday night before. I would fast until the infusion started, when I would eat lunch. I usually ate a little dinner when I came home and then fasted the day after. I am not a doctor and am not giving any medical advice, but if you more information about the potential benefits of fasting on chemo, you can read about it here.

How many sessions?

The original plan was for me to have six sessions, each three weeks apart. At first, I was annoyed with this schedule. I wanted to GET IT OVER WITH. A good friend explained it to me like this: think of cancer as bad guys and chemo as the police. The chemo comes in and raids the first time and kills some of the cells. The cells lay low for a bit and then, when they think its safe to start running again, the chemo comes in again and surprises them with a new attack. This made sense to me and made me feel better about it. Then, when I realized how normal I felt pretty much all the time, I was sold. I liked having the break between infusions. Around my third infusion, my liver enzymes started to take a negative turn. By my fifth scheduled infusion, my liver enzymes had gotten even higher and because I had already had such a good response to the chemo (I had mid-treatment mammogram and ultrasound to see how it was going and the tumor had shrunk so much you could not see it on the mammogram, which kind of begs the question why we bother with mammograms and don’t just go straight to ultrasounds, but I digress) my team decided to skip the fifth treatment altogether. I was thrilled to skip it and give my hair and my body a break, but I will say, this decision resulted in a good bit of anxiety that the tumor was growing, unchecked, because we skipped a session. (It wasn’t).

Why chemo before surgery?

My breast surgeon explained that the oncologist would ultimately decide, but that she may prescribe chemotherapy before surgery to shrink the overall tumor. This was not what I wanted to hear because I wanted that little fucker out of there. When I first met with the oncologist, she said that we might do surgery first (I assume because of size and proximity to surface) but when she realized that I would have both breast surgeon and plastic surgeon present, she did not want to wait on scheduling to get started, so we moved forward with chemo.