Breast cancer, Cancer, Hair loss, Hair regrowth, Health, Ireland, Radiotherapy, St Vincent's, Women's Health

Radiotherapy: Week One

New Year, new cancer treatment…

Rounds of radiotherapy done: 3

Rounds of radiotherapy to go: 30

Feeling: Pretty good!

I arrived at the Herbert Wing of St. Vincent’s hospital, Dublin, on Jan. 2 for my first radiotherapy session and was shown almost straight away into one of the radiation rooms (unmissable due to the above sign). Inside the big, spacious room full of machinery, two lovely Irish ladies explained a little about what they were going to do, while I stripped off my top half and changed into the attractive and somewhat Christmassy white robe with red and white patterns (you can’t quite see the Christmassy-ness in the below photo). I then lay on top of the platform/bed you can see in the photo and put my arms into the red arm-rests above my head while the two of them fiddled around with machinery and called out various different numbers. (A lot like being at the dentist’s).

I’m lying on my back and can see three green laser beams – one directly above my head and one to the left and right of the room. These green laser beams line up exactly with the mini tattoo specks in the middle of my body and on my left and right sides, and this in turn lines up the equipment. Once it was all lined up, the girls quickly exited the room and proceeded to control the radiation machinery remotely (so as not to zap themselves in the process).

In the below photo, you can see the large machine above my head. The round plate thing detaches from this and rotates into different positions while giving me the radiation from a sideways position so as not to give too much zapping to my lungs and heart. It spent maybe five minutes on my left side and five minutes on the right side, while I just lay there, still as a sleeping lion, listening to One Direction on the CD player, having a whale of a time. (I had read in one of the radiotherapy booklets that you can take your own CDs for them to play while you wait, but frankly with the likes of 1D on the menu, I don’t think I’ll be needing to.)

After about 10 minutes, it was all done and I got dressed again and headed home. Meanwhile Mum, who came with me for the first few days and has now gone back to England, made friends in the waiting room and managed to get the entire verbal Tourist Guide to Dublin from the very friendly pal of a fellow patient.

On Jan. 3, I went back for round two. This time I was in a different room and Duffy was playing on the CD player. Two different lovely Irish ladies (I think they said there are five in total, so I knew I’d have met them all by day three) fiddled around with the machinery this time and called out the numbers, then they fled for about 10 minutes while the machines buzzed around me and I got radiated.

Jan. 4, much of the same. I was in room two again and Duffy was still on the CD player (I fear they peaked with One Direction on Wednesday and nothing else they play will ever live up to it). This time, the girls were back in the room within about five minutes and I said “That was quick!” It turns out the part where I’m receiving the radiation only takes about two minutes. Radiation is measured in units called “grays” and I have two grays each time. Two grays, it seems, takes about two minutes to deliver, and this time they didn’t need to take any photos with the machine, so I was in and out faster than Duffy could warble something about Warwick Avenue.

And that was that. I get the weekend off then it’s more of the same for the next six weeks, every single week day. The main side effects of radiation are extreme tiredness – which I’m told will get worse and worse, peaking about two weeks after the last session (i.e. beginning of March), and red, sore, burnt skin in the area receiving the radiation. This takes a couple of weeks to kick in, so in about two weeks I’ll have a really red, burnt, painful breast to look forward to! I can’t use deodorant (so apologies to my workmates if I stink) or underwired bras or perfume around the area, and I have to lather it in pure aloe vera gel or E45 cream twice a day. I already feel like I have a little ‘prickly heat’ in the area, but it may just be the association effect of the aloe vera gel, which I only ever use when I’m sunburnt.

Apart from that, it feels great to be back in Dublin and back in my apartment, living a more ‘normal’ life. Yesterday I went for my first run since the end of June – I ran about a mile and didn’t die, so that’s progress! A week or so ago, I could barely walk up a flight of stairs without nearly keeling over, so my fitness is coming back fast.

