Chemotherapy and you
This information has been to help you and your family understand your chemotherapy. We hope it answers most of the questions you may have about your treatment but, if you have any other queries, please discuss them with your doctor.
What is cancer?
Cancer is a disease where normal cells begin to grow erratically. While all body cells grow and divide, cancer cells grow more rapidly, resulting in cancerous growth.
Not all cancers are the same. They grow at different rates and respond to different treatments. However, all cancers are characterised by the unruly growth of cells.
How is Cancer treated?
Cancer can be treated by:
The form of treatment or combinations of treatment selected for you by your treating team depends on your particular type and stage of cancer.
What is Chemotherapy?
Chemotherapy means the treatment of cancer with drugs. There are many different anti-cancer drugs in use at the present time. Some have been in use for many years while others have only recently been developed.
In each case the drugs used are those which are known to be effective in the treatment of your particular type of cancer.
How does Chemotherapy work?
The chemotherapy drugs enter your bloodstream, are distributed to all parts of your body, and can enter and destroy cancer cells. Cells which divide quickly, such as cancer cells, take up most of the drug and are most affected. The rate of uptake and destruction differs with each type of cancer. Unfortunately, anti-cancer drugs also affect normal rapidly dividing cells, causing side-effects.
How is Chemotherapy given?
Chemotherapy can be given as a single drug, or as a combination of two or more drugs. Some drugs are given by mouth as pills, capsules or mixtures. Many, however, are injected directly into the bloodstream. The intravenous drugs may be given in a few minutes or dissolved in a large volume of fluid and given over several hours or days. The exact method of giving the treatment depends on the type of cancer and the drugs which are being used.
Why is Chemotherapy used?
Chemotherapy is used for one of the following reasons:
Some cancers can be completely cured by chemotherapy either alone or in combination with other treatments.
Many cancers can be controlled with chemotherapy by shrinking the tumour and preventing it from spreading.
Relief of symptoms.
Sometimes it isn’t possible to completely control a cancer but chemotherapy can be used to help relieve distressing symptoms. For example, the chemotherapy can shrink a tumour, thus relieving pain.
Is there research into Chemotherapy?
Active research is being done to develop better drugs for the treatment of cancer and also to find ways to reduce the side-effects of drugs currently used. Some patients will be asked to participate in one or more research programs (clinical trials). However, you can be assured that you will not be included in a research study without your full knowledge and consent and only if it is possible for you to benefit from the new treatment.
What are the side effects?
The normal body cells most commonly affected by chemotherapy are those in the gastro-intestinal tract, in bone marrow, in hair and in the reproductive system. Most of the side effects are temporary, as normal cells have a remarkable ability to regenerate. The side effects you might experience depend on the drugs you receive. You may experience no side effects at all. Before your treatment begins, Dr Zimet will discuss with you the likely side effects of your particular treatment.
Effects on the gastro-intestinal tract
Nausea and vomiting are the most common side effects of chemotherapy. The onset and duration vary with the drugs and with your individual reaction. If vomiting does occur it usually subsides within 24 hours. An anti-nauseant will be prescribed and can be taken at regular intervals until you feel better. While nauseated, take small amounts of liquids as frequently as possible such as ice-chips, icy poles, water, juices, tea or clear soups. Advance to more solid foods as nausea decreases.
Chemotherapy may cause constipation or diarrhoea. It is important that you report any changes in your bowel movements to Dr Zimet so appropriate measures can be taken to correct the problem.
Effects on the mouth
Good mouth care is very important, as cells in your mouth may be affected by the chemotherapy. Some drugs cause a tender or ulcerated mouth. We suggest you use a soft toothbrush to avoid damage to the soft tissue and use the mouthwash provided. If mouth sores occur, be sure to tell Dr Zimet or nurse.
Effects on bone marrow
Three types of blood cells – red cells, white cells and platelets, are produced in the bone marrow. Chemotherapy can temporarily decrease production of these blood cells. Decreased red cells lead to anaemia, decreased platelets can result in a risk of bleeding. If an effect on your blood is anticipated, Dr Zimet will arrange for you to have regular blood tests between courses of chemotherapy. A blood test on the day or just prior to chemotherapy is performed to check that your bone marrow has recovered.
Effects on hair
Many, but not all, chemotherapy drugs cause loss of hair. Apart from scalp and beard, eyelashes, armpits and pubic areas may also be affected. Hair loss varies from thinning to complete baldness. However, hair loss is not permanent and the hair will grow back. When your hair returns there may be some alteration in the colour or texture. If hair loss is expected with your particular treatment, we can assist you in obtaining a suitable wig. If you prefer not to wear a wig, you should take precautions against sunburn or extreme cold.
Effects on sexual function
Chemotherapy does NOT impair your ability to experience a satisfying sexual relationship. You may feel some tiredness due to the treatment, which may lessen your desire for sexual relations. If you have a problem in this area, please discuss it with your doctor or your chemotherapy nurse.
Effects on fertility
Some of the drugs used can cause permanent sterility, particularly in men. Therefore, if you plan to have children in the future, you should discuss this with your doctor. In men, sperm can be stored to allow future artificial insemination. It is strongly recommended that contraceptive precautions be taken during chemotherapy by both men and women, as the effects of the drugs on the unborn child are unknown.
Other side effects
Occasionally other side effects can occur. If you notice anything unusual during chemotherapy, be sure to discuss it with Dr Zimet as it may affect your further treatment.
Should my diet change?
A balanced diet is particularly important during chemotherapy but provided your nutritional needs are met there are no special foods which are of extra benefit. A dietitian can help you select a balanced diet and can advise you on foods your body may not tolerate as well as usual.
Some anti-cancer drugs can affect the bladder or kidneys, so it is very important that the drugs be flushed out of your body. Increase your fluid intake to at least 2-3 litres of fluid per day, particularly for the 24-48 hours after intravenous therapy or on each day that you are taking oral medication. Fluid intake can consist of the following: water, tea, coffee, soups, soft drinks, ice cream, or any other non-alcoholic liquids. Please check with your doctor regarding alcohol, as it can react unfavourably with some medications.
What can I do?
Your reactions to the diagnosis and treatments are very individual and may have both physical and emotional effects. You may feel isolated because of these feelings, so learning to discuss your feelings or problems may be helpful to you. Family and friends often provide this needed support. Health professionals both here and in the community are available to help you in overcoming difficult times. Since we treat many patients with your condition, we are well aware of the problems and side effects you may have. Please ask us for assistance.
You may need to re-adjust your lifestyle to help you cope with the side effects of chemotherapy. You may need to assess your energy level and allow yourself time to rest during the day. If you find that side-effects interfere with daily activities, it may help to adjust your work and social calendar around your treatments.
Most employers are very good about giving time off for treatment. Dr Zimet will be pleased to write to your employer’s medical department if necessary.
Things to watch
Keep all drugs out of reach of children.
Report ALL your medications to anyone treating you, including your own doctor and dentist.
Do not use aspirin or products containing aspirin without consulting Dr Zimet.
If you miss a dose of oral medication, DO NOT take a double dose to catch up and do tell your doctor at your next appointment.
Phone your doctor if any of these problems occur:
- Any pain of unusual intensity or distribution, including headache.
- Persistent and severe vomiting that continues more than 24 hours after your treatment.
- Diarrhoea or constipation lasting more than 48 hours after your treatment.
- Spontaneous or easy bleeding or bruising.
- Fever of 38 degrees Celsius or any shaking chills.
- Dizziness, extreme fatigue or shortness of breath.
- A cough producing phlegm.
- Burning when passing urine, blood in urine or decreased urine output.