The Next Line: Preparing For Your New Cancer Treatment
Last updated: November 2022
Even the most seasoned cancer patient may feel anxious when it is time for "the next line" of their cancer treatment.
New treatment after cancer progression
When one starts their next line, it typically means they have had progression - meaning growth or spread - of their cancer. In the world of metastatic disease, since there is no cure treatments are what keep us alive. Some people with certain subtypes have "easier" treatments, such as oral chemotherapy they can take from home. This is sometimes called, "soft chemo", and often the side effects are easier to manage, and require less preparation.
Others have "harder treatments", such as IV chemotherapy, which requires full days at the hospital several times per month. This is often called, "hard chemo", and the side effects can be more intense, requiring more preparations to make the treatment as easy and comfortable as possible.
Whatever your subtype and treatment, there are a finite number of options available "on the line". Aside from the anxiety that may be caused by knowing you have progression, and one less treatment available to you on your line, it is common to face new treatment and its side effects with trepidation.
Preparing for your new treatment is crucial!
When I had severe progression last year, it was a whirlwind starting my new treatment, two IV chemotherapies for triple-negative breast cancer called Carboplatin and Gemzar (nicknamed, ''Carbo and Gem'').
Carbo and Gem were the ultimate tag team, and quickly obliterated my new "meets", but it came at a huge cost in terms of side effects. I found myself violently vomiting after treatment, incredibly weak, and barely able to function at my full-time job. It was also overwhelming to manage the schedules of my three young children by myself. After some major life changes, such as retiring from my career, being a stay at home mom, and working freelance from home, I was able to adjust to my new treatment.
Preparing for potential treatment side effects
Fast forward one year later and I have once again had progression, this time slight, and am moving onto the next treatment on my line, chemotherapy called Abraxane, and immunotherapy called Tecentriq. In order to prepare, I made sure I understood the side effects and what I would need to do to manage them.
A lot of chemotherapy causes hair loss, and I decided that after losing my hair once I did not want to lose it again. I plan to utilize the Dignicap machine at my cancer center to "cold cap". This will keep as much hair from falling out as possible, but also requires me to do a number of things. These include purchasing the cold cap, and arranging child care so I can be at the cancer center at 6:30 am. I am also purchasing an electric blanket to keep warm during the infusion, and dry or baby shampoo to wash my hair.
In the past, when I lost my hair, I prepared by purchasing a wig, satin pillowcases, and headscarves. A lot of people choose to microblade their eyebrows before starting treatment.
Aches and pains
Other common side effects include muscle and joint pain, as well as neuropathy. I know from past experience with chemotherapy that massage helps relieve these side effects for me. Since I have one week off of treatment a month, I have decided to make that my massage therapy day, and have found a great deal on packages at my local Thai Massage Center.
Fatigue is common and often lingers. Rather than becoming overwhelmed, I looked at what makes me the most tired and make a plan. Like most people, housework for me can be endless and overwhelming, so I decided to enlist monthly house cleaning services. Cleaning For A Reason offers bi-annual cleaning for free to cancer patients in participating areas, and many cancer centers offer financial grants to help with household services and bills during your treatment.
Nausea and vomiting
Nausea can be overwhelming in the days after treatment, and since my treatment will be on Fridays over the course of four months I am arranging a Meal Train. This is so I can ensure my family and I are fed without the worry of cooking after a long day at the hospital.
We never know if we will be vomiting after treatment, but it is best to be prepared, just in case. I have certain comforting "go-to's", such as ginger ale, sparkling water, crackers, and pretzels stockpiled in my pantry.
It is also a good idea to refill any prescription meds, especially the anti-nausea ones.
Taking care of the children
For people who have young children, I highly recommend having someone on standby to help. Even if it's just taking them out to the park, it is good to know you have the ability to rest when needed. I have just relocated but explained my situation to my new neighbors who invited my kids to play with theirs when I need a break. Win!
In addition, I am stocking up on easy things to keep my children entertained. This includes new crafting supplies, play balls, kinetic sand, playdough, and movies. It is easy to forget that when we have cancer, our whole family has cancer, too, and our kids might need a little extra love, attention...and surprises!
In terms of my house, I am wrapping up any major chores and making sure I have all of the things we need. (Is my family the only one who mysteriously runs out of spoons, coffee mugs, socks? Where do they all go, anyway?). I have also signed up for online grocery delivery and have been doubling my recipes-freezing meals to have ready for when I am too tired or nauseated to cook. My objective after treatment is to rest and conserve my energy for doing things I love; not necessarily assembling flat-pack Ikea furniture or making a Costco run!
If you don't have anyone around to help you, reach out to your oncology social worker. They can provide whatever resources they have available to make your treatment easier. Even friends and family who cannot help in person might be able to help. They can top this by contributing to your Meal Train, purchasing needed items from an Amazon Wish List, or covering the cost of a house cleaning or massage therapy session. Most people want to help and just don't know how, so don't be shy about asking for what you really need!
Transitioning on to a new treatment
Starting new treatment can be daunting and scary, even for the most seasoned cancer patient. But with some preparation, the transition can be a smooth one! The most important thing is staying well and taking care of yourself, so do whatever you need to do to make that happen. Our bodies and minds go through a lot during treatment!
Editor’s Note: We are extremely saddened to share that on Friday, October 29, 2021, Danielle Thurston passed away. We know that Danielle’s voice and perspective continue to reach so many. She will be deeply missed.
Advanced breast cancer is an isolating and lonely disease.