After a long wait, a change of country, one surgical procedure and a lot of pain, next week I’ll start the induction chemotherapy. The target of this stage is to reduce the tumor’s size, to cut its head off in another surgical procedure. It will be the first cycle of 6. Each one lasts 3 weeks, so in total this chemotherapy will last 18 weeks.
The drugs I’ll have are called VIDE:
- V – Vincristine
- I – Ifosfamide
- D – Doxorubicin
- E – Etoposide
In addition to these, I’ll also have some others in the cocktail, since I’ve always loved long drinks. Thereby, during three consecutive days I’ll be hospitalized at Duran i Reynals hospital (CIO – Catalan Institute of Oncology), since every session lasts 12 hours. Once finished these 3 sessions I will be able to go back home and rest to recover. The next cycle will start in 3 weeks, and so on.
Here I have a list of side effects. I may have a few of them. They may be mild or more severe. A side effect may get better or worse through my course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times I’ve had the drug before
- My general health
- The amount of the drug I have (the dose)
I will prepare a check-list in order to let you know which ones I have and which ones not, but this will take some time, as you may know.
Common side effects
More than 10 in every 100 people have one or more of the side effects listed below:
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and I can become very ill. I may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or I may feel cold and shivery. In any case, if I get a fever over 38ºC, I’ll have to go directly to emergencies.
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – I may need a blood transfusion.
- Bruising more easily due to a drop in platelets – I may have nosebleeds, or bleeding gums after brushing my teeth.
- Hair loss
- A drop in blood pressure can happen if etoposide is given too quickly
- Sensitivity to sunlight. I should protect my skin with sun screen, hats and sunglasses.
- Irritation of the bladder and kidneys – I should drink as much water as possible to flush out the ifosfamide
- Changes in nails
- Severe constipation with abdominal pain occurs in 1 in 3 people (30%). Vincristine can temporarily stop the normal waves of contraction that go through the gut, causing sickness, a swollen abdomen, and cramps.
- Loss of fertility. This is why I had to cryopreserve my sperm
- Confusion, sleepiness or extreme lack of energy (lethargy) and hallucinations occur in about one person in 8 (12%).
- Numbness or tingling in fingers and toes affects between 1 and 2 out of every 10 people (10 to 20%).
Occasional side effects
Between 1 and 10 in every 100 people have one or more of the side effects listed below:
- Temporary taste changes
- Loss of appetite
- Jaw pain, caused by vincristine affecting my nerves
- Fevers and chills
- A skin rash, which may be itchy
- My skin may temporarily become darker with ifosfamide
- An allergic reaction occurs in 3 people in 100 (3%) who have etoposide – I may have a sudden rash of pink, itchy bumps on your skin and a reddening of the skin along the veins
- Damage to heart muscle can occur, which is usually temporary but for a small number of people may be permanent. My doctor will check my heart before, during and after the treatment
Rare side effects
There is a small risk that I may get a second cancer some years after VIDE treatment.