The Taooftash July brings Lapatinib

Lapatinib is massive, these is a true to life image

Chemo: Cycle One, Week One;

In the run up to Tuesday morning I could tell that Tash was getting increasingly apprehensive about the start of the new Chemo regime, understandably this apprehension worked on many levels, not least the most obvious, 'why do I have to put myself through this'.

The NHS put on another display of their usual incompetence, on Monday Tash commented on the fantastic abilities of the dispensing pharmacy at the hospital; they would only make up your prescription while you were present, thus, after she took her ticket, another 60 minutes of her life was eaten up as she sat and waited for her number to appear on the display on the wall, along with a significant number of patients who had just come down from the chemotherapy ward.

You'll of course appreciate that sitting around on an uncomfortable plastic chair for an hour is the only thing you'd want to be doing after being pumped full of the most toxic drugs the human body can withstand.

So we got over that one...

Chemo Diary

Day One:

The day started as I said earlier with a reasonable level of anxiousness and apprehension, fortunately this gave way as the day went on to, .....well not much really, which is as good as we could ever have wanted.

Day Two:

Pete and Lucy were over from Spain this week, they came over to us on Wednesday for a social. Mid way through the evening Tash confided to me that she had experienced feeling a tingly sensation in her fingers, a sign of the drugs at work, though, she then commented, it could equally have been to do with the way she was leaning on her arm. With that the girl finished her wine and we laughed. The Dean's don't stop for no man, least of all chemotherapy (that is until it flexes it's muscles, shows us it's real power and we listen).

Day Three:

Unfortunately there was some mild nausea today, "it took me over an hour to eat my lunch" Tash said in the evening, not particularly an odd comment if you are a Mediterranean, but in the London desk-bound, time poor, office lifestyle this is an unusual turn of events.

drugs that I stick up my nose Regime menu

8.00am - 5 x 250mg Lapatinib tablets, on an empty stomach.
9.00am - 6 x Capecitabine tablets, (3 x 500mg + 3 x 150mg) with food.
9.00pm - 6 x Capecitabine tablets, (12 hrs after am dose) with food.

The Pill

This Lapatinib tablet, the height of desirability in pharmacy circles, no doubt, are a little on the orange side and boy, they are big. I did initially wonder which end they were supposed to go in until Tash commented that she had to take 5 of them each morning.

The chemo tablets are best described as "a more convenient size".

Chemotherapy, Capecitabine

As I mentioned earlier Lucy and Pete stayed with us on Wednesday, I thought that I would repeat the explanation I gave them here.

Chemo is best described as 'an old school' drug, whereas Herceptin and now Lapatnib are part of the new breed of cancer treatments who work their way through the body greeting all the cells they meet with "Hello old chap, I see by the cut of your jib that you're one of those cancer cells, fancy a hug" (and thereby covering the cell and preventing it from further multiplying).

Chemotherapy drugs on the other hand are from an earlier time and are not as sophisticated.They are more thugish in their outlook preferring to charge through your system screaming "CANCER CELLS GROW FAST, KILL ALL FAST GROWING CELLS!!"....

Then you feel like shit and your hair falls out......

This chemo has been described to us as being 'well tolerated'. No doubt this is the reason for it being allowed out of the Chemo wards, the packaging doesn't even carry the usual "DANGER CYTO-TOXIC CHEMICALS - STAY 500 METERS AWAY UNLESS YOU HAVE CANCER" sticker that was always visible as the thickly gloved nurse connected the bag of Taxol up on the intravenous drip stand. Oh hold on, it does, just smaller, so that is OK.

We are not expecting Tash to lose much, if any, hair this time, due to the fact that the drug is administered daily over a two week period, rather than dumped into her arm in one session. You can experience how this feels by performing this handy experiment.

1. Lick two fingers and hold a small AA battery, creating a circuit between them, there is 9 volts flowing through you, this is what the Capcitabine feels like,

2. Now take a little square PP3 battery (it is small, square and not the really big one with coils on top, you'll regret it if you use one of those) and put it on your tongue. That's what Taxol is like.

Admittedly this highly accurate experiment is only going to be successful if you don't try to make the circuit using your tongue on the AA battery as well.

Kind regards, M&T

More next week

Previously this month.....

The prize, a tin of Vitale Pomodri Pelati tomatoes, for last months "spot the error" competition is going to Mrs Dean of inner London who wrote in and correctly spotted that in the last post I confused my measurements when discussing the size of the largest tumours in Tash's Liver. The big boys are in fact about 5cm and not 5mm. Obviously a bit of a worry for some of you, but you'll just have to follow our lead, this isn't bad, winning the lottery would of course be better, but for now we are focusing on the next couple of weeks.

