23. Cancer Diaries - Business As Usual (BAU)

Last time I wrote I mentioned that I had completed the first 5 radiotherapy treatments. Apart from fatigue I was coping well. The medical team were excellent and always so chirpy as they looked after me each day. I also had catch ups with my Clinical Oncologist to check on progress and also chats with another member of the team to check on my general wellbeing and if there was any further support that I needed. 

When you go through a cancer journey you spend months inside a bubble of continuous medical care and attention. When these large treatment stages finish the patient can suddenly feel a bit isolated, now released back into the wild to manage their drug therapy, mostly alone, as frequent touch points aren't needed. Good news, there are many associations and charities out there, who understand what the patient has gone through and can offer emotional support and practical tips to move forward with their lives. I've been given a booklet called 'Moving Forward' with lots of tips and connection points should I have the need. 

In the big scheme of things I've handled my cancer journey pretty robustly. Writing this blog has helped a lot, and knowing that you, dear reader, are there has helped immensely too. We all find ways of managing the situation.

In addition to the support, the facility where I went for Radiotherapy also offered complementary therapies, such as massage, reflexology and reiki. I'm all over that sort of thing at the best of times so I dived in and selected reflexology. I'm the sort of person who is happy for someone to play with my feet all day - just ask 'him indoors'. Anyway, my reflexology session was very relaxing, so I decided to book in for another session, with a dash of reiki on the side, on week 3 as an additional treat.

As I had learnt from my previous procedures, having special treats booked into the calendar acted as important stage markers to look forward to. Radiotherapy was given in an intensive block, every weekday for 3 weeks. At each weekend we planned some entertainment. The first was Pantomime, the second was a more highbrow play at another Theatre and the last weekend, dinner to celebrate the completion of all the sessions. 

Radiotherapy is now completed and I'm now recovering from the treatment. My skin has become red, like sun burn, so I'm applying the special cream to calm things down. I've also been given these cooling bandages to put on any inflamed areas. They are like disposable contact lenses, if you leave them in the air then they will harden, become brittle and snap.

Formally, the large scale treatments have now been completed. I've gone through chemo, surgeries and radiotherapy. Now I move onto the drug therapy stage. This stage is normally less impactful for the patient but goes on for a much longer duration - years. I've now entered into the BAU (Business As Usual) stage. 

I saw my Oncologist (Mixologist) this week to find out what was in store for me. The answer wasn't simple, is it ever? My cancer started out as one that was fed by my hormones. It was slightly hormone receptive. When the biopsies came back from my surgeries the cancer cells were found to be 'triple negative', as in, they did not use hormones to grow. I asked how could my cancer have changed? Turns out, it didn't, both types of cancers were in my body the whole time. 

Here comes the science bit. In your average tumour exists both positive and negative cancer types, and maybe others - who knows. When a biopsy is taken it is pot luck on what type of cells are extracted for analysis. 

For me, positive hormone receptor cancer cells were taken and so my treatment was based on those findings, but as I learnt, I also had negative cells. So, what does this mean for my drug therapy stage? 

My Oncologist sought advice from others in the trade on what the best approach would be. Do we treat the initial positive hormone results or tackle the negative results that were found during the surgeries. The answer that was been concluded upon, is both. 

Remember, I am cancer free and this is another phase of preventative medicine. Essentially drug therapy will be telling my body that it's not a good idea to create any cancer cells, in order to keep any future cancer away. 

We are going to start with drugs to tackle the negative cancer cells. Unfortunately, this means chemo drugs. Ugh! I've had to have a blood test to check if I have an enzyme in my body to cope with this drug. If I don't then there is a risk of death, which is a tricky impact, so an alternative drug will be given. 

These chemo drugs aren't quite as easy as popping a normal pill and going about your day. I'm back to the concept of cycles. I will take pills every day for 2 weeks and then have one week off. Before each cycle I will have to have my bloods and other observations checked to ensure I am fit enough to take the next batch of drugs. I will have 8 cycles. There will be side effects - oh the joy! I will also have to take 10 pills a day to make up the recommended dosage. I'm going to rattle! 

After 6 months of chemo drugs I will have completed this phase and then move onto tackling the positive cancer cells. This will be a one pill a day for 5 years and seems to be the most frequent approach to drug therapy care for my particular cancer type. 

10 pills a day for 6 months seems a large number. 5.5 years of drug therapy seems a very long time. But, these are just numbers and I will make my way through them, one pill at a time, one day at a time. Taking this belt and braces approach will mean that my future prognosis will be even stronger than first considered. This really is the gold standard and I'm so fortunate and grateful that I have access to an all embracing medical process, being looked after by real experts in their field, surrounded by such caring teams.

So, this will be my life for years now. Welcome to my BAU.