The First Chemotherapy

As I'm now clear of infections, ailments and other delaying factors, the doctors gave me the all clear to finally go ahead with chemotherapy treatment. It's the first step in returning my insides to normal.

It's a weird one though. This morning, I honestly felt fine. As well as anybody could feel. Then I voluntarily stuck out my arm and received a number of drips. I'm writing this now and feeling a little lousy. And that's it. Chemotherapy is pretty much the treatment of cancer by making you feel worse in order to feel better. It's strange to think about.

Time for a little medical information about the specific chemotherapy drugs. In the case of advanced Hodgkin's lymphoma, it is normal protocol to use what is known as the ABVD combination. It involves four intravenous infusions, back-to-back, with each letter representing a different drug.

Adriamycin - this is a DNA intercalating agent, slipping inside DNA strands to disrupt them.
Bleomycin - this causes irreparable breaks in DNA.
Vinblastine - this helps to prevent mitosis in rapidly dividing cells.
Dacarbazine - this is an alkylating agent, which irreparably damages DNA.

To summarise these, they pretty much screw up cells so they cannot multiply. But this is the exact reason why the drugs will affect me so much. They have very limited ability to target cancer cells and instead attack any cells which they come into contact with. All the side effects, from nausea to hair loss, are caused by the chemotherapy drugs attacking my healthy cells. Of course, once treatment stops, my healthy cells will recover and ideally the cancerous ones will not.

The chemotherapy session was comfortable enough. You can understand that it was never going to be pleasant nor fun, but it really felt like the nursing staff were doing everything they could to make the experiment more pleasant and more fun. Good job they were chatty. I know I am. Let's hope they can put up with my jabber for another fifteen bouts.

The drugs went in, one after the other, and took around five hours. I was well entertained by Mum, Dad, my nurse Holly, the iPad and every single one of you who sent me a message this morning. The process was almost painless, with the exception of Dacarbazine which is a strong irritant. That one stung a little.

Taken 3rd December 2013.

Towards the end of the session, the lunch cart swung round and took my orders. They gave me a packet of custard creams to tide me over. They are my favourite 'crappy' biscuits - please, if you want to give me biscuits in a care package (hint, hint), my favourite 'non-crappy' ones are Borders Ginger. Anyway, lunch was fish and chips with mushy peas. The whole thing was mushy. But more than edible. My highlight of the day came in a large, clear plastic jar. It was red. It was wobbly. It was delicious.

My favourite food forever and ever.
Talking of red, the Adriamycin turns your pee red. Don't let that catch you by surprise!

Next, it's the medicine to take home. Christmas came early here. Well, if Santa were to wear a nurse outfit. Ho ho ho.
Tonight's dinner.
I've been given:
- two types of antiemetic (anti-nausea) drugs, Domperidone and Ondansetron.
- a preventative antiviral, Zovirax.
- a preventative antibiotic, Co-Trimoxazole.
- an absorber drug, Allopurinol, to mop up all of the nasties that are released when a cancer cell is destroyed.

And yes, Domperidone sounds like a particularly fancy brand of champagne. Please add to the care package mentioned above. Ta.

Big step one is now over and I'm well and truly pooped. Nausea is low for the moment but I'm having problems focussing and just generally want to lie down and nap. I'll be back with an update in two days, talking in detail about random things and side effects. Maybe jelly deserves a blog post of its own.

Final note... We've hit 6,000 unique views in just a week! I've already been approached for sponsorship deals and people wanting to fundraise for lymphoma charities. I truly appreciate all of the support everyone is bestowing upon me. You are amazing. I urge you to continue sharing so we can educate and interest as many people as possible.

Joshua Lerner

Hi! I’m the 'star' of Livin' With Lymphoma. The blog was founded on the 31st October 2013, on the day I was diagnosed with Stage 4B Hodgkin's lymphoma. I hope you find it funny and informative.

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  1. good luck with it all, iv chemo is thoroughly unpleasant, I had a treatment called FEC, that also turned my pee red. I am currently taking a tablet form of chemo now, I had two different types of iv chemo, and several hormone tablets, still waiting for the effective treatment, I sincerely hope that it is first time lucky for you :)

  2. I truly admire your courage. You seem like such a truly lovely guy, and I really hope your recovery is as relatively painless as can be. Will be checking up on your progress and sending you good vibes. Hang in there! - Joanna xx

  3. Good luck mate have been there got the hat. t shirt and bald head lol Take every day as it come mate PJ X

  4. Good luck fella hope all is good for your next treatment. Keep strong and kick this illness in the arse. #uralegend

  5. Wow really impressed with this blog Josh. Saw a link shared on fb from all of your fab cousins! Good luck and keep updating. ....I will be following. Lots of love Georgina, Robert and Oliver Selwyn (friends with Claire and Sara) xxxx

  6. Hey Josh - Surprise!?!
    Freya/Belinda has told me about your news. This is just to let you know that I am thinking of you and hope that you give this HL a good kicking - if anyone can, you definitely are the one to do so. Go get em...........
    Chappie X

  7. Hi Joshua - you don’t know me (I’m a friend of Antje Derks who I gather works with your sister).

    Just wanted to give you some words of support having literally just gone through the whole Hodgkins routine myself. I was diagnosed in June (though early stage - 2A). I completed 3 months of chemo at beginning of October - and my PET scan at end of Oct revealed I was all clear.

    I know that everyone’s experience is different, but I can honestly report that in my case, it wasn’t that bad. Other than losing my hair and having to avoid public transport at peak times, life went on pretty much as normal. I was able to carry on working - other than once a fortnight having to go into the hospital to have the chemo drugs pumped into me.

    You are taking pretty much the same side effect tablets as I did - and they did the trick - I had no issues with nausea at all. The only time I got tired was on the 4th day after each chemo session (slump Sunday) when you stop taking some of the pills. You'll probably have to take injections to boost your neutrophil (white cell) count - that does make your bones ache first time - but nurses told me to take paracetomol with injections and that worked a treat.

    Again, I know everyone is different, but all I can say is the overall prognosis for Hodgkin’s is very good - you’ve also got age on your side (I’m 50, so if an old fart like me can get through it relatively painlessly, I’m sure you will too).

    Appreciate that you are 4B - but if I’m not mistaken, Andy Murray’s mate Ross Hutchins was 4B - and he got the all clear after 6 months of chemo.

    Keep thinking positive thoughts. You’ve got an army of people on your side - medically and emotionally - you will get through this - I have no doubt ;)

    Onwards to victory.

  8. Rick, Karen and kids7 December 2013 at 12:59

    Hey Josh - what a great site! I think it's brilliant to de-mystify this stuff and make it real. It helps us to understand what you're going through and relate to your journey, but it also seems to lay things out so it feels more beatable, one chemical step at a time. Your inner strength shines through, and that's got to be a great factor working in your favour. We're thinking of you, Josh, and wishing every day is another day closer to the 'all clear' result. Much love and hugs from the cous's down in Adelaide, (-: