Chemotherapy

What is Chemotherapy?

Chemotherapy is a crucial part of cancer treatment, utilizing powerful drugs to combat and control the growth of cancer cells. It aims to shrink tumors, making surgery safer and more effective, especially in cases of breast cancer where immediate surgery may not be feasible.

How does it work?

Chemotherapy targets rapidly dividing cancer cells, but it can also affect healthy cells, leading to side effects. Your individual experience with chemotherapy will be unique, and a supportive team of healthcare professionals is here to guide you through the process.

Before Starting

Addressing basic health needs and emotional support is crucial before starting chemotherapy. Ensure your mental health is addressed and consider having a family member or friend accompany you during sessions. Various medical tests, such as a heart test (ERNA or ECHO), chest X-ray, CT scan, abdominal sonar, bone scan, and blood tests, may be conducted to assess your readiness for treatment.

Emotional Wellbeing

Chemotherapy brings significant changes to your life, impacting your health, daily routines, and relationships. It’s normal to experience a range of emotions, and our goal is to support you emotionally throughout this journey.

10 Coping Strategies For Everyday Life

• Focus on Treatment Goals
  Keep your treatment goals in mind for motivation on challenging days.
• Rest and Relax
  Prioritize rest, acknowledging reduced energy levels during treatment.
• Prioritize Nutrition
  Eating well is crucial for rebuilding tissue and regaining strength.
• Exercise When Possible
  Moderate physical activity fights fatigue, boosts appetite, and enhances overall well-being.
• Explore Hobbies
  Try new hobbies or revisit old favorites for mental stimulation.
• Share Coping Strategies
  Connect with fellow patients, exchanging ideas and support in the chemo room.
• Journaling
  Keep a journal to understand your thoughts, activities, and feelings, aiding communication with your healthcare team.
• Knowledge is Power
  Learn about your disease and treatment from reliable resources to reduce fear and increase a sense of control.
• Ask for help
  Learn to ask family and friends to help you with tasks like washing, cooking, and looking after kids. Asking for help and being specific about how people can help you is brave and empowering and allows those who cares for you to show it in a meaningful way.
• Simplify
  Focus on essential tasks, letting go of less important things.

 

Treatment & Side-Effects

Blood-related Side-effects

Chemotherapy affects blood cell production, leading to a decrease in red blood cells (RBC), white blood cells (WBC), and platelets. Regular blood tests are conducted before each chemotherapy session to monitor these components.

Monitoring your blood

Though chemotherapy temporarily decreases blood cell levels, the body can recover and generate new blood cells over time. Monitoring these levels through blood tests is crucial, and appropriate
interventions, such as transfusions or special injections may be recommended to manage specific conditions.

RBC (Red Blood Cells): Carry oxygen; low levels cause anemia, resulting in fatigue and breathlessness. Blood transfusions may be necessary.

SIGNS OF Anaemia

• Tiredness
• Shortness of breath
• Cold and pale hands and feet
• Chest pain

WBC (White Blood Cells): Combat infections; low levels lead to neutropenia, making it challenging to resist infections.

Practical Tips

• Keep a thermometer at home1.
• Call the clinic if you develop a cough, sore throat, or pain during urination.
• Wash hands frequently.

SIGNS OF Neurtropenia

• Fevers and chills
• Cough
• Sore throat
• Skin or mouth ulcers
• Burning urine
• Severe diarrhea
• Bacterial infections are more likely when white cell counts are low, typically 7 – 12 days after chemotherapy.

Nausea & Diet

Managing nausea during chemotherapy is important for your well-being. If you experience nausea or vomiting, it’s crucial to let your doctor or nurse know, as not all chemotherapy drugs have this side effect.

Changes to your appetite

Chemotherapy may alter your taste and appetite, making you sensitive to strong smells. It’s normal not to have much appetite initially, but it improves as you recover.

