Chemotherapy (VCD) – Basics

Information here is taken from various booklets received by me and interpreted in a non-expert way – they should not be taken in any other context than my own – possibly muddle opinions.

Chemotherapy is not a single thing. It is not a static process but a dynamic one which combines different drugs taken over a time period.

Chemotherapy techniques are used to fight a range of cancers including multiple myeloma.

The aims of Chemotherapy

  • Reduce the number of myeloma cells as far as possible
  • Control the myeloma upon it’s return
  • Relieve symptoms
  • Reduce complications
  • Improve life quality
  • Prolong life

There have been advances in the treatment of Myeloma over the past decade and the newer options are offering improvements in all of the areas above. There are always risks involved and these are weighed up against the benefits.

Different pathways follow different routines and may or not involve a rest period between successive Chemotherapy treatments (cycles).

In my case they anticipate 4 cycles with a week gap between each one.

I am on the VCD pathway standing for the three drug combo being used

  • Velcade (aka Bortezibomb)

    • This is a type of drug called a proteasome inhibitor
    • Basically it stops proteins from building up and is highly effective on myeloma cells
      • Proteasomes themselves remove, break down and recycle damaged proteins when the cell no longer needs them.
    • In myeloma these proteins are more common than in normal cells and blocking the action makes them more sensitive to Velcade.
      • Directly kills myeloma cells
      • Alters the chemical signals vital for growth and survival of the myeloma cells
      • Prevents the myeloma from sticking to the bone marrow
  • Blocks the growth of new blood vessels which are needed for oxygen an nutrients.
  • Given as a subcuteaneous injection straight into the tummy.
  • Cyclophosphamide

    • A chemotherapy drug used for a number of different cancers including lymphomas, leukemias, lung cancer and breast cancer as well as myeloma
    • Given by a cancer doctor / nurse following a blood sample to check whether it is OK to administer.
    • Given with an anti-sickness (anti-ematic) treatment
    • Given as tablets and swallowed whole in my case.
    • Highly toxic so should not be handled directly by anyone including me, the patient.
  • Dexamethasone

    • A steroid used as part of the chemotherapy treatment.
      • aka Cortiosteroid
    • Helps with side-effects
    • Natural substance of the body but also man-made
    • Control different functions
      • Immune system
      • Food use
      • Reduce inflammation
    • Taken as tablets – in my case.

They have started me on this quickly to limit the effect on my kidney – if this can be arrested quickly it is more likely my kidney can return to good health – prolonged attack by the myeloma paraproteins would lead to severe damage which would be  more difficult to remedy. Also destroying the myeloma cells will help my bones to slowly repair  and incredibly slow process.

There are as mentioned side – effects which I will leave for a later post.


In a shocking turn of events yesterday a friend of mine, Rachel passed away whilst undergoing similar treatment for Leukaemia in Oxford – in her case it was an infection which got in whilst she was at her lowest immunity levels, she was many months further down the line than I. It was a difficult thing to hear and my heart goes out to all of those affected closely.

Although it is a different disease it was related closely enough to be of concern. I am reassured by the doctors here, that that Myeloma is not so risky – even so RIP Rachel – you fought a brave battle.  

For Andrew, her husband, her teenage children and the rest of her family, God’s Blessing at this very challenging time.



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