It's in
the bag

 

In the medical theater, chemotherapy is about as interesting to watch as the janitor sweeping between vacated seats. A murmuring quiet prevails in a room full of people hooked up to suspended plastic bags. Fluid particulates into tubes attached to catheters that, in turn, link to the jugular. The hypnotic drip-drip-drip into the body's pathways promises to route out proliferating demon cells. Why else would one voluntarily come to be injected with toxic substances?

The good news is that chemotherapy stops cancer cells from multiplying and kills them. The bad news is that the chemicals go after any quickly dividing cell, cancer cell or not. It's not exactly cells in white hats pummeling cells in black hats. Even cells you like go bye-the-bye, like hair cells and taste buds.

Different chemotherapy drugs attack cancer cells at different stages cells go though. Take one of the latest³taxanes. Normally, something called microtubules connect the old cell and new cell. When the cells divide, the tubes break down and are eliminated. Taxanes stop microtubules from breaking down so cells cannot divide. Other chemo drugs strangle the blood supply to cells in a tumor so they can't grow and thrive. Others attack proliferating cancer cells at different stages of the dividing proces. That's why a combination of drugs is often used. Each works differently and makes you feel differently. Your doctor is obliged to tell you about ALL possible side effects. Talk about a nausea factor.

The reaction may be "Whew, this isn't as bad as I thought it ws going to be." Or it may be "Why am I shelling out so much to be tortured?" With the Adriamycin and Cytoxan combo I started with, nausea and dry mouth were the drawbacks (but mostly just the first week). Taxotere produced aches in muscles and zombie-like fatigue. Toe nails turned purple, and my eyes ran. Callouses separated from my feet, replaced by new skin. Tons of savings...I won't have to go to a podiatrist for months.

On the other hand, ask yourself if it's better to rely on stories from an aunt or friend's mother treated 10 or 15 years ago. Devastating as it was, mastectomy was the way to go, they swear. They can say this, of course, because they are still alive. Now, although, mastectomy is often counseled, lumpectomy with chemo and/or radiotherapy is a choice, with comparable success rates, depending on the time and efficacity of intervention.

Counter measures are in place for many of the side effects, even the prick of the IV needle. An anesthesia can be applied to the catheter area a half hour before going for treatment. Once I applied the circular applicator during a subway trip to the clinic, when it dawned on me—and I'm sure my seatmates—that it was packaged like a condom. No doubt, they wondered why I was applying a condom under my collar bone.

Little actual physical change takes place during the hour or two you sit there, although responses are highly individual. During the AC treatments, saliva started tasting dryer about half-way through (but I REALLY had to pay attention to detect even this). Sometimes something like a nervous stomach came on, but it's hard to tell if this was chemically or emotionally induced. No one is impervious to the perils of uncertainty.

Correction: There IS a predictable physical reaction, causing you to push your bag holder on rollers to the bathroom. All that liquid has to go somewhere.

Chemo rooms are meant to be soothing, routine. It's a good place to do crossword puzzles, thumb through tattered magazines or sleep. I highly recommend chemo if you need quality time to yourself. Unless, of course, you can't stop thinking about how many Versace outfits you could have gotten for the price of your lumpectomy. Or the vacation you could have taken for each chemo treatment.

Some people prefer to be accompanied. Husbands sit by wives, usually conversationless, reading what they would read on the subway. Boyfriends look at their loved one wondering what to say—the wisest holding hands, lest they say the wrong thing. Girlfriends chat about the rest of the day, mutual friends, clothes, job...subjects just as valid here as anywhere. The younger the person is, the sorrier you are that she is here. Most men are alone and stoic—except those with shirts wide open, displaying hairy chests around their catheter. Women cover up to as close as possible to where the catheter must be exposed.

Beepers go off periodically. If it takes the attendant too long to replace a bag, it gets irritating. Not nearly as irritating as the nervous, chattery person making excessively light of this experience. Nervous laughter penetrates, causing more psychic pain than any normal part of the experience.

Postures are revealing. You see the slumped and resigned as well as the arms-crossed defiant. Some manage to slip in this appointment amid a busy day, tapping a foot, impatient to go on. Others use a significant amount of energy just to get there. It's obvious who is not faring well, but look around, most are. Some women take considerable pains to spruce up their appearance with makeup, scarves and hats. An occasional head-in-the-raw testifies to the ease one feels with her baldness. Others disappear under a blanket.

What are they covering up? you wonder. Fear? Denial? The will-I-be-safe question? For how long? Will life go on pretty much as it did before the diagnosis? Any of the above could be right. Or they could just be cold. Or the blanket is just a way of saying I don't want to be here.

I didn't either my first time. I tried to sink into the chair invisibly, like I wasn't really there. Then I started stealing glances at the others, getting bolder. By the third session I was trying to analyze how others were dealing with this—wondering how the fast-forward questioning of life cancer causes is affecting those around me. Does the wigged one know more about the meaning of life than me? Who's had an epiphany? Who is withdrawing? Who is getting an outpouring of love? Who is learning to verbalize what should have been said all along? Who is discovering courage unknown before finding herself in a situation she never would have chosen?

Attitudes vary as much as the people who come in. It's okay to rail against your fate. On the other hand, you can marvel at medical advancements and consider yourself lucky to have access to them. It's okay to cry when you feel miserable, and it's okay to spurn sympathy, just as it is to accept support and love. It's okay to resent the forced association in the chemo room, but one thing is sure—shared hope links you all as surely as the IV tube links you to your bag.

hair (or lack thereof) • radiotherapy "fallout" entry page