A woman with tears in her eyes looks up through the clouds at rays of light.

Completing Gemcitabine Induction Therapy: Week 6

I haven't cried in years. I mean, I have not had a good gut-wrenching belly-aching cry in a long time. But I have needed it.

I have needed what is known as catharsis - a purifying release of pent-up emotional tension. I haven't only needed to purge from the last two stressful years of the COVID pandemic, compounded by bladder cancer treatment. I was already repressing PTSD from several life-altering events. After a while, tears just didn't flow.

And then today, I felt that old familiar belly ache that precedes an outburst. It happened as Maximus was dying at the end of the movie Gladiator. I only shed a few tears, but I could feel that my catharsis was on its way.

Gemcitabine for a case of recurrent NMIBC

The other day, I had the last of 6 intravesical instillations with gemcitabine to prevent the recurrence of non-muscle invasive malignancy in my bladder.

Why am I not in a state of unspeakable joy? The treatments were extremely tolerable. Apparently, the drug causes milder side effects than the mitomycin I previously received.

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My treatment experience with gemcitabine

Aside from some expected incontinence, the only symptom I felt was fatigue. The nurse described it as "an angry bladder." I had trouble holding any fluids, including chemo. The second treatment went a little better after learning the benefit of not drinking anything before my appointment.

There was no incontinence during the third and fourth treatments. I knew to neither eat nor drink 4 hours before treatment by then. It wasn't easy to refrain from hydration first thing in the morning. I was also concerned about missing breakfast, my first protein-enriched meal of the day.

However, my other systems seemed to handle the fasting well. In fact, I held the chemo perfectly during treatments 3 and 4.

Surprisingly calm

The UW Urology/Seattle Cancer Care ride for week 5 was similar to the first one. Traffic backed up on the interstate, and my bladder released 3 times. Surprisingly, though, my bladder stayed calm through the treatment. I listened to my spirit guide and continued wearing disposable underwear to each appointment.

Some people mark the end of chemotherapy with a ritual or ceremony. And why not? Surviving the most challenging ordeal of their life is worthy of celebration. But for me, it feels anti-climactic since I don't celebrate so easily. On the other hand, I am completely open to someone throwing a party for me.

My last treatment day

I spent my last treatment day listening to inspirational music and texting loved ones. It was a good day until an argument with a neighbor drained my positive energy. It left me feeling exhausted and irritable.

On top of that, I am suffering from chronic complex mouth sores and oral thrush. It hurts to move my mouth sometimes, let alone eat. My urologist oncologist doesn't believe they are related to intravesical chemotherapy. Nor does she attribute them to the aftereffects of my shingles outbreak. Meanwhile, I am getting no relief from home remedies and OTC anti-inflammatory medications. An appointment with my primary care physician is now on my to-do list.

Feeling a lot after this recent recurrence

Since I have had "the easy cancer," I have been able to keep working during treatments. I haven't been nauseous, nor have I lost my hair. Some bladder irritation is necessary to indicate that the chemo is working. However, it has been milder than it was years ago with mitomycin. My worst side effect has been sleeping more than usual. And yet, it is reasonable to start feeling stronger effects toward the end of treatment.

Today, I didn't feel like myself. My mouth hurt. I felt irritable. So, I left work early, went home, and napped for a bit. I started writing as the movie Gladiator streamed on TV. Sometimes I struggle to pull my thoughts together. But the storyline of an enslaved warrior inspired me to put some words down.

It further reminded me that after the last 10 years, and especially more recent events, I am overdue for a great big ugly cry. Maybe I am due more than one.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The BladderCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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