Practical Tips to Cope with nausea:

• On the day of your treatment, opt for a light, small meal.
• Ginger is an excellent and natural way to combat nausea while also boosting your immune system – you can chew on it or add it to water and tea.
• Eat what appeals to you. Generally, healthy starches like brown rice, brown bread, potatoes, sweet potatoes, veggies, and hot cereals are well-tolerated. Avoid foods that are processed and high in sugar.
• Don’t skip meals, as an empty stomach can worsen symptoms. Try nibbling on something you enjoy or drink a healthy shake, smoothie, or soup.
• Stay hydrated by drinking plenty of fluids such as herbal teas, water, sports drinks, and diluted juices. Avoid fizzy and high-sugar drinks.
• Consider freezing meals in advance to make eating healthy easier when you don’t have the energy to cook or seek help from friends or family.
• Sensitive Smells: Avoid odors, especially during meals, that make you feel sick.
• Maintain a regular diet with enough calories to support your strength and immune system.
• Reduce intake of salt, very spicy foods, and dairy products if they worsen nausea.

Acid reflux, when food backs up into your esophagus, may cause burning or pain. If you experience this, inform the chemo Sister for appropriate medication.

Coping with Acid Reflux:

• Avoid acidic and very spicy food
• Healthy Fats, High Fiber: include fruits, lots of vegetables, whole grains, nuts, and healthy fats like olive or coconut oil, avocados, and fish in your diet. This is also excellent for helping your body heal.
• Coffee and Alcohol should be limited as this can worsen reflux

Diarrhea
Certain chemo drugs may cause diarrhea. If it’s severe or exceeds 5 bowel movements in 24 hours, contact the clinic sister. Over-the-counter meds can help, but get approval from the chemo team first.

Constipation Concerns
Combat constipation with more fiber and water. Stay active. If it persists, inform the chemo sister or doctor for potential solutions. Adding psyllum husk or slippery elm may help.

Oral Hygiene, Skin & Eyes

Chemotherapy can impact the cells lining the mouth and throat, leading to a condition called “stomatitis,” causing discomfort and pain while eating and swallowing. Skin Sensitivity occurs and sun
exposure may cause dryness, itching, and changes in skin color. Nails can darken, and lines may appear. These changes are temporary and will stop once treatment ends.

Eye Changes

Certain chemotherapy drugs can lead to eye issues.

Possible Symptoms:

• Difficulty with contact lenses, causing irritation.
• Blurry vision and clogged tear ducts.
• Excessive tearing due to chemo.
• Sensitivity to light.

Tips for Good Mouth Care

• Maintain Oral Hygiene: Keep your mouth clean and check for issues like bleeding areas or white patches. Report any changes to prevent mouth infections.
• If at all possible, visit your dentist as your teeth may become brittle, more sensitive, and more prone to cavities.
• Watch Your Diet: Avoid very acidic and carbonated drinks, as well as hot and spicy foods that can exacerbate discomfort.
• Rinse with Bicarbonate of Soda: After meals, rinse your mouth with a solution of a teaspoon of bicarbonate of soda in a glass of lukewarm water to soothe irritation.
• Keep Your Mouth Moist: Sucking on hard sweets has been reported to provide relief.

Caring for Skin & Nails

• Avoid prolonged sun exposure.
• Always use sunblock when outdoors.
• Wear a hat when hanging laundry and cover your arms.
• Keep skin moisturized with a good moisturizer to prevent dryness.
• You can also use castor oil or coconut oil to hydrate your skin.
• Massage cuticle cream or castor oil into the cuticle area to prevent dryness, splitting, and hangnails.
• Wear gloves while doing chores such as washing the car or the dishes.

Fatigue

Fatigue is a common chemo side effect, ranges from mild to feeling completely drained. Unlike regular tiredness, it doesn’t improve with rest but typically lessens once chemo concludes.

Practical Tips:

• Prioritize rest and incorporate short breaks during the day.
• Engage in regular, gentle exercises.
• Maintain a balanced diet, stay hydrated, and limit activities to conserve energy.
• Seek help from friends, family, or neighbors when needed.
• Rise slowly to prevent dizziness after sitting or lying down.
• Discuss any sleep issues with the doctor or chemo sister for tailored advice and support

Neuropathy

Symptoms: Tingling, burning, numbness, or pain may occur due to nerve dysfunction during chemotherapy. Commonly affected areas are fingertips and toes, but other areas can be involved.

