The Miami Herald

Hanging in when chemo treatments get rough

Breast cancer treatment felt like a bad Halloween joke. About two weeks after my first chemotherapy, I woke up to the image of a monster.

I had shaved my head. My body was covered with itchy red hives. I had a burning rash under my left shoulder. My stomach hurt. I had blurry vision. I couldn’t process thoughts with clarity. I felt weak. I was scared of getting sicker. I was scared of dying.

Several breast cancer survivors had warned me about the discomfort. I tried my best not to panic, took deep breaths and turned my face away from the mirror.

Earlier that month, Paula Lede Richards of Weston had explained how she had survived breast cancer. She talked about her experience with chemo, which kills rapidly dividing cells indiscriminately.

“Chemo can be really tiring, but it is what will kill the cancer,” said Richards, a mother of two. “You just have to hang in there and be patient. It works.”

I was willing to do what ever she had done, so I turned to friends for courage, and walked into the University of Miami’s Sylvester Comprehensive Cancer Center to meet its deputy director, Dr. Marc E. Lippman. He used the words “curable” and “cure” interchangeably.

“You have garden variety cancer,” said Lippman, who is a pioneer in studying the role of estrogen in breast cancer. According to the pathology report, estrogen was what was feeding the invasive ductal carcinoma found in my left breast and a lymph node.

Lippman explained that neoadjuvant chemotherapy (administered before surgery) is sometimes preferred over post-operative chemotherapy for two reasons: It can help conserve breast tissue, and it can allow for a more accurate examination of the tumor’s response to a particular combination of drugs.

“I have seen chemotherapy significantly reduce the size of large lumps,” Lippman said. “I have seen them disappear.”

Lippman recommended four cycles of Docetaxel and Carboplatin every three weeks over the course of three months. Docetaxel inhibits enzymes from making proteins needed for cell reproduction, while Carboplatin directly damages DNA and can cause long-term damage to the bone marrow.

I asked my friend Pilar Uribe, a vivacious actress, to accompany me to my first therapy. About a year earlier, she had sat at a nearby beige recliner for her chemotherapy sessions. Now she was glowing with life.

“Take deep breaths,” Uribe said, trying to calm me down. My heart was racing and I couldn’t stop shaking my leg.

A nurse was holding a long needle. To access my bloodstream, she plugged the needle into a port that had been surgically inserted under my skin earlier that month. She lined up bags containing the poison, and had me and some one else double-check the labels.

“Don’t call it poison,” Uribe said. “Call it the sacred healing juice.” She said she was sharing the wisdom that others who had survived breast cancer had passed down to her.

The entire process took about three hours. I thought I was going to be able to work from home. I thought it would feel like I had the flu, but I was wrong. My life would come to a halt, after that day.

During the first two cycles, I spent about two weeks after chemo walking from my bed to the bathroom. I felt weak. My joints and bones hurt. Sometimes I felt like I needed a walker to get by. The fear of getting sick — especially during cold and flu season — made me feel unsafe in large crowds. I stayed at home. I told myself over and over: The sacrifice would pay off.

Six weeks later, the lump — made up of three tumors — did not seem to be getting smaller. Lippman said that he would re-examine me two weeks after the third cycle of chemo to see my progress.

“If that lump is still about the same as it is now, I am going to switch horses and change to another chemotherapy,” Lippman said. “I might want to intervene with surgery. I realize this is going to be a very unpleasant six months. The idea is to get you through it, and get you finished.”

The voices of those survivors who have gotten out of this black hole were what kept me from screaming “NO!” Instead, I smiled and said, ‘OK.’

Fear boiled inside me for days. Surgery would complete the monster look. I pictured the possibility that the mischievous cells were invading my bones and my lungs, like silent killers, waiting to strike when least expected.

My mind had to be stopped. Uribe, who chronicled her journey with breast cancer in a documentary, shared a few tricks to wrestle with fear.

“You have to close your eyes and know that the cancerous cells are dying,” Uribe said. “Envision yourself healthy and alive. Free of cancer.”

It is not an illogical thought. The numbers are in my favor. Lippman has led many other women to victory. Chances are he will do it again.




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