Managing The Side Effects Of Chemotherapy

October 1, 2014

Chemotherapy aims to destroy cancer cells, but in the process it can damage healthy cells in the brain, lining of the digestive system, hair roots, or any other cells in the body.

Each person with cancer reacts differently to chemotherapy, so, the side effects too differ from person to person. Usually, the side effects go away after completion of chemo, but sometimes they persist for a few months.

Going through chemotherapy is tough. Being informed on how to manage chemo side effects can help you deal with it better, say researchers. Tell your doctor about your side effects that occur during chemo and after chemo sessions.

To help you manage your chemo side effects better, your doctor needs to know the details of your symptoms. For example, if the side effect is pain, you need to share with your doctor details such as –

Time of the day when pain occurs and how long it lasts.
The intensity of the pain in a scale from 1 to 10.
How does it affect your routine or daily activities?

Physical side effects of chemotherapy
Here are some suggestions on how you can manage common physical side effects of chemotherapy.

Nausea and vomiting
You may be given anti-nausea medication. Ensure that you understand how these drugs are to be taken. There are also a few things you can do to cope with nausea –

Try ginger tea, ginger lollipops or ginger drops to relieve nausea. The American Cancer Society, however, cautions – ‘While ginger may be effective in treating nausea and vomiting linked to some cancer treatments, it may also interfere with blood clotting. If this happens, it could be life threatening to some patients receiving chemotherapy’.
Take lots of fluids. If necessary, go for IV fluids.
Avoid sweets, fatty or fried foods and foods with a strong odor.
Eat small portions throughout the day.
Eat and drink slowly.

Acupuncture, or rather, electroacupuncture has been supported by the National Center for Complementary and Alternative Medicine (NCCAM) as a complementary therapy to relieve acute nausea that sets in within 24 hours of chemotherapy. According to Marc Blackman, M.D., Director of NCCAM’s Division of Intramural Research, ‘The scientific evidence supporting use of electroacupuncture for relief of acute nausea following chemotherapy is very encouraging’. The researchers conducted to trials to find out whether electroacupuncture was effective for delayed nausea after chemotherapy.

Fatigue
Feeling excessively tired is a common side effect of chemotherapy. Take the treatment prescribed by your doctor for fatigue. OTC drugs are a big no-no for chemotherapy-based fatigue. The following tips may help –

Get enough rest. Try taking several short naps in a comfortable chair rather than in bed.
Take a walk or exercise lightly if possible.
Get help from family or friends with tasks you find tiring.

Hair loss
Hair loss is perhaps the most distressing of all side effects of chemo. Depending on the chemo you have, hair loss will begin 7 to 21 days after the first session. Fortunately, chemo-based hair loss is temporary. Hair regrowth usually starts after you finish your treatment. A little caution here – be prepared for new hair with a different color or texture.

Here’s how you can cope with hair loss –

Shave off your head once your hair starts falling off.
Wigs are another option. Plan to have it written in the doctor’s prescription since some insurance companies cover the cost of wig.
Another option is wearing a cap or a scarf.

Infection
Chemotherapy reduces the number of neutrophils (type of white blood cells that fight infection) to a very low level. Neutrophil counts get to a very low level in about 7 to 14 days of chemotherapy. This is when the risk of infection is at its greatest.

You can prevent infections by –

avoiding people with infectious diseases, cold, or pneumonia
avoiding scratches or abrasions on skin
cleaning cuts with an antiseptic and keeping wounds dry and clean until they heal
washing your hands thoroughly before eating, using the restroom, handling the garbage, or touching pets
keeping your home dust-free; laundering your clothes and dish towels often
avoiding consumption of processed foods

Diarrhea
Some chemo drugs can cause diarrhea.

Drink plenty of fluids to replace lost fluids and salts. Water, Gatorade or Pedialyte are good options.
Try changing your diet. Include more of well-cooked, fresh, high protein foods instead of fatty and processed foods. Cook the vegetables instead of eating them raw.
If the diarrhea gets worse, it is better to get a prescription from your doctor rather than taking OTC medicines.

