next stop on the chemo train...

Despite my best effort, Xeloda joins the likes of Abraxane, Ixempra, and Adriamycin... chemos that I have tried and had to move on from (either because they didn't work, they stopped working, or the side effects were too risky).

Next stop on the chemo train is an oldie-but-goodie:  CMF.  CMF is a "cocktail" of 3 drugs:  Cytoxan, Methotrexate and 5-FU.  CMF has been fighting breast cancer for as long as I have been alive.  In 1976, researchers found that CMF chemotherapy used post-operatively reduced the risk of recurrence.  It quickly became the standard of care.  Since then, AC+T (Adriamycin, Cytoxan & Taxol) has demonstrated superior efficacy, but CMF is still a worthy soldier in the fight against breast cancer.

There are a few different regimens for CMF.  I am starting on a 28 day cycle, with chemo given on days 1 & 8.  The first dose of CMF was relatively uneventful.  The nurses accessed my port and drew blood, took my vitals and then Dr C did a quick exam.  He still can't feel my liver, which is a good sign (I was getting pretty paranoid and nervous given that I had been off of chemo for a few weeks!  My body was certainly feeling stronger, but I just don't trust it... and am much more comfortable now that I am back on the chemo train).

Prior to the chemo itself, they give me a steroid (dexamethasone) and Aloxi to prevent nausea and vomiting.  The Methotrexate & 5-FU are both given by an IV "push" (the nurse pushes the drug from a syringe into the IV line).  The Cytoxan is an infusion and it is given over 1 hour.  All told, the visit lasts about 3 hours... it is pretty mentally tiring, so I often take a pretty good nap after chemo.

When I went in for my second dose, my white blood cell counts came back quite low.  Dr C decided to still give me chemo, but he cut the dose in half.  I also took a Neulasta shot this week (to stimulate WBC production) -- we are heading to Mexico for a family vacation and Mexico is not someplace that I would like to wind up unable to fight off an infection due to low counts. 

So far, the side effects are fairly manageable.  While I don't feel great on Wed/Thursday, I also don't feel awful.  A little slow, a little nauseous, but overall, I can't really complain.  Most likely, my hair will "thin" but I shouldn't lose it all.  It would be nice to hang onto my hair for a while since it is finally starting to look like a normal haircut once again.  Though, if you could promise me that the chemo would work, going bald is a small price to pay!

Next chemo is Feb 7.  We'll have to wait and see what my counts look like -- they may play with the dosing a bit to avoid any disruption due to low counts. Hopefully, the two weeks off will be enough to rebuild my strength and we'll keep on moving with this current plan.  If not, we'll have to get back on the train and head to the next station.  There are still a few approved drugs/cocktails left to try, but I am really hoping that CMF works well and that it holds the beast at bay for a good long while.

Bright yellow methotrexate

Cytoxan