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!”