Chemotherapy is evil stuff. It’s a necessary evil, as the saying goes, but whatever kind you’re given it is, at heart, a poison. It works by flooding one’s system and hammering on everything you’ve got, cancer cells and good cells alike. Cancer cells are fast growing (which is the basis of what makes them a problem) so, like weeds, they are more vulnerable to poisons than slower-growing cells. The chemo doses are carefully tailored so you’re given enough to knock your normal cells down but not actually ‘out’ – but any fast-growing cells suffer more seriously. Aptosis, or cell death, of the cancer cells is the aim.

Unfortunately it’s not just cancer cells that are fast growers. The hair follicles in your scalp and the lining of your stomach are two things that are also fast growing, which is why chemotherapy so often makes people lose their hair. (Although annoyingly not from legs or chins; that hair doesn’t grown quite as fast.) It’s also why stomach upsets are common; lose some of your stomach lining and you’ll suffer from significant nausea, abdominal discomfort and sickness.

Another negative effect is on the bone marrow that produces the white blood cells that fight infections; that’s also the kind of cell that grows quickly. After a few chemo sessions your white blood cell count is likely to be low. If it’s lower than a certain point you may need drugs to boost production of these cells. If it’s worryingly low you may have your chemo postponed for a week or two while you recover.

More worryingly, a low white blood cell (WBC) count means you are at risk of infection. I don’t mean you’ll just catch a cold or that a cut will get a bit inflamed, I mean you’re at serious risk of developing neutropenic sepsis. That can happen really quickly – in a matter of hours – and can be fatal if not dealt with promptly. Seriously, this is ‘Do Not Mess Around’ stuff.

In September I caught something from somebody (see Sepsis!). It was probably just a cold virus or something similar, but I went from feeling a bit shivery and weak to being a priority admission in the emergency room. Yep, in a matter of hours. Not good. Nor was the pulmonary emboli caused by lying in bed essentially motionless for two days.

I’m now much more careful. But oh man, you wouldn’t believe quite how sick you feel when you have sepsis. Wow.

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