A GLAMOUR girl’s cancer diary: Cancer, chemotherapy and cold caps

The treatment plan.

01 Apr 2018

This year, around 1.7 million women across the world will be told they have breast cancer - that's three women every minute. One of those 1.7m women has worked at GLAMOUR UK for 14 years. Meet Grace Wasyluk, 38, Associate Publisher of GLAMOUR. Just before Christmas she was given the news no woman wants to hear: “You have breast cancer”. Grace, who is married with two children under the age of five, is sharing her journey exclusively with GLAMOUR. From the devastation of discovering she had cancer to her chemotherapy journey, via all the things she wished people had told her, she is sharing a different part of her journey in all its candid detail.

WEEK TWO: How many more "C's"? Christmas, cancer, chemotherapy and cold caps

For most people, the run up to Christmas is synonymous with carol singing, mince pies and quaffing mulled wine. My pre-Christmas treat was meeting my Oncologist.

Isabel Castillo Guijarro

Following the decision from the medical multi-disciplinary meeting that my best course of treatment would be neo-adjuvent chemotherapy and then surgery, Remy and I found ourselves sat behind another desk.

Leah, my breast cancer nurse, offered to join us so that we didn't miss any vital information. It was just as well she did; that meeting blew my mind and my doctor may as well have been talking Mandarin.

In that 90-minute meeting, we discussed everything from hair loss (inevitable) and heart problems to the menopause. I reckon he probably answered the same question ten times as my brain couldn't seem to decipher this new language. Not only is my oncologist a genius (a Professor in fact!), he was also hugely personable and understanding. I was rather alarmed, though, when asked to sign off on my treatment plan there and then. I felt like I needed time to digest and review what I was getting involved with; you don't buy a house after just one viewing.

My oncologist kindly drew a treatment timeline to help us understand, but he just kept on drawing until it felt he was going to draw off the end of that massive desk. Each block represented a treatment or a week but I wasn't concentrating on the words coming out of his mouth, just counting those tiny little blocks on that giant piece of paper - it was now in double figures. Then it hit 20; 20 weeks of chemotherapy. That's 5 long months.

I just kept thinking: “I don't even feel ill, why do I need 5 months of chemotherapy? Can I not just take a few pills?”.

Needless to say, the oncologist then had to repeat himself several times and spell out each and every one of the drug’s names. The chemotherapy drugs are used to kill those fast dividing cancer cells. As my cancer is HER2 positive, they can use targeted therapies that fall under immunotherapies. If you're interested, my treatment plan reads something like this:

Stage 1:

4 x AC chemotherapy sessions every fortnight (doxorubicin, also known as Adriamycin and cyclophosphamide).

Stage 2:

12 x Paclitaxel (Taxol) weekly, starting after the 4 cycles of AC, Herceptin (Immunotherapy) every 3 weeks for one year (starting at the same time as the Taxol), and Pertuzumab every 3 weeks (given at the same time as the Herceptin until surgery).

Stage 3:

Surgery.

Stage 4:

Hormone therapy for 5-10 years.

As the names, scientific terms and explanations started to sink in, the tears came; big, fat childlike sobs heaved from my body as I sat on the steps of the hospital post-meeting. I had reached rock bottom. Remy was at a loss of what to say or do and I imagine it was just as daunting for him.

We made the trip home in a fog and then it was Remy's turn to write a list. He sat and researched every single thing our oncologist had told us and then created an amazing document citing all the details and timings, which helped us compute what was to come. This document also became incredibly useful as we shared it with our family and friends.

People with cancer could spend an infinite amount of time researching these drugs, the side-effects, other people's stories and questioning why their journeys differ to other people’s. Essentially, I'm not an expert in this field and I have to follow the medical advice I’ve been given. Yes, I feel helpless and out of control, but really, what are my other options? Ignore it and see what happens? I would love to think that drinking some sort of herbal tea may rid my body of this tumour but, alas, there's no concrete evidence to support this and so I have no choice other than to deal with this as rationally and logically as I can do and get on with it. I don't think anyone actively wants to have chemotherapy.

Four long days later, the treatment plan was signed off. My first chemo was scheduled for January 5 so I can "enjoy" Christmas. I had my hair fashioned into a pixie hair cut (I figured it would be less traumatic to see short strands falling out rather than long pieces of my beloved hair). Other new experiences on my journey included going for an Echo-cardigram, which registered the state of my heart as some of the drugs can affect this, and having a portacath inserted.

A means that chemo can be administered directly through this rather than accessing a vein in your hand every time. Given that I was set to have 16 treatments, used to pass out when going for blood tests and didn't wish to have ‘granny hands’ by the age of 40, I opted for a port.

This was inserted under general anaesthetic (although it can be done under local) and whilst my port works brilliantly, I found the whole experience rather difficult. It took six weeks for the bruising to subside and a good two months before I could pick my daughter up. While they are meant to be unobtrusive, given my small frame, my port actually protruded further than the offending breast!

So, I was pretty much set (as much as you can be) for the chemo but still couldn’t quite decide whether I was going to brave the in a bid to save my hair. The cold cap is essentially a hat that freezes your head so that the blood flow is reduced and thus carrying less chemo to the hair follicles, resulting in reduced hair loss. From what I could decipher, it's painful wearing an ice cap and only has a 50% success rate. However, surely if there was a chance to save my hair then I should take it? Tune into my next column where I reveal what my decision was.- and delve deeper into my treatment plan in candid detail.

What I learnt from my experience and what you should know, too…

- Find the right oncologist for you, who is sympathetic to your life stage. Ideally, they would be connected to a large cancer centre such as St. Barts or Christie’s, which means they are often at the forefront of new trials and pioneering drugs.

- All chemotherapy treatment is individualised so whilst I may have the same diagnosis as a lady in her sixties, my treatment will be different.

- Chemotherapy temporarily stops your periods and can affect your fertility. Your oncologist will discuss your family plans ahead of your treatment.

- Book an appointment at the dentist. Chemo really affects your mouth so make sure your dental health is in good condition.

- Ask about a Portacath as they are a very safe and efficient way of administering the chemo, other intravenous medicines and taking bloods. Plus, it means you have your hands free!

- If you are petite, ask about the feasibility of using a child's portacath.

- There will be pre-medications administered before chemotherapy to help you tolerate the side effects better, such as anti-sickness drugs and steroids, so make sure you ask about these and what they are being used for in your consultations.

- Chemotherapy destroys all the fast dividing cells in your body (even the good ones), so it compromises the stomach. As I've always looked after my gut health, I wanted to help this as much as possible. Ahead of treatment, consider taking a super-strength probiotic. I use Symprove, which is a liquid taken in the morning.

- It's a very personal matter, whether you wish to deal with the news privately or to share with family and friends. I felt I wanted to - and needed - their support and help, but others wish to continue on a private journey.

- If you do share your journey then ask one friend to set up a WhatsApp group to keep everyone informed; that way you only need to update one person.

- The Chemo Rota! Treatment days essentially mean being sat in a chair whilst various bags of medicine are fed into your body, so I wanted to make these days as enjoyable as possible. I set up a rota, meaning each session had a different friend joining me to gossip and catch up - it's amazing how hearing other people’s problems is the best distraction!

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