Despite the fact that chemo finished nearly six weeks ago, I am still bald as a baby and looking a bit like a baby chick again with short hair at the back and sides but nothing on top – not a good look! I’m hoping it will start growing back as proper ‘stubble’ soon and I’ll be able to go out sporting the Sinead look, but for now I think it’s wigs all the way… Roll on the next six months so I can have my pixie back!

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Breast cancer, Cancer, Humor, Humour, Ireland, Radiotherapy, UK§, Women's Health

Boob Tattoos, Turkey Sarnies and Celeb Spotting

5am Get out of bed, 9am arrive in Dublin, 9:30am eat leftover turkey-and-stuffing sandwich and sausage for breakfast in taxi to hospital, 10:45am locate correct wing of enormous hospital and have CAT scan and three boob tattoos all before 11:30am. Plane journey sitting next to the most vile, drunken chav duo from hell, then back to Manchester in time for dinner at a city bar, spot I’m a Celebrity… Get Me Out of Here! and Coronation Street actress Helen Flanagan out on the razzle dazzle with her mates and leave just as the paparazzi arrive… Bed by midnight. All in a day’s work for a dedicated cancer-fighter like me!

Apart from the paparazzi (who I think were there to photograph Miss Flanagan, rather than my dear self), I expect what most intrigued you from the above were the words “boob tattoo,” so let’s delve a little further into that subject. Disappointingly, the tattoos are not actually on my boobs. They are all in a line below my boobs – one in the very centre, and one on each side.

First, I lay on the machine while the big whirring CAT scan machine bobbed me under and took a few pics (this was painless and took two minutes). Then a young man called Owen (or Eoghan – I’m not at one with Irish spellings yet but will ask him next time) appeared as if from nowhere with a felt-tip pen and drew some lines on me in an X-marks-the-spot fashion. He and another lady called Olivia stuck some stickers on me and finally Owen/Eoghan tattooed me with a needle at the meetings of each of the three Xs. It wasn’t painless but was basically just the same pin-prick as a quick injection and was over in minutes.

Above-left, you can see what one of the tattoos on my side looked like yesterday after the tattooing took place (please excuse the bra marks). It looks sort of painful and bruised, but I can assure you it’s just ink and was not in the least bit painful. Fortunately the Xs washed off, and to the right you can see what the tats look like post-wash. I was kind of expecting them to be a little smaller – you can certainly see them – but I couldn’t care less. I now have three permanent scars from my cancer and three little tiny speck tattoos, and I love having the war wounds to remind me what I’ve been through. Something to show the grandkids, I s’pose…

I have just posted the pics of the tiny specks on my side as I have a feeling I might regret it if I post the one in the middle of my cleavage, so I won’t…

Meanwhile, it seems the lovely Miss Flanagan decided to go bra-less last night, according to the Daily Mail. I’m thinking maybe she was doing it in sympathy for me?

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Breast cancer, Cancer, Health, Radiotherapy, Women's Health

The Radiotherapy Plan

So I’m done with surgery and six rounds of chemo for my breast cancer, but if you thought that was the end of my treatment, you’re in for a surprise – I still have a good couple of months of radiotherapy to go!

Firstly, you may be wondering what radiotherapy really is. I have often wondered the same myself, and have provided such vague answers to my friends as “Well, you lie on a machine and they sort of ‘radiotherap’ you… Erm, I mean, they give you radiation on your boobs” or something like that. I never know the right verb. So here’s a better definition, courtesy of the St Luke’s Hospital breast cancer radiotherapy guide:

“Radiotherapy uses carefully measured doses of radiation to treat many conditions, most of which are cancers… A high dose of radiation damages cells and stops them from growing and dividing. Cancer cells, which are abnormal cells, tend not to recover… Radiotherapy is given to the same part of the body each day.”

I have to have 33 sessions of radio – that’s every day, Monday-Friday for 6 1/2 weeks, starting Jan. 2. That includes 25 sessions of radiotherapy on my whole breast and a further 8 sessions just in the area where the tumour was. Each session only lasts 10-20 minutes though, so it’s not like chemo, and I should be done by the end of February.