Alert Signs: Report any sense of imbalance or difficulty feeling your fingertips to the chemo Sister or Doctor. Early reporting helps control symptoms and prevents further nerve damage.

Practical Tips for Comfort

• Avoid tight shoes or socks
• Opt for soft, loose cotton socks and padded shoes.
• For burning pain, cool hands or feet in cold (not icy) water for 15 minutes twice a day
• Massage your hands and feet to improve circulation, stimulate nerves.

Fertility & Sexual Health

Birth Control Crucial: Due to potential toxicity to unborn children and the risk of stimulating hormone-sensitive cancer cells use non-hormone birth control like the copper T during chemotherapy. Changes in menstrual cycles may occur, even leading to the absence of periods. Women should still take precautions not to get pregnant even in the absence of a period.

Menopause Possibility: Chemotherapy may temporarily halt periods or induce permanent menopause. Effects vary based on chemotherapy type, age, and proximity to natural menopause.

Menopausal Symptoms: Hot flushes, decreased sexual drive, vaginal dryness, mood changes, and sleep disturbances may occur. Don’t hesitate to discuss symptoms with the chemo Sister or doctor.

What to Do:

• Dietary Choices: Eat naturally cooling food like watermelon and cucumber and drink cold water.
• Prescription Medication: The doctor may recommend medication.
• Avoid over-the-counter “natural” anti-menopause medication especially if you have hormone-sensitive cancer as these still contain estrogen that may stimulate the growth of cancer cells.
• Comfortable Clothing: Wear light daytime clothing and cotton pajamas for better sleep.
• Buy a hand fan – these are very handy to cool you down and add flair to any outfit.
• Vaginal Health: Use vaginal creams regularly for irritation. Consider vitamin E or olive oil for increased lubrication during sexual activity.

Hair Loss

For many, losing hair (alopecia) is a challenging aspect of chemotherapy. Not all chemo drugs cause hair loss, so consult with the chemo sister or doctor to understand what to expect.

Hair loss typically begins 2-3 weeks after starting chemotherapy. The extent varies – from minimal loss to complete loss of head, eyelash, eyebrow, and body hair. Hair loss is usually temporary and grows back after treatment. Although it can’t be prevented, it doesn’t affect everyone.

New hair growth usually occurs 2-3 months after stopping chemotherapy, with potential differences in color and texture. Hair may initially be soft and curly, returning to its original texture over time.

Coping with Hair Loss

Coping strategies can help navigate the emotional and practical aspects of hair loss.

• Before hair loss starts, you may opt to cut your hair or shave your head.
• Use a soft pillowcase or place a soft towel on the pillow to ease cleanup during shedding.
• Consider a soft satin pillow to minimize distress from seeing hair on the pillow.
• Purchase a drain catch for the shower to collect shedding hair.
• Choose headwear that makes you comfortable – whether it’s a wig, hairpiece, scarf, hat, or turban. Protect your scalp from sunlight and cover up outdoors.

Chemo Brain

The Facts: Research indicates that chemo can impact thinking for up to 10 years post-treatment. It subtly affects concentration, memory, understanding, and reasoning.

Identifying Chemo Brain:

• Forgetting usual things (memory lapse).
• Trouble concentrating, short attention span, occasional “spacing out.”
• Difficulty remembering details, names, dates, or significant events.
• Struggling with multitasking, slower task completion, disorganization.
• Trouble recalling common words to complete sentences.

Management Tips:

• Stay Organized: Use a detailed daily planner for reminders.
• Brain Exercise: Engage in word puzzles to stimulate your mind.
• Prioritize Rest: Ensure enough sleep and rest.
• Physical Exercise: Regular exercise enhances alertness and mood.
• Vegetables in Diet: Studies link increased vegetable consumption to brain alertness.
• Establish Routines: Stick to consistent daily routines.
• Single Task Focus: Avoid multitasking; focus on one thing at a time.
• Seek Support: Don’t hesitate to ask for help; loved ones can assist with tasks.
• Mindset Matters: Laugh about uncontrollable situations to cope better.
• Consider using omega 3 and 6 fatty acids as supplements or increase food that naturally contains these like nuts and fish. You can also try Biostrath as a mind-boosting supplement.