How chemo cycles work
Bill is on a 28 day cycle where he is on a drug called Temodar for 5 days, and then off for 23 days. The 5 day portion begins on a Wednesday night, and his last dose is on Sunday. Each day during chemo, Bill eats an early dinner, then takes a Zofran anti-nausea pill about half an hour before bed. At bedtime, he takes 4 x 100mg Temodar pills and ideally sleeps through most of the nausea. The Temodar dosage is based on body surface area, which is a whole weird calculation based on height and weight that they do at the doctor’s office.
So far, he has felt fine on Thursday and Friday of the cycle, but Saturday around lunchtime is when I really start noticing the slowdown. His appetite plummets and he doesn’t get off the couch for much at all. The side effects really max out on Monday, the day after he takes his last dose. Some of the side effects last through much of the week following chemo. He’s mostly back to normal (with a little reduced appetite) the following Saturday. Basically, Bill feels like crap for a whole week each month.
Let’s break chemo down by side effects...
Nausea
During cycle 3, the nausea managed to break through the powerful anti-nausea drug, Zofran, and Bill threw his back out while vomiting up his meds on a Sunday night (the last night of the 5 day chemo cycle). After an after-hours call to the doctor, the last dose of chemo for that round was canceled, since he was having a really rough go of it.
For round 4, Bill was upgraded to an anti-nausea patch (Sancuso) to wear on his arm through his chemo cycles and a couple days afterward. The patch seems to keep the nausea at bay and keeps a pretty steady dose of anti-nausea drugs in his system. He didn’t puke at all during round 4! Fingers crossed that Sancuso continues to work through the rest of whatever chemo rounds Bill does.
Appetite
Another side effect of Temodar has been reduced appetite. Even when Bill isn’t feeling nauseated, he doesn’t want to eat much, and most savory foods are really unappetizing. Even TacoDeli tacos are too much. Shocking, I know.
We’re managing his lack of appetite by finding the few things that do seem appealing. Bill has done okay with Enu shakes so far, and at a little under 500 calories in 11oz, they are pretty dense. He also likes applesauce, ginger ale, and ginger candies. He seems able to drink cold sweet things like milkshakes and smoothies while on chemo, so P. Terry’s is getting a fair amount of business from us. Our goal is to keep Bill from losing too much weight during each round of chemo, so getting some calories in is important. I’ve never been so grateful for calorie-packed milkshakes as we try to keep him around his normal weight.
Digestive… uhh… issues...
It wouldn’t be an accurate cancer blog if I didn’t talk about poop a little bit. Let’s just say that poop is important and when poop isn’t going well, nobody’s happy. There are lots of methods for managing poop (OTC drugs and prunes among them), but the main message for anyone on Temodar is to keep track of poop so that you can manage poop before poop is a problem. Poop.
Good riddance 2015. Hello 2016!
Bill has an MRI on Monday, January 4th to take a look at the remainder of his tumor and see if any changes are happening. Keep your fingers crossed for a stable (or even better, SHRINKING!) tumor!
The next round of chemo starts on Wednesday, January 6th. If we only do twelve rounds, the final round will be done in late July 2016, at which point we will be taking a serious vacation once Bill feels okay. There’s a possibility we will do 24 rounds instead of 12, but we’ll jump that hurdle when we come to it.
After a fair number of illnesses and deaths among our friends and family this year, we’re in agreement that 2015 was not the best year, but we’re optimistic for the new year. Here’s to a better 2016!