So, this Thursday (Dec. 27) I’m going back to Dublin for the day to have a CT scan to determine the exact location for my treatment (my left boob). I then have to have two permanent tattoos done somewhere near my boobs so that the doctors can line the radiotherapy equipment up in the exact same place each time according to my markings. The tattoos are basically just two tiny little specks, like small freckles, but I’m thinking maybe I could have them elaborated into something bigger in a year or so!? Perhaps a “Cancer woz ere” or some little symbols… Hmm!

I will then return to Dublin on Jan. 1 to start the treatment the following day and hopefully return to work as much as I can. Unlike chemotherapy, radiotherapy doesn’t make you feel sick and is generally seen as the kinder of the two treatments. However, it still has its own set of side effects, such as making the skin very sore, irritated and red for a few months. The main side effect of radiotherapy is the tiredness, which gets worse and worse as the treatment goes on, and lasts for a month or so afterwards. And, in a very small percentage of people, (I think 3 in 1,000), radiotherapy can cause another type of cancer later down the line, so fingers crossed I’m not that unlucky.

The good news is radiotherapy won’t stop my hair growing back. Phew.

So… that’s that. Goodbye chemo for 2012, welcome radiotherapy for 2013!

This will probably be my last post before Christmas, so here’s wishing you all a very merry Christmas. Thanks to all those of you who’ve sent me very thoughtful cards and things – I have definitely received more than I would in a non-cancerous year so it’s nice that you’re all thinking of me!

And finally, a special thanks to John Hartson and his sister Victoria, who very kindly sent me a signed copy of “Please Don’t Go,” John’s book about his own battle with cancer. I’m looking forward to reading it!

Happy Christmas from me! xx

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Breast cancer, Cancer, Chemotherapy, Ireland, Taxotere, UK§, Women's Health

Dublin in a Day, Back to Neutropenia and the End of the World

Phew! So yesterday I got back from an exhausting two-day tour of the UK and Ireland’s cancer hospitals.

It started with a 5am rise on Tuesday for my flight to Dublin with Mum, to meet the oncologist who’ll be looking after my radiotherapy treatment. By 9am I had trekked through two airports and endured a cramped Ryanair flight with a screaming, kicking child in the seat behind me, people coughing all around me and the constant intrusive din of Ryanair’s overhead advertising of refreshing J20, a selection of hot drinks and snacks and a very special, exclusive 2-for-1 scratch card deal. Let’s just say I understand why air travel is not recommend during chemotherapy treatment. It’s exhausting.

First up, I headed to work to see my colleagues and pick up my post before going to my hospital appointment. At 11:30, after greeting half of my department with a hug and being regaled with tales of how half of them had just got over the 24-hour vomiting bug that’s sweeping Britain and Ireland, I called my doctor for the results of Monday’s blood test and found out I was neutropenic again. My white blood cells and neutrophils had completely reversed their earlier gain and were so low that I had virtually no infection-fighting abilities and shouldn’t really be around anyone at all, let alone sitting on Ryanair flights and hugging germ-ridden workmates (no offense!). However, I was already in Dublin by that point and any damage had already been done, so the hospital said they’d test me when I got back to Manchester.

Next up, my appointment at St. Luke’s, a specialist cancer hospital in the leafy Dublin suburb of Rathgar. Now, for those of you who’ve been reading this blog since the beginning, you’ll know I was diagnosed at St. Vincent’s, which is a large hospital in Dublin, and I was expecting something similar. But as soon as we pulled up in the taxi outside St. Luke’s, I could see it was different. You can’t really tell from the photo to the left but it was more like a quaint old people’s home or an American chapel than a hospital – just one storey high and with a very friendly, intimate vibe. I loved it immediately. (Well, as much as it’s possible to love a hospital where you’re about to be blasted to pieces with radiation).

I walked up to reception and said “Hi, I’ve got an appointment with Dr McVey” and the response from the reception desk was a very hearty, smiley, “Ah, you must be Laura!”

