Posted 7/22/2012 7:16 PM (GMT 0)
I wrote a summary of my chemo experience and associated lessons learned. Hopefully, this can prove helpful to anyone that may be considering or facing chemotherapy for prostate cancer. This post is a little lengthy but I thought it best if put my thoughts in one place.
Protocol:
· Infusion Drug: Taxotere (docetaxel)
· Other drugs: Prednisone, twice a day; Dexamethasone, the day before, day of, and day after infusion
· Frequency: Six 3-week cycles
· Dose: 60 mg/m2; for my body mass, that translated to 117 mg
· Administration method: IV infusion
Reflections and Lessons Learned
· Port versus IV: Get a port. If I had it to do over again, I would get a port instead of using an IV. I am a hard IV stick. I probably had 15 IV stick attempts over those 6 sessions. My poor arms were a pin cushion.
· Neulasta: Get a Neulasta injection every time. I skipped the last cycle, and wound up in the hospital with neutr openic fever.
· Prednisone and Dexamethasone: Be prepared for the initial start of Prednisone and Dexamethasone. My appetite blew through roof and I was wired for the first 2-3 days each cycle. These side effects (SEs) eased up as I went through the later cycles.
· Icing: I sucked on ice chips and held freezer cold packs in my hands during infusion. I don’t know if this helped or not.
· Hair loss: I lost about half my hair on my head, two weeks after the first cycle. After that, it was a slow, gradual loss. By the 5 th cycle, I was looking fairly mangy. So, I buzzed it very short. My eyebrows thinned but I never lost all of the eyebrow hair. I lost all the hair on my legs and most of the hair on my arms. My wife was jealous of my smooth, hairless legs. I lost all the hair in another spot I will not mention here.
· Taste: my taste would go “off” for a week after each infusion. I still ate and enjoyed eating, but certain foods just tasted odd. I would adjust the menu to have foods that seemed appetizing to me. Spicy and savory seemed best. Sweet items did not taste very good to me.
· Nausea: At first, I had virtually no nausea. They gave me Aloxi the day of infusion. In the early cycles, I would take a few of the anti-nausea pills I was prescribed. I eventually stop taking those. However, in the later cycles, I started getting some low-grade nausea for a few days. It was not bad and I kept eating. It was a nagging, slight nauseous feeling that seemed to hang around for several days after the infusion.
· Neuropathy: I had very little neuropathy. Some of my left toes would feel a little numb after infusion. In the later cycles, my fingers, maybe, had some strange sensations. But, at this point, I don’t seem to have any lingering neuropathy.
· Nails: My fingernails were fine. Some of my toenails started to discolor and became sore with the last cycle or two. That has seemed to clear up.
· Tear duct scarring: The jury is out on this SE. At times I had weird sensations in my right eye area. After the last cycle, my right eye is watering and dripping all the time. I don’t have time to pursue this at the moment (vacations, travel, etc.) but I may have this checked out in September if it is still a problem. If I have scarring, the solution is a tear duct stent. It is fairly aggravating at the moment.
· Fatigue: The fatigue got worse as the cycles wore on. Days 3 and 4 after the infusion were the worst. The best analogy I can think of: it is like catching the flu every 3 weeks.
· Incontinence: I was prone to drip for the first couple of days after the infusion. It was as if my sphincter muscle and bladder were completely relaxed. I would even drip a bit at night when I was sleeping. I never found an explanation or solution to this issue. Even today, my confidence is a bit shaken. I seem to have more drips than a year ago. Risky moves include standing from a deep seated position and getting out of my pickup. I now have to do a quick Kegel in those situations to avoid a drip. There may be issues, other than chemo. I had stopped doing Kegels. I have now doubled down on doing Kegels. I’ll see if that makes a difference.
· Constipation: Eat plenty of fiber! I was caught off guard for the first cycle and I had a tough time. I wound up drinking some magnesium citrate (yuck!). After that, I was on top of things.
· Exercise: I tried to keep exercising and mostly succeeded. I would have to back off on the worst days.
· Work: I kept working. My boss and co-workers were great. Also, I have the flexibility to work from home. I definitely took advantage of that at times. I also took a fold-up cot into work and would occasionally unfold it and nap in my office. Fortunately, I have a walled office with a door. Getting a quick nap at work is nice! I think I am going to keep that cot there. Although, I can’t keep playing the chemo card to excuse napping.
Typical SE profile the week of infusion:
o Monday: infusion
o Sunday – Tuesday; high energy; wired; hard to sleep
o Wednesday: energy crash; fatigue sets in
o Thursday and Friday: The worst days: lots of fatigue; food tasted weird; aches and pains. The best analogy: It is like catching the flu every 3 weeks. I took lots of naps.
o Saturday: things start easing up on Saturday. By Saturday evening I would feel a little more normal.
o Monday – Tuesday: Energy level was mostly back to normal. Taste was back to normal. The time to get to full energy level seemed to be greater as I went through each cycle. For the last cycle, it was 3 weeks before I felt my energy level really hit 100%.