【Journey 07】mFOLFIRINOX therapy and side effects

Hello, I’m Chico.

In my previous article, I wrote about my emotional journey of accepting my illness.

In this issue, I will talk about the first treatment with anticancer drugs, the side effects after that, and the effects of anticancer drugs.

Anticancer drug treatment begins

Hospitalized from March 11, 2019, the cancer treatment has finally started.

mFOLFIRINOX therapy

The treatment I received was mFOLFIRINOX therapy.

This treatment consists of three types of anticancer drugs plus one type of potentiator.

The above 4 medicines will be administered by drip for 3 days.

Hospital stay is not my thing

The first dose of chemotherapy required hospitalization due to the need for follow-up.

This is the third hospitalization in my life.

By the way, the 1st and 2nd time was hospitalized for cancer inspection.

And this time, I was finally hospitalized for the administration of anticancer drugs.

I really hate being in the hospital.

I can’t sleep at night, and during the day I feel out of place because I don’t feel sick.

Woman who became a friend while in the hospital

M, who was in the same room as me, relieved my tension.

She had the same pancreatic cancer and was close in age.

So we often enjoyed eating and chatting at a hospital cafe.

She always encouraged me with those words.

We talked and shared our dreams for the future, recalling the ups and downs we’ve experienced along the way.

After M invited me, we promised to go to a fireworks display together this summer.

Fear and nervousness in facing my first chemotherapy treatment

Despite the festive atmosphere at the hospital, a Intimidating challenge awaited me.

The time had come for my chemotherapy.

Two nurses in protective suits came up to me.

Seeing such fully-protected nurses makes me even more nervous and fearful…

Dok, dok, dok…

My heart beats faster and I feel like my heart is about to explode.

Despite my extreme nervousness, the nurses proceeded with the work skillfully.

No kidding, that’s my heart’s scream…

After the first hour or so of taking the anticancer drug, my heart was pounding like crazy.

But then I started feeling better as I realized my body wasn’t freaking out or anything.

Discharge from hospital and relief

After successfully completing the first round of anticancer drug treatment despite the difficult journey, it was finally time to leave the hospital.

Before departing, I said goodbye to M, who had become a close friend during my stay.

After successfully completing my first round of anticancer treatment, I felt relieved and refreshed as I returned from the hospital.

On the way home, we took a leisurely stroll through the pedestrian mall in Ginza, enjoyed a relaxing walk in the Hamarikyu Gardens, and eventually made our way back home.

Side effects appear

After finishing my first round of inpatient treatment, my second round of chemotherapy was done through outpatient treatment where I visited the hospital for treatment.

Treatment was interrupted due to leukopenia

The mFOLFIRINOX treatment is administered in two-week cycles.

In my case, the first treatment was on March 12th, 2019, so the next one would be scheduled for March 27th.

March 27th

When I arrived at the hospital at 8:30 am on March 27th, the first thing was to undergo a blood test.

I had to wait for about an hour and a half for the test results and to see the attending physician.

On that day, the value of one of the white blood cells, neutrophils, had dropped below the administration criteria of 1500/μl to 1410/μl.

Although I encountered setbacks right from the start and felt anxious, it was decided that I would try again in two days, on March 29th.

March 29th

But guess what!?

・・・

Once again today, my neutrophil count was below the standard level and I had to withdraw from treatment.

I took a three-day break and made a third attempt on April 1st.

April 1st

Unfortunately, my neutrophil count was once again below the standard level, and what’s more, the value had dropped below 1000, which increases the risk of infection.

To raise my depleted neutrophil count, I received a G-CSF injection and was scheduled for another checkup two days later .

And then, two days later on April 3rd arrived.

April 3rd

Thanks to the G-CSF injection, my neutrophil count had dramatically increased.

Finally, I was able to undergo my second round of FOLFIRINOX treatment!

Applause, please 🙂

Three postponements due to bone marrow suppression

Wow…

Can you believe it? My second round of chemotherapy was postponed three times due to bone marrow suppression.

It took four attempts to finally receive the treatment.

So, the second round of chemotherapy happened on the 23rd day since my first treatment, even though it was supposed to be administered every 14 days.

FOLFIRINOX is really something…

Side effects one after another

Every medication comes with side effects, and the same applies to the FOLFIRINOX therapy, which has many potential side effects.

FOLFIRINOX’s side effects

Generally speaking, FOLFIRINOX’s side effects can be divided into two categories: those that are not noticeable and those that are noticeable.

The occurrence of these symptoms varies depending on the patient’s constitution, physical strength, time from administration, and number of administrations.

Side effects I experienced

As for my case, the major side effect I experienced was bone marrow suppression.

When the bone marrow, the tissue that produces blood components, is damaged, the number of white blood cells and neutrophils decreases, as in my case. If the essential white blood cells that protect the body are low, chemotherapy must be discontinued.

Although I experienced side effects that had no noticeable symptoms, such as bone marrow suppression and reduced liver function, immediately, during the first administration, the side effects that were noticeable, such as nausea, numbness, and fatigue, were not severe.

However, with each subsequent administration, they became more severe.

I also experienced some surprising changes in my body.

During pollen season, while wearing a mask and walking outside, I developed a rash and was suddenly overcome with intense itching.

Hives aren’t the only thing that can strike suddenly.

I would sometimes feel dizzy or fatigued, and my condition would suddenly worsen.

That made it impossible to go out alone.

At home, I found that I could no longer wash dishes or do other household chores.

When my hands came into contact with water, they would become cold and numb, and I would drop dishes.

Eventually, we had to buy a dishwasher.

And then, there was hair loss – the side effect that many people associate with chemotherapy.

My hair began to fall out spectacularly about a month after starting treatment.

In the shower, my hair would fall out in clumps and get tangled around my fingers.

For me, there was not such a dramatic scene where I wept over my lost hair like in the movies.

Rather, I just had to focus on constantly cleaning up the hair that was scattered all over my house, while I couldn’t help but smile at my comical appearance in the mirror, where I was losing my hair.

I will summarize the side effects and coping strategies in a separate article.

The moment I thought my breathing would stop…

One of the toughest side effects I experienced at the time was fatigue.

An unprecedented exhaustion that I had never felt before.

One day, I was lying on my bed and couldn’t move my body, and even breathing became difficult.

My consciousness drifted away, and my breathing became shallow…

I felt like I was about to go to my deceased mother and asked her,

Then, suddenly

It felt like my mother had appeared for a split second.

And the next moment, my breath returned, my body felt lighter, and I could move again!

Of course, it might have been my imagination or a coincidence.

But for me, it was a wonderful moment where I felt very close to my late mother.

Lessons learned during this period – Que sera sera, What will be, will be

During my time undergoing the FOLFIRINOX therapy, I was so consumed with battling the side effects that I honestly wasn’t in a state to learn anything.

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Before falling ill, if I felt unwell, I would make efforts to improve my physical condition. However, the physical distress caused by chemotherapy was too much for me to handle, and I eventually resigned myself to the fact that there was little I could do to help myself.

My mindset became “Que sera sera” – whatever will be, will be.

So, I decided to talk to my mother who had passed away and asked her, “Will I be joining you soon?”

And then, all of a sudden, my body started responding.

◇　　◇　　◇　

In reality, I don’t know why my condition improved so suddenly. However, I feel like my decision to accept that “whatever will be, will be” may have had an impact on my body.

Conclusion

In this post, I talked about chemotherapy treatment and its side effects.

Next time, I will talk about life during the treatment.