The Lowdown on MVAC (Part 1)
About 4 and a half months into my diagnosis, I had my first office visit with my oncologist. I met him a few times while I was an inpatient after my radical cystectomy (RC). My treatment plan was to have my RC first, followed by chemo.
Going home for the first time after surgery
Due to the post-op complications, I was bouncing between the hospital and a rehab facility for 2 months before I was discharged home. I took some time to adjust to being home with a urostomy. I wanted to enjoy my birthday 5 days after returning home and Thanksgiving a few days after that. The week after Thanksgiving, I saw my oncologist, got my port, and started chemo.
What is chemo?
Chemo. Short for chemotherapy. The National Cancer Institute defines chemotherapy as a type of cancer treatment that uses drugs to kill cancer cells.1 Chemotherapy uses one or more drugs to kill cancer in your body. I was super lucky - I got 4 drugs in my ultra-special chemo-cocktail. My oncologist told me that it was one of THE strongest combinations that they're allowed to give.
He told me it would be rough and it would knock me down. What he didn't tell me is that it would almost take me out for good! My dad always used to tell me that getting old wasn't for sissies. At this point, I would add: neither is cancer!
My chemo combination was called MVAC
The ultra-special cocktail of my doctor's choice was called MVAC. I still can't remember what it all stands for. I have to look it up every single time. Now, whether it's chemo brain or blocking out the trauma, who knows. I just know I can't remember what it stands for, but I can remember how horrible that time in my life was.
What is MVAC for bladder cancer?
MVAC is methotrexate, vinblastine sulfate, adriamycin, and cisplatin. In my case, all of these lovely things were given to me via infusion into my port.
M - Methotrexate
Methotrexate was developed in the late 1940s and they started using it to treat cancers in the 1950s. Prior to this, cancer treatment was limited to surgery and radiation, which - as I'm sure you can imagine - did not have great survival rates on their own. According to my research on Cancer.gov, the introduction of methotrexate increased cure rates to 80%.2
Methotrexate side effects
Known side effects include blurred or sudden loss of vision, confusion, decreased urination, difficulty breathing or swallowing, difficulty moving, fever, hair loss, headache, hives, impaired speech, itching, joint pain, loss of consciousness, memory loss, muscle pain, reddened eyes, seizures, skin rash, stiff neck, swelling of extremities, swollen gums, vomiting, and weakness.2-3
V - Vinblastine sulfate
Vinblastine was isolated in 1958 from the Madagascar periwinkle. They quickly learned to make it synthetically to yield higher volumes.4
Vinblastine side effects
Known side effects include bone pain, chest pain, chills, constipation, diarrhea, difficulty breathing, dizziness, fever, hair loss, headache, hearing loss, jaw pain, loss of appetite, miscellaneous aches, mouth sores, nausea, neuropathy, seizures, sore throat, stomach pain, unusual bleeding or bruising, unusual tiredness or weakness, vomiting and weight loss.4-5
A - Adriamycin
Adriamycin is also known as doxorubicin hydrochloride. Adriamycin is a brand name. It was in clinical trials through the 1960s. In 1974, it was approved for medical use in the US.6-7
Doxorubicin side effects
Known side effects are diarrhea, difficulty breathing or swallowing, dizziness, eye pain, hair loss, hives, increased thirst, irritated eyes, itching, itchy eyes, loss of appetite, mouth and throat sores, nausea, neuropathy, reddened eyes, seizures, separation of fingernails or toenails from the nail bed, skin rash, stomach pain, unusual tiredness or weakness, vomiting, watery eyes, weight gain, and weight loss.6-7
C - Cisplatin
Cisplatin has been around forever. It was discovered in 1845! They did not start using it medically until the late 1970s though.8
Cisplatin side effects
Known side effects are black or tarry stools, bloody vomit, chest pain or pressure, chills, coffee-ground vomit, dark urine, decreased sweating, diarrhea, difficulty walking, dry mouth, eye pain, feeling an electric shock-like sensation when you bend your neck forward, fever, hair loss, hiccups, injection site issues (burning, pain, redness or swelling), loss of ability to taste food, loss of vision, muscle cramps, nausea, neuropathy, red blood in stools, seizures, signs of dehydration, sore throat, sudden changes in vision (including color vision), unusual bleeding or bruising and vomiting.8-9
That's a lot of side effects!
Combined, that's nearly 70 documented side effects. Of those, at various points, I personally experienced about half of them. I was scheduled for a grueling cycle of 6 rounds. Each round consisted of 2 back-to-back days of treatments. I received each of the cocktail drugs separately in addition to being infused with saline for hydration purposes and anti-nausea and vomiting medications plus Lasix between 2 of the medications. Lasix to keep the drugs from interacting with each other (of all things, right?!)! Each round was 2 weeks apart.
My body handled as much as it could
I actually completed 5 of those 6 rounds. My body, based on the lab results and my doctor's call, could not handle much more. As my doc said, "It's like your body is screaming, "UNCLE!'"Besides, 1 treatment isn't going to make it or break it at this point. If the cancer isn't gone by now, 1 round isn't going to change that."
Have your views towards bladder removal changed since you were diagnosed?