Honestly, I have never felt so welcome (even at a hotel, never mind at a hospital!) It turns out I had been in touch with the friendly woman on reception via email, and when she saw me with my little wheelie suitcase she realised I was from out of town and put two and two together that I must be the young British girl coming over for radiotherapy. But still! What lovely people.

Unfortunately, after all that, it turns out I won’t be able to have my radiotherapy at St. Luke’s because they couldn’t fit me in on the public system so I have to go privately at St. Vincent’s instead, but that’s fine because it’s closer to work and my flat. I’ll write a separate post about my radiotherapy treatment plan because it’s too much information for this post, but basically I should start on 2nd Jan and finish at the end of February, with 33 radio sessions.

Flying Back to Manchester

On the flight home, with Aer Lingus this time, I was momentarily delighted when I saw that we were sitting in the emergency exit seats, i.e. plenty of leg room and as much space as possible away from my fellow passengers with their various vomiting bugs and winter flu. The delight was soon snatched away from me, though, when your lady from Aer Lingus looked at me, gestured towards the window I was sitting next to and said “You’re guarding the emergency exit there, are you willing and able to initiate an evacuation in an emergency?” (You see, I had taken off my wig by this point and was wearing a snazzy purple beanie and I obviously screamed “cancer patient/invalid” to her.)

I paused for a moment, recalling the opening scenes from series 1 of LOST. Was I really strong enough, after six rounds of chemo and one exhausting day of travel, to lift a 15kg aeroplane door off its hinges in a crash and lead my fellow passengers down the inflatable slide into the sea, making sure they all took off their heels so as not to puncture it?

“Yes,” I finally said. I was too exhausted to move and I really didn’t care that much about my fellow passengers anyway. (Apart from Mum, and I’d help her down the inflatable slide first anyway). Plus the evacuation procedure looked simple enough.

“Please ensure all electronic devices and mobile phones are switched off,” the cabin attendant said, eventually, preparing for take off.

“Oh NO!” Mum exclaimed from the seat next to me. She had left her mobile phone on, and the cabin lady had insisted we put our bags up in the overhead cabins so as not to block the emergency exit, and now we were all firmly belted in and ready for take-off. “What should I do?” she said, looking at me for answers.

I was in two minds. I knew Mum’s phone was unlikely to cause a crash during our 40-minute flight to Manchester, but I wanted to avoid any increased risk that I would have to get off my poor chemo-sapped arse and shuffle 100-odd passengers out of that emergency exit, so eventually we asked the cabin lady to get Mum’s bag down so she could switch her phone off.

The plane did not crash. We made it safely to Manchester. Then I got a paper cut from one of the items of my mail I’d picked up from the office. Will it ever end?!

Back to the Christie

Luckily, we had the good sense to stay overnight in Manchester on Tuesday, otherwise I don’t think I’d have even had enough strength to get myself back there on Wednesday (purely due to tiredness and still fighting this infection). I was in for my three-week post-chemo check-up, which truly marks the end of chemotherapy – hooray!

Because I was neutropenic on Monday, I went in for another blood test on Wednesday. Unfortunately, I was dehydrated from our overnight stay in a stuffy hotel room (I know people commit suicide sometimes but I really wish hotel rooms had openable windows…) and it took three painful attempts before the nurses could get blood from me. Yuck! Seriously, I must have had more than 100 needle injections so far in 2012.

Then followed a tense wait for my blood count results. If my white blood cells and neutrophils went down from Monday, I would have to be admitted as an inpatient and be hooked up to a drip again for a few days in hospital – possibly spending Christmas Day at the Christie Clinic. But if they went up, I would be allowed to go home. So you can only imagine how relieved I was when the doctor told me they’d gone up. Not exactly by much, but honestly, I couldn’t care less as long as I was able to go home.

Now please let me not have picked up any vomiting bugs in the past two days! (Not that it matters anyway, seeing as the world is going to end tomorrow…)

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Breast cancer, Cancer, Chemotherapy, Hair loss, Hair regrowth, Health, Taxotere, Women's Health

Is the Chemo Working?

