Alright team, let’s talk about the chemo crew. When your child is diagnosed with ALL (Acute Lymphoblastic Leukaemia), it’s like your body is about to play the biggest match of its life, and the chemo drugs are your players – each with their own special skills.

Some are small and sneaky, others come in like bulldozers. Some play rough (and leave bruises), others quietly support from the bench. It’s a huge squad, and knowing who’s who, what they do, and how they might affect your child, can make a world of difference.

It’s scary, overwhelming, and full of weird names that sound like spells from Harry Potter – but we’ll give them rugby nicknames to help make sense of it all. Because when you can talk about it, you can tackle it.

Let’s break it down for the young players, the parents, and the sideline squad.

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🏉 The Big Hitters: The First-Team Chemo Crew

Dexamethasone – “The Hulk” 💢

This one turns your child into a hangry, roid-raged beast. Seriously, Dexamethasone is a powerful steroid. It fights inflammation but also messes with mood, sleep, hunger… everything.
Watch out for: Mood swings, mega appetite, emotional storms.
📝 Tip: Keep snacks handy and go easy on them—they’re not themselves when Hulk mode hits.

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Vincristine – “The Twister” 🌪️

Vincristine goes in fast and disrupts cell growth. In Sammy’s case, it was one of the early causes of hair loss – a rough side effect that hit early.
Watch out for: Hair loss, numbness, balance issues, constipation.
📝 Tip: Stretching, gentle movement, and Senokot (more on that later).

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PEG-Asparaginase – “The Asparagus” 🥦

This one’s scary-looking – it’s a massive injection (or two) into the thigh(s). But it’s a key player that cuts off the leukaemia’s food supply.
Watch out for: Reactions like fever, pain, or tiredness.
📝 Tip: Brave face time. Give lots of cuddles and a “you smashed it” sticker after.

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IT MTX (Intrathecal Methotrexate) – “Brain Coach” 🧠

This one goes straight into the spine during a lumbar puncture. It’s like the team doctor checking the game plan for the brain.
Watch out for: Headaches, tiredness, sore back.
📝 Tip: Plan an easy rest day after. Don’t pack in too much.

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6-Mercaptopurine – “Captain Night-Time” 🌙

This one’s taken at bedtime, and it’s quiet but strong. Helps stop leukaemia cells from coming back.
Watch out for: Tummy pain, low blood counts, feeling sick.
📝 Tip: Take on an empty tummy, and keep a routine—it helps.

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Cytarabine – “The Sprinter” 🏃

In Sammy’s case, this one’s delivered via the wigglies (central line). It hits fast, attacking fast-dividing cells.
Watch out for: Fever, rash, tiredness.
📝 Tip: Make sure the area is cleaned well and rest up.

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Cyclophosphamide – “The Tank” 💥

This chemo means business. Heavy-duty stuff, used when it’s time to throw everything at the opponent.
Watch out for: Nausea, bladder irritation, tiredness.
📝 Tip: LOTS of water afterwards to protect the bladder. In Sammy’s case, the hair loss came earlier from Vincristine and MTX – but this one can hit harder later.

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HD-MTX (High Dose Methotrexate) – “The Strategist” 📈

Given in hospital with fluid support. Needs close blood monitoring.
Watch out for: Mouth sores, liver strain, tiredness.
📝 Tip: Mouthwashes and oral care every day.

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Doxorubicin – “The Red Rocket” 🚀

This one’s BRIGHT RED. It gets in fast and hits hard.
Watch out for: Red wee (don’t panic!), tiredness.
📝 Tip: Let kids know the colour change is normal—it freaks out adults too.

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🩺 The Side Squad: The Support Crew

Amlodipine – “The Pressure Coach” 🩸

Keeps steroid-induced high blood pressure in check.
Watch out for: Dizziness, headaches.
📝 Tip: Chill after taking it.

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Co-Trimoxazole – “Bug Blocker” 🛡️

Fights off infections like pneumonia when neutrophils are low.
Watch out for tummy upset and rashes.
📝 Tip: Even when your kid seems fine, don’t skip this one.

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Ondansetron – “The Nausea Ref” 🤢

Prevents sickness during chemo.
Watch out for: Constipation.
📝 Tip: Give 30 mins before chemo for best results.

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Senokot & Laxatives – “The Movers” 🚽

Steroids and Vincristine can block things up. These get things going again.
📝 Tip: Stay ahead of the problem, not behind it!

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Lansoprazole – “The Gut Defender” 🛡️

Helps prevent stomach damage from all the meds.
📝 Tip: Take on an empty stomach first thing in the morning.

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Other meds

Antibiotics, antihistamines, pain relief, creams for sore skin, and other stomach stuff… the list gets long. But every med has a purpose – even the unsung heroes.

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🎯 The Wigglies – The Secret Weapon

Your child might feel like a pin cushion, but those tubes are absolute game-changers. No endless needles, no repeat pokes. Sammy’s Hickman line is his tunnel to treatment – and it’s treated like gold.

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🧠 Parent Note – Don’t Be Fooled by the Calendar

During “chemo-free” weeks, you might think recovery’s on the way. But bloods often crash AFTER chemo ends – because it takes time to do its work.

That’s when neutropenia hits hard. When Sammy’s neutrophils drop below 0.5, we go into lockdown.

And yes – some people say:

“But he still needs a normal life!”

No.
This is not a normal life.
A simple cold could wreck your child. A flu could hospitalise them. Worse.

If you’re a protective parent, if you say no to playdates and parties during neutropenia, you’re not being paranoid – you’re being a damn good coach.

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🏉 Final Whistle – Game On, One Dose at a Time

It’s a mad, messy, medical whirlwind. But with every dose, every brave face, every cleaned line, and every “you’ve got this” whispered after a meltdown – you’re playing the hardest game on the biggest field.

Sammy’s smashing it. Brave, bold, and somehow still smiling through the madness.

And if you’re reading this? You are too.

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🗣️ Rugby vs Cancer Quote to End On:

“In rugby, we protect the ball. In this fight, we protect the child. There is no off-season, no easy games – just the will to keep going, and the strength to never give in.” 🏉💚🔥

⚠️ Disclaimer:
I’m not a doctor—just a dad, sharing what we’ve learned from Sammy’s journey with ALL. The medications listed here are based on what Sammy has received, but every child’s treatment plan can vary depending on their needs, risk level, and how they respond. Always follow the advice of your medical team, and never be afraid to ask questions—you’re your child’s best advocate. 🏉💚