10. 17th May 2021 - Oncology

I think today is the day I have been most apprehensive about. Even now I haven't really accepted what is happening. I still feel that everything is going on around me and I am in a bit of a haze, but having an appointment with an Oncologist is a bit of a reality check.

My wonderful friend C has recently had an horrific experience with her Oncologist so I am quite nervous as you don’t get to choose who you see - it is just potluck who you are assigned to - I just hope I get a compassionate one.

I arrive at the MacMillan Centre at my local hospital, again alone due to Covid restrictions. I pass the centre every day when I’m at work with barely a glance but now I need cancer treatment and have to actually go inside - and I just feel sick. I take a deep breath and go through the door to check in at reception. As I’m not having treatment today I’m not allowed to stay in the department and they give me one of those timers you get at restaurants and send me outside to wait. This is making me quite anxious as I am still nervous of Covid and I have to wait in a busy thoroughfare at the hospital main entrance. I try to pretend that I am actually waiting for my table to be free at some lush restaurant - and then wonder if I will ever do that again. I have always been a glass half empty kind of girl so I struggle with being positive and I tend to slide up and down the ‘I’ve got this’ scale with alarming regularity.

My little alarm starts buzzing, I take yet another deep breath and go through the doors. My Oncologist, Mr V, is there to greet me and he is full of apologies for being late as he leads me through to his consulting room. He seems really nice and looks about 12 - but tells me he had to do an emergency school run so he must be old enough to be a doctor!

Mr V informs me that he has reviewed all my scans and he has no doubts that he can treat my cancer and that it is very unlikely that I will not recover from it. I hear the words but am not sure that I actually believe them yet - the little pessimistic voice in my head just keeps saying ‘what if? What if you are the 1 that it doesn’t work for? What if?’

We have a very in depth conversation about my medical history, concerns and general well being. He is so lovely, nothing I ask is too much trouble and I never once feel that I am on a conveyor belt and need to rush along.

We then get to what treatment he recommends - there is so much information I feel a little dazed but Mr V is so caring - he advises me to just concentrate on one bit at a time - this will be a long, gruelling process but I will get through it.

As my cancer is considered curable and has not metastasized (spread to other body parts) I will initially have a course of chemotherapy. I will then have Adjuvant treatment to lower the risk of the cancer returning. Adjuvant treatments may include radiotherapy, oral chemotherapy drugs, hormone therapy etc.

Mr V says I will need 4 to 6 cycles of a chemotherapy drug called Docetaxel. He explains that it is quite a harsh drug with some difficult side effects and I may only manage 4 cycles but he would really like me to have 6. Obviously he doesn’t know me and my strength of character - if he wants me to have 6 then I shall have 6 - whatever the consequences! He confirms that I will lose my hair - probably on the 2nd cycle - I have written a separate blog about hair loss and my feelings surrounding it which I will post shortly.

My management plan is as follows:

6 cycles of Docetaxel infusion - to be given every 3 weeks

Trastuzumab (Herceptin) injection - to be given every 3 weeks for 1 year

Radiotherapy - duration to be decided post chemo

Letrozole - post chemo - 1 tablet daily for 5 years

Zoledronic Acid infusion - post chemo - every 6 months for 3 years

I found this hard to hear - 5 years of treatment sounds crazy - even knowing that they expect me to be completely cured at that point. It just seems such a huge mountain to climb and I still feel this isn’t really happening to me - I’m not sure when acceptance will even arrive - I am literally existing in a daze - I’m functioning normally but it’s all very surreal.

Mr V advises me to book an urgent dental appointment as the drugs I will be on can cause damage to the jaw bone (it’s very rare but they have to cover all bases). I also have to have a Transthoracic Echo (TTE) which is a check of my heart as the Trastuzumab can be toxic to the heart - it all sounds wonderful - nothing to be worried about at all!

He hands me a wad of information on each drug for me to read through - they detail all the possible side effects etc - when I read them later that day it does nothing to reassure me - this is horrific and I’m terrified!

Before I leave my appointment I am introduced to one of the MacMillan Breast Care Nurses who takes me aside to discuss any concerns I may have. I talk to her about how to get through the next few months, how it may change me, how I help my family to cope - all the usual things you can imagine asking. She is very blunt and tells me the next 6 months are going to be harrowing and I need to only concentrate on myself and how I will cope. She says that the chemotherapy is usually the worst it will get but the side effects can be crippling. No 2 people are the same so you may get all or you may get none of the side effects - it’s just a lovely little game of potluck! This is hard for me because, being a control freak, I like to know exactly what is happening - maybe this will be a lesson in patience for me - if so I would have preferred a less traumatic one! As with the Breast Care Nurses in the Breast Clinic, I am once again assured that the MacMillan Nurses are there for me whenever I need them. I am given a mobile number and can call or text at any time and they will always call back. I can confirm this is absolutely correct - I have had to contact them on a few occasions and they always respond and help.

I leave the department feeling overwhelmed but knowing I am in safe and caring hands - I await my ETT appointment, and I also need a Covid test and a blood test - if they are all ok I will be contacted with the date of my first chemo session. And life carries on.