Chapter 4
Decisions, Data & The Hair Thing
Oncotype DX
The type of cancer I had meant I was eligible for a specific test to help decide whether chemotherapy would be beneficial.
After surgery, a small sample of my lump was sent to the USA for an Oncotype DX test. Because I was under 50 years old, the threshold for avoiding chemo was a score under 16.
My result?
38.
So that was that.
Time to meet my oncologist.
First Meeting
On 27th February, my wound had healed enough for the next big step - sitting down with my oncologist.
She was another amazing woman added to the list of incredible professionals who had cared for me so far. Easy to talk to, patient, and happy to explain everything in detail. She loved numbers and statistics - just like me.
- I liked her instantly.
She walked us through the Oncotype DX results and said chemotherapy would reduce my 10-year recurrence risk from 26% to 15%.
- That 11% difference made it a no-brainer.
The treatment plan was clear:
➡️ Chemotherapy, followed by
➡️ Radiotherapy
I’d already prepared myself for both. It had been mentioned early on, and I was mentally ready.
She explained the proposed chemotherapy drugs. Two different medications.
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The first would be administered once every three weeks for three cycles.
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The second would start immediately after, for another three cycles.
In total:
6 cycles of chemo.
Three of each drug.
We set the start date:
22nd March 2023.
Hopefully finishing before the kids broke up for the summer holidays.
It was time to go home and read the leaflets.
The Door To Chemotherapy
The Chemo Drugs
The two most commonly used chemotherapy drugs for breast cancer are:
Epirubicin / Cyclophosphamide (EC)
A combination given intravenously.
Side effects included:
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Red urine (right after administration)
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Fatigue
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Nausea
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Hot flushes
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Hair loss
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Weird taste changes
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Achy bones
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Lowered immune system
…and more.
I was given a leaflet listing every possible one.
Docetaxel (Taxotere)
Also given intravenously.
Side effects included:
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Bone pain
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Awful taste
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Skin drying and cracking
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Hair loss
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Nerve issues in fingers and toes
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Nails falling off
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Lowered immune system
…and more.
I was given a leaflet listing every possible one.
24 Hours Later
The first day after my appointment, the emotions hit.
I asked myself a lot of questions:
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Will chemo help stop my cancer coming back?
Yes.
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Do I want it?
No... but yes. If it reduces the chance of recurrence.
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What will the side effects be?
Grim, more than likely. But I’m OK with short-term grimness for long-term peace of mind.
And the biggest question of all…
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Am I OK about losing my hair?
No - but also, yes.
Another Day... Another Waiting Room!
Brilliant Book!
Hair Loss
I made the decision not to use the cold cap to try and preserve my hair.
I’d done my research.
- For me, this was one thing I could control.
Cancer had taken over so much already - I wanted to decide what happened to my hair.
I didn’t want cancer choosing which hairs I got to keep. This was something I could own. Something I could say yes or no to.
That mattered.
I had no doubt that I’d be devastated when the hair started falling out. I already had hats sitting in my online shopping basket, and I was looking into “hats with hair” - a tip from a brilliant book I was reading.
Next up on the to-do list:
- Wigs.