In 2019, I found the decision to undertake chemotherapy (chemo) difficult. My oncologist clarified that it was like an insurance policy with no guarantees that my cancer would not return. I was traumatised from the lengthy stay in hospital and adjusting to the neobladder. I went into the treatment believing it would poison me instead.
In 2021 I was in a better physical and mental state thanks to medicinal mushrooms, resolving emotional trauma and meditation. I used chemo to buy time while sorting myself out mentally to prevent it from returning. At three months, the cancer was no longer active, and at six months, I was clear.
This post examines chemotherapy, its treatment, how it treats bladder cancer and my experience.
What is chemotherapy?
Chemotherapy is a cancer treatment that uses one or more anticancer drugs. It may be given with curative intent or aim to prolong life or reduce symptoms. Chemotherapy is one of the major categories of the medical discipline called medical oncology. It is the most well-known form of therapy for cancer and is also one of the most misunderstood and feared.
Traditional chemotherapeutic agents are toxic to cells, preventing their replication or growth, and so are used to treat cancer. But cancer cells vary widely in their susceptibility to these agents. Damage to normal cells results in the majority of side effects of chemotherapy. Side effects caused by normal cell damage include decreased production of blood cells, which leads to immune suppression, inflammation of the lining of the digestive tract, and hair loss.
The history of chemotherapy
In World War II, researchers discovered that people exposed to nitrogen mustard agents developed reduced white blood cell counts. Researchers investigated whether mustard agents could be used to halt the growth of rapidly dividing cells such as cancer cells. Two Yale pharmacologists examined the therapeutic effects of mustard agents in treating lymphoma.
After World War II, a pathologist from Harvard Medical School studied the anticancer effects of folic acid, an essential vitamin in DNA metabolism.
In the 1950s, researchers found that plant alkaloids benefited leukemia patients. This led to using plant alkaloids as anticancer agents in the 1960s.
Over the next two decades, combinations of chemotherapy drugs came into use. The concurrent use of drugs with different actions has led to further improvements in patient survival. Mortality rates have declined each year from 1990 until now.
Chemotherapy for bladder cancer
There are two forms of chemotherapy for bladder cancer:
Intravesical chemotherapy
Intravesical chemotherapy is often the first option for bladder cancer patients when the cancer is only in the bladder’s lining. In this treatment, the chemo drug is put right into the bladder. I did not receive this treatment.
Systemic chemotherapy
Chemo drugs given intravenously are known as systemic chemotherapy. The drugs go into the bloodstream directly and travel throughout the body. The drugs can then act on cancer cells anywhere in the body.
When is chemotherapy used?
Systemic chemo can be used before surgery to shrink a tumour so that it’s easier to remove and lower the chance of recurrence. This is known as neoadjuvant therapy.
Chemo given after surgery is known as adjuvant therapy. This is what I had in 2019. The goal of adjuvant therapy is to kill cancer cells that may remain after other treatments. This can lower the chance that cancer will recur.
Systemic chemo is also the primary treatment for bladder cancers that have spread to other body parts. This is what I received after my second diagnosis in 2021.
Chemo drugs used to treat bladder cancer
Depending on usage, and a person’s overall health, you may receive a combination of drugs. The most common variety of medications used without radiation is gemcitabine and cisplatin. This is the combination I had on both occasions.
Gemcitabine and cisplatin are given intravenously into your bloodstream. It takes up to three hours to receive both drugs, including anti-nausea drugs. You can have treatment through a long plastic tube that goes into a large vein in your chest. A surgeon puts a portacath in place in a minor procedure before treatment commences.
If you don’t have a portacath, you receive treatment through a cannula that goes into a vein in your arm each time you have treatment.
In my experience, gemcitabine is particularly hard on the veins when given intravenously through a cannula in your arm. It is notorious for causing problems, including hardening of the veins in the forearm, blood clots and infections.
I suffered from all three complications in 2019. In 2022 I opted for a portacath in my chest that made life much easier.
Cycles
You receive chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks. I had four cycles of 2 weeks where I received treatment and then one week off.
Blood Tests
You have blood tests before and during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
It is pretty normal to have your white blood cell count plunge during treatment cycles due to the chemotherapy attacking quickly dividing bone marrow cells. Your next treatment may be delayed, or you may receive an immune-boosting drug.