The continuing tao of treatment

The trial Oncologist eventually appeared back on the radar, but it took a lot of effort on the part of Natasha and "The Slev's" secretary Lesley to get his attention. Tash is keen that you understand the timetable for the next couple of weeks, and hopefully months.

Before the trial can start there has to be a set of baseline scans, a bone scan and a heart scan. These are going to happen during the next week.

On Friday (20th) Tash has an appointment with DR.ONCO.II, this should be a quick chat reviewing the scan results and then off to the pharmacy to collect her new drug stash.

Tash relayed the story of what she had to do to arrange the scans,

"Knowing how useless they had been in booking the previous appointment (the confirmation letter turned up the day after, confirming an appointment with an entirely different doctor in a separate department) I phoned Dr Gallagher's secretary, who gave me the option to have the scans next week, both appointments right in the middle of the day" (you also remember gentle reader, that as Tash works alternate early late shifts, that she can usually fit in these appointments without having to take time off work).

"is there anything more convenient, both on the same day perhaps?" Tash said she asked the increasingly unhelpful secretary,

"mid August" came the reply.

So providing Tash doesn't find herself in the Colorectal department instead on Friday, Tash's new medicine cabinet will contain the following tablets:

Capecitabine Chemotherapy, 2 weeks on, one week off, read the side affects section please.

Daily Lapatinib tablets. These are replacing Tash's old Herceptin treatment regime. These tablets are what the fuss is all about.

Our expectations for the trail are simple,

Good: The tumours respond to the new drug and shrink to a more manageable size.
Medium-good: They shrink a bit, but not too much, then that is good too.
Medium: They don't shrink at all, but we see no new growths or worsening of her condition at the next set of scans, i.e., the drug simply stabilises her condition at this time.
Bad: The drug has no effect and off we go on "The Slev's" plan B, which he has assured us he has.

We won't know where we are until more than 6 weeks into this regime, so bare with us. It is important you appreciate that this treatment though experimental, which means that we don't know how long it's good effects will last for, is still on the preventative side of cancer treatment. This is a good thing.

You can help Tash in these next few months by remembering that, though the treatment contains a well tolerated chemotherapy, it is still chemotherapy. So please Mr Vic and others, no late night drinking sessions and Mr Doherty, she has her own drugs, so doesn't need any of yours.

Your lecture is over and now as way of light relief, this is what we have been up to this month.

Tash has a knitting club at work now, she set it up and is fast becoming fully accepted into the wider London knitting clique. For those of you that don't know, knitting is the new Pete Doherty... oh hold on, maybe it is the other way around, hard to tell these days, every time I go to use the computer, where as previously the web pages would always be stuck on the "Spirit of Albion" or some other such romantically titled lovefest to the drug taking, prison dodger, now there is an equal change that I am greeted by a large picture of a set of knitting needles.

She was at one such meet recently, the story goes that Tash sat down next to one girl who was 'beavering' away on some massive pink number, that Tash says, looked like no normal woolen project, when one of the other girls present challenged Natasha to ask what this industrious wool maker was knitting ( suspect it was a form of initiation), she got the answer,

"a vagina"

"ohh OK" was apparently Natasha's nonchalant answer. This wooly item was to be a piece of headgear worn in some performance theatre production destined for the Edinburgh festival (one imagines it will have some relevance to 'woman's issues', or will just be a very rude prop in a version of Agatha Christie's, Murder on the Orient express), the next thing this pornographic Knitter started, using only brown wool, got the liberal knitting circle worried, "it's a piece of poo" the girl replied when asked, following the statement up with, "only joking, really it's an ipod cover"

So there you are, knitting is the new rock and roll.

Speaking of which, guess who finally got to meet the drugtakingsupermodelshaggingbadguitarplayingidiot at his book signing, well I say book, picture book possibly, even then he has already admitted that not all of the pages were authored by him (I use the term loosely, drawn may be closer to the mark here), it was in colour, so I can't go as far as to use the phrase "colouring book" but, well hmmm, not really a Grande Prose.

Birthday Girl

Tash was 33 last Monday and foregoing a large amount of the first stage of the Tour de France, I also joined her in Southwark park along with most of the London posse and Michelle (supporting the home counties and Essex) for an afternoon picnic. I took her to Locanda Locatelli for lunch on Monday, her favourite restaurant and favourite Italian lust object, as far as I can tell, followed by a somewhat abortive attempt to stay out all afternoon drinking around the West End. We were home by four, neither of us fitting well into our dressed up clothes had to change and then went over to the pub to see out the evening together.

Anniversary

Not that it should be that important to you, but we have been together 10 years this Thursday. I don't think that there are any cards in the shops to celebrate this "congratulations on putting up with each other for so long" or maybe "Best wishes on your extended sentence".

...and oh yes, we have had a make over, hope you like it.

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