Many of you have asked me whether my chemotherapy is working, which is a very good question.

Sometimes chemo is given to people before they have surgery, to reduce the size of the tumour and operate once it has shrunk. The doctors do scans routinely to see whether or not the tumour is shrinking, so it’s possible to see whether the chemo is doing its job.

In my case, my tumour was relatively small and my surgeon hero successfully removed the whole nasty thing in June. He also took some of the surrounding tissue and tested it for cancer cells, and this came back beautifully clear (which is why I declared myself footloose and cancer-free in early July). It was the best possible outcome and I got it.

My chemotherapy and radiotherapy, therefore, are entirely preventative. I am technically as cancer-free as the rest of you, but because I am young, I need to be blasted to bits with the strongest drugs and radiation just to make sure that if there is even one minuscule, evil little ‘C’ cell still hanging out somewhere inside me, it gets absolutely obliterated and never, ever, EVER has the chance to grow and multiply and make friends with other little nasty ‘C’s to form a tumour again.

Because my chemo and radiotherapy are only preventative, there is no need to do any tests or scans to see if it’s ‘working,’ according to my oncologist. Giving me scans to check for anything at the moment would expose me unnecessarily to further radiation, so there will be no scans for the foreseeable (although I may have to have one before radiotherapy, to decide where the radiation will be given).

So, the answer to the title question is “we hope so!”  It’s basically a case of trusting the statistics and assuming that subjecting my body to all this short-term poison is doing me some long-term good… Here’s hoping!

In other news, I still have a very croaky, husky voice and a horrible cough and cold (along with half the nation) and am on the antibiotics and going for another blood test tomorrow (when will the needles stop?!) But the good news is my hair still seems to be growing nicely in random patches and there has even been a vague glimpse of some sideburns. I never thought I’d be so happy to see those big, dark sideburns again!

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Breast cancer, Cancer, Chemotherapy, Cooking, Food, Nutrition, Women's Health

What the Nutritionist Said

Oh dear. I’ve had a very mild, tickly cough for about a month and yesterday it escalated into a full-blown, nasty choking, phlegmy cough. During the night I developed a painful sore throat and woke up this morning having largely lost my voice, so I am now on the antibiotics. So much for having a super-sonic immune system with 39.7-level white blood cells! Pah!

So, the nutritional therapist. I had a 1 1/2-hour consultation on Friday with Liz Butler, founder of Body Soul Nutrition, with a view to getting some advice on what I should be doing to keep my cancer away, and finding out whether any of my eating or lifestyle habits could have developed a better environment for the cancer to grow in the first place. One of the things she said was that many people have their cancer treatment and then go back to living their lives exactly as they did before – continuing to eat the same things, maintaining the same stress levels and doing the same amount of exercise, thus preserving the same body conditions in which the cancer initially thrived. It’s vital, according to Liz, to make drastic changes, both emotionally and nutritionally, to keep the cancer cells from growing again.

Her main recommendations were that I cut out dairy altogether and avoid sugar as much as possible. She also gave me some nutritional plans and talked to me about how each meal should be ideally composed, i.e. 50% vegetables and fruit on each plate, 20% starchy carbs (but only whole grains – no white rice, white pasta, white bread etc), 20% protein (eggs are allowed – phew!) and 10% fats (including nuts, pulses and butter, which is the only dairy allowed).

All of the above seems largely doable, apart from the giving up of dairy products and sugar, which is difficult for me to envision for the rest of my life. Two weeks, as I proved before, is easy peasy, but a life with no pizza (cheese), tea and coffee (milk), cheese and biscuits, cake, chocolate and many other tasty things is hard for me to get my head around. On the positive side, she did say I’m allowed red meat (once or twice a week, max), as long as it’s the best type of meat I can get my hands on – i.e. organic, free range etc (because the lower quality the meat, poultry or fish, the more likely it is to have been injected with antibiotics, hormones, etc).