I experienced this both in 2019 and 2022 and received the immune-boosting drug in 2019. My immune system bounced back soon after treatment ended.
Side effects of chemotherapy
Chemo drugs attack cells that divide quickly, which is why they work against cancer cells. But other cells in the body, new blood cells in the bone marrow, the lining of the mouth and intestines, and the hair follicles also divide quickly. These cells are also likely to be affected by chemo, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs and duration of therapy.
Common side effects of chemo include:
- Nausea and vomiting
- Loss of appetite
- Hair loss
- Mouth sores
- Diarrhea
- Constipation
- Increased risk of infections because of a shortage of white blood cells
- Easy bleeding or bruising due to a lack of blood platelets
- Fatigue due to a lack of red blood cells
I experienced all these symptoms except hair loss and diarrhea at one stage or another but less so in 2022 because I was taking medicinal mushrooms.
These side effects usually go away over time after treatment ends. There are often ways to lessen these side effects or prevent them. Anti-nausea drugs received before chemo help prevent or reduce nausea, although this can cause constipation. You will most likely receive a steroid to mitigate the shock of the treatment on the body.
Some chemo drugs can cause other, less common side effects. For example, medications like cisplatin can damage nerves. This can sometimes lead to symptoms in the hands and feet, such as pain, burning or tingling, sensitivity to cold or heat, or weakness. This is called peripheral neuropathy.
I’ve experienced nerve damage to a mild degree, including some pins and needles in my hands. I’ve also noticed that my feet are more susceptible to the cold in winter.
Staying sane during chemotherapy
There is no doubt that receiving chemotherapy is stressful. But you can use several strategies to make the experience easier and enhance your healing. I have written posts about medicinal mushrooms, diet, exercise and supplements to support treatment.
But there are several other strategies that I’ve learned along the way to help you cope with chemotherapy.
Impose a media blackout
During my chemotherapy in January 2019, bushfires raged across the country, and smoke was choking Melbourne. In my highly anxious state, I got myself worked up about the effect of the smoke on me. It was irrational, but that’s how my mind worked back then. So I imposed a media ban on myself: no more news or social media. I disengaged from what was going on around me, and it worked. When COVID-19 hit in March of 2020, I continued my self-imposed ban. Instead, I got my information from government websites only.
In 2021 I extended my prohibition — no more news about Donald Trump, the war in Ukraine, or the economy. Instead, my focus was solely on my healing. I had to raise my vibration, not lower it. No one needs to listen to the daily fearmongering of the media, nor the bright shiny lives on Instagram or Facebook.
The healing power of music
I found listening to music during chemotherapy both relaxing and healing. Music can help you visualise that the treatment is working. During my chemotherapy and immunotherapy sessions and daily walks, I would listen to a playlist of healing music on Spotify. I would experience frisson, similar to goose bumps, while listening to music, knowing that it enhanced my healing.
In survival mode after my first diagnosis, I had no energy for anything other than watching TV. Late in my recovery in the hospital, I would listen to meditative music first thing in the morning. I can no longer listen to that music as it triggers traumatic feelings. Midway through my chemotherapy, I started watching music videos on YouTube. It was the first sign that my brain was moving forward again.
During the period between my two diagnoses, I started listening to Deep House and Trance music, which I found uplifting. After the second diagnosis, music became central to my healing. I listened to an eclectic mix of music based on Anjunadeep artists and Johann Sebastian Bach.
Conclusion
Chemotherapy can be terrifying due to its side effects. Chemotherapy may be a blunt instrument, but it may be your best option when facing imminent death. It’s your choice. Each of us has a path to tread. Listen to your heart and decide based on what is best for you and your family.
References
- History of Chemotherapy; Available at URL: https://www.news-medical.net/health/History-of-Chemotherapy.aspx#:~:text=Chemotherapy%20was%20first%20developed%20at,reduced%20white%20blood%20cell%20counts
- Bladder cancer chemotherapy; Available at URL: https://www.cancer.org/cancer/bladder-cancer/treating/chemotherapy.html
- Gemcitabine (Gemzar); Available at URL: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/gemcitabine#:~:text=What%20is%20gemcitabine%3F,have%20it%20alongside%20radiotherapy%20treatment
- Cisplatin; Available at URL: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/cisplatin