Emotional side effects of chemotherapy
Depression, feeling sad, confusion, hard time thinking or remembering things, are some of the common emotional side effects of chemotherapy.

Depression and anxiety
Not everyone goes into depression or anxiety after chemotherapy. But if you are among the ones that do get them, look out for symptoms such as –

changes in mood
changes in sleeping patterns, or appetite
inability to enjoy life
no interest in the activities or people that interested you earlier
emotional numbness
a sense of guilt or worthlessness
hopelessness or helplessness
crying a lot
feeling suicidal

The most important thing is to recognize what puts you at risk for depression. Try to avoid those circumstances and environments. If you feel suicidal, seek immediate help. Tell someone nearby about your feelings, ask them to stay near you if you are alone.

Call your doctor. Your doctor may prescribe medication and psychotherapy, or both. Follow your treatment plan and take your medicines without fail. Keep a journal of your feelings during treatment.

Cognitive changes: Chemobrain
Problems with thinking and remembering because of chemotherapy is called chemobrain. These changes could be the result of damage to the brain during chemotherapy, or because certain connections in the brain may be affected by chemotherapy, suggest researchers. Fortunately, this is a temporary change, and you could return to normal within 1 to 2 years of completing chemotherapy.

Coping with chemobrain symptoms involves finding out ways you can remember things and keep your memory sharp. The following suggestions may help.

Make lists of things you need to do, things that you may forget.
Keep track of appointments (doctor or social) using a personal organizer or a planner, or a wall calendar.
Remember to keep things/objects in their designated place.
To stay focused for a longer period to avoid distractions try the auditory cue method. For example, place your spectacles on the bedside table. Keep saying aloud “My spectacles are on the bedside table.” This method will help boost your memory.
Keep your mind active by doing puzzles, word games, solving problems on subjects you are interested in.
Exercise regularly, eat healthy and get plenty or rest.

Dealing with body changes
Chemotherapy can change the way you look. Weight gain or weight loss, hair loss, changes in skin color, scars on the head and neck are some of the side effects of chemotherapy. These bodily changes can be short term and some changes can last forever. You may feel shame or fear. You may feel angry or aggrieved. That’s natural! After all, our body is our sense of self.

Here are some suggestions on how you can cope with your bodily changes:

First thing is to feel good about yourself by focusing on your positive features. Is it your beautiful smile? Is it your expressive eyes? Like Ann Frank said – ‘I don’t think of all the misery but of the beauty that still remains’.
Disguise your weight change by wearing clothes that fit well. Too tight or very loose clothing is more likely to draw attention.
Try a new haircut, a different hairstyle, a new makeup, or anything that would enhance your appearance.
Ask your health care professional on how you can care for your skin.
Feeling bad about your body can lower your sex drive. You are more than your cancer. Remind yourself about that. Talk about your fears and feelings with your partner. Communication is very important. Try relaxation techniques such as playing soft music or relaxing massages.

Don’t keep your feelings about body changes boxed up. Mourn and grieve. Let it out.

Talk about your problems with your family and friends. An understanding family or friend is a great source of encouragement and help.

References:
Cancercare.org (2014). Chemotherapy, Nausea, Vomiting, Fatigue, Neutropenia, Diarrhea, Constipation, Hair loss, Mouth Sores, Neuropathy, Chemobrain. CancerCare

Cancer.org, (2014). Ginger. [online] Available at: http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/ginger [Accessed 27 Sep. 2014].

NCCAM, (2002). Electroacupuncture Trial Is NCCAM’s First Intramural Study. [online] Available at: http://nccam.nih.gov/news/2002/061202.htm [Accessed 27 Sep. 2014].

Dana-farber.org, (2014). Your Emotions After Treatment. Dana-Farber Cancer Institute. Boston, MA