19 November 2009

My battle with cancer – part four

In his latest report on his battle with testicular cancer, Jean Meiring encounters one of the nastier side-effects of chemotherapy – hair loss.


In his latest report on his battle with testicular cancer, Jean Meiring encounters one of the nastier side-effects of chemotherapy – hair loss.

On the Wednesday of the third week of chemotherapy, I started moulting. My hair came out, initially in small tufts and later in sizeable clumps, leaving me looking decidedly inelegant. The beard, which my laziness had cultivated, came out as quickly. Even only casually adopting the pose of Rodin’s The Thinker caused an impressive bit of beard to remain in my hand.

When I pulled a bar of soap across my armpits, they too shed hairs. Most of my other body hair was somewhat more resilient; most notably the hair on my arms and legs remained unmoved.

My oncologist would later explain that this was simply the result of the fact that the chemicals used in chemotherapy attack all the fast-growing cells in the body, not only the cancer cells, which are of course also fast-growing.

This shotgun approach means that the hair on many patients’ heads fall out, and they often suffer from nausea, since the cells that line the stomach are fast-growing. Arm and leg hair grows much slower. So too, eyebrow and eyelash hair. (Although I had met a woman suffering from breast cancer whose eyebrows also fell out.)

By the Friday I had lost a significant proportion of the hair on my head, but still passed for normal. Only just, though. I spent the weekend at a friend’s home; on the Friday evening we had a braai. A mate who arrived after dark jokingly asked why I had not lost any hair yet and grabbed at a tuft. When it remained in his hand, he laughed uproariously from sheer embarrassment. I found this rather amusing.

Steadily shedding hair
During the rest of the weekend, I gradually lost more hair. On the Saturday morning I awoke and my entire pillow was covered in wisps of hair. I started wearing a peaked cap to protect me from the blazing February sun and from the stares of all and sundry. By the Sunday my friend’s house was virtually entirely covered with a fine dusting of hair. (I kept apologising.)

On my head remained a thin, patchy coat of whitish blond hair; my hair colour ordinarily is darkish brown. In fact, I looked a bit like a vulture. Marvellous, I thought to myself peering in the mirror.

This layer of short hair proved to be more tenacious than that which had been shed, and on the Wednesday of the fourth week I had it shaved off. And, I emerged a skinhead. Now I only needed a motorbike, leather garb and some attitude …

On the Monday of the fourth week of chemotherapy – or in other words, the first week of the second cycle – I arrived at the oncology unit bright and breezy at 9am. Blood would be drawn to see how I was reacting to the treatment. I was confident that all would be well; I had after all not suffered tremendously from the predicted side effects. Surely I was winning this round.

The oncologist came into the room with the test results a little later, slowly shaking her head.

‘No cause for concern’
“We can’t begin with the second course today,” she said, ominously.

“What is the matter?” I asked.

“Your neutrophils count has not recovered as much as it should.”

“What does this mean? Is this normal? Does it mean that I am not reacting well to the treatment? How long is this delay going to be?” Some of these questions remained unspoken.

She assured me that this was nothing to be concerned about; that it was entirely normal; that the rate at which the count recovered after a barrage of chemo was something entirely personal, and that her decision to structure the courses of chmeotherapy as she had, was at least to some degree based upon an educated guess; and that this was not bad news …”

I was thoroughly unconvinced. She said that I should take the week off and return the following Monday. One would have thought that having a week off – a brief respite from chemotherapy – would prove to be a saving grace. But, increasingly I felt frustrated and depressed.

Going into the oncology unit and doing something about this alien thing inside of me, would have suited me far better. I felt a bit hopeless and helpless. And, I had too much time on my hands to think.

I realised that I had not yet come to terms with what was happening with me. In some ways, ironically, the fact that my prognosis was good had cast me into a no man’s land. I was ill, and seriously so, but at the same time everyone continually assured me of the inevitability of my surviving.

This was a week free from the chore of going to the oncology unit every day, but hardly a holiday. I went in the next Monday – five weeks after the start of the first course – and very nervously awaited the result of the blood test. I thought melodramatically: Would this prove to be more bad news?


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