Velcade administration

Because I wrote the last update in a state of sleeplessness, I was bound to miss  a few details, so this is just a quick appendix.

As soon as Velcade was mentioned for treatment, I asked about receiving it subcutaneously, as I’d already heard other people’s experiences and comments with particular regard to peripheral neuropathy. I understand that with subcutaneous injections, this side effect occurs about 50% less than when administered intravenously. Check out this brief article on the Myeloma UK website.

When I had subcutaneous GCSF injections this summer, prior to the stem cell collection, they were virtually painless and so easy my friend could administer them.

In terms of benefits though, the first for me would be not having to be cannulated each time. The difficulty in finding a good vein and successfully and painlessly inserting a cannula keeps being repeated and it gets harder and harder the more the veins are used. It’s not quite so bad when it’s only every four weeks, and now only every eight weeks, for Zometa. But twice a week for two weeks in every three for up to six months really isn’t fun.

Having said that, I was very pleased yesterday that Angie managed to get one in first time without more than a brief twinge of stinging. It was my quickest ever visit to DayCase – in and out in just over an hour!

So of course I asked about subcutaneous administration even before I started the treatment. Sarah told me that other centres are already delivering Velcade subcutaneously and at Nottingham, they had already applied to the licensing authority to do so. They had received a response requesting various pieces of information, which they have provided. She thought the next bit was waiting for Pharmacy to do their bit – maybe receive training or be checked, as making up the dose is slightly different to how they do it for the injection. She didn’t think it would be ready for my first cycle, which it wasn’t, but they do want to deliver it subcutaneously as soon as possible. She assured me that Dr Cathy Williams is keeping any eye on the issue and following it up, so as soon as they can, they will offer it.

Thanks to all of you who read my last post and suggested the subcutaneous option. I have seen the nasty side of painful peripheral neuropathy first-hand when my mum suffered trauma following a back operation. I so want to avoid that.

As a quick aside, I watched The Big C on television last night. It’s the second series about Cathy, a woman with cancer (played by one of my favourite actors, Laura Linney). She is now on a clinical trial, which requires a daily subcutaneous injection into her leg. She doesn’t want her husband to do it as she doesn’t want him to see her as a patient but as his partner, so she is attempting to inject herself but baulking at the act. In strolls stroppy teenager Andrea, their new houseguest (played by Gabourey Sidibe) who used to give her grandma the same type of injections for a dollar a time. She simply whips the needle out of Cathy’s hand and peremptorily does the deed, no anticipation, no stress, no pain, done! with a final quip of “the first one’s free!”

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4 Responses to Velcade administration

  1. Pam smith says:

    Hi jet
    Thank you so much for your blog. Very therapeutic as I am almost in the same situation as you. I was diagnosed in may 2010, CDT followed by SCT this time 2011. Have just heard that para proteins are rising rapidly so likely to start velcade in next couple of weeks. You will know what I mean when I say that the last couple of weeks have been truly awful. Fortunately, all bloods 100% so feel fine, it’s just the pesky para proteins creeping up…….! I love your quote about dancing in the rain – do you mind if I adopt it?


    • Good to hear from you Pam. I hope you respond well to Velcade and I assume, like me, you’ll be heading for an allo SCT after that. Let’s hope they find a 100% match for both of us and that they’re successful. Please stay in touch, let me know how you get on and by all means, adopt anything you like. I have to say, like you sound too, I feel a lot less like dancing in rain or sun or anywhere right now, but making plans for each week off treatment might bring back the wanting to dance…? More on that later. 🙂


  2. Pam says:

    Thanks for your reply Jet. Not sure yet whether another SCT is on the horizon but meeting doc next week to discuss treatments etc. Have spare cells in the freezer (!!) so luckily don’t need an alo. Hmmm, I too have bad cold so certainly don’t feel like dancing anywhere but ……. I know I will want to again as prior to the bad news a couple of weeks ago I felt 100%. Last Sunday was my 1 year SCT anni! Look after yourself while on Velcade – have been doing lots of research on nutrition, e.g. no green tea. Thinking of you. Pam.


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