One thing to stress is that the nutritional therapist didn’t say I have to give up all these things entirely – she said it’s fine to have a little of what I fancy, when I fancy, i.e. a couple of squares of dark chocolate every couple of days or a slice of cake or a dessert once a week, which is also fine. But I will struggle more with dairy because I eat a lot of it.

I decided for my last chemo I would be good to myself and let myself eat what I wanted, because often you feel so miserable and your tastes change so much, I didn’t want to punish myself like last time. So I’ve been eating something sweet most days, though not going overboard. And Christmas is coming up, so I’m not going to punish myself then either. But it’s important during radiotherapy to eat well to minimise the side effects, so I will definitely start being a little more strict in January.

I plan to take Liz’s advice to the extent that I can manage, cutting out dairy and sugar as much as possible but essentially allowing myself what I want in moderation. I am still very much aware that the oncologists don’t recommend any specific dietary changes and they certainly don’t recommend giving up sugar and dairy, and there is no proof or concrete evidence that doing so would guarantee my cancer never recurs, but at the same time changing what I eat to some extent will at least allow me to have a little more control over the situation. Nevertheless, I thought I might as well start as I mean to go on…

I started off well. Saturday morning, I had my first ever black coffee, and I quite enjoyed it. (I forgot to mention she told me to give up caffeine, but I may have to do things gradually!) Then I had a ginger steeper (fresh ginger in boiled water) at Leon. For lunch at Giraffe, I ordered a fresh fruit smoothie and a brown-rice sushi salad consisting of spinach, smoked salmon, mango, avocado and various seeds. But because I didn’t quite have the 50% veg/20% carbs ratio quite right, I ordered a separate side helping of sauteed veg (green beans, peppers and the likes – delish). Which brings me to Nutritional Problem #1: eating better is way more expensive. The better quality and the more organic the meat or the veg, the more the price increases. And the more veg portions you order to try and get the right balance, the more you end up paying. And Nutritional Problem #2: The better you want to nourish yourself, the more you have to plan what you eat, where you eat, when you eat, etc.

And then it all went down hill. As mentioned in Tuesday’s post, Saturday night I went to Bubbledogs and ate two hotdogs. I am not convinced the pork sausage was the most organic meat in the land (largely because I do not know its origin) and I can take an educated guess that barbecue sauce and ketchup both have a fair amount of added sugar. That said, at least I didn’t have a pudding, and the jalapeños on the Mexican dog would have been good for me. But I did have a glass of champagne.

Sunday, it went further down hill, with a bacon sandwich on white, a cheese toastie and sausage, chips and veg for dinner. And Monday, a decent lunch of Eggs Florentine (bit of spinach, decent amount of protein) and a handful of Niki’s fries, then fish and chips on the train home (free first-class food, I could hardly refuse, could I?) I suspect the quality of the fish on East Coast Trains may not be the best in the world, which brings me to Nutritional Problem #3: It’s particularly hard to change your nutritional habits when you’re away from home. But, like I said, I’m not being strict on myself at the moment as a) I’m still under the wicked spell of the last chemo and within the three-week cycle, b) I’m sick and c) it’s the season to be jolly, tra la la la la la la la la.

Thank you all, though, for adhering to my request not to send me any more junk food. Alice very kindly oven-roasted me some assorted nuts in fennel and honey and they are amazing – I’ve been munching my way through them as only a gannet would. I since found out that honey is on the no-no list of sugary foods (Sorry, Mr Curado, I misinformed you), but I’m happily munching through them anyway (see points a, b and c). Thanks also to Beth for the lovely tin of personalised soup, as pictured at the top of the page (don’t ask why “Bobr”).

So, that’s (the very much abridged version of) what the nutritional therapist said. I still have a lot of reading and researching to do, and I confess I am slightly skeptical that following all this advice will keep the cancer away for good, because I have always eaten so healthily and it’s most likely my cancer was caused by a gene fault (just not the one I tested negative for). However, I have to do something to take this into my own hands, and improving my diet seems to be a good place to start (she says, while slurping through a cream-heavy tin of chicken soup…)

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