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What Is Chemotherapy?
How Does Chemotherapy Work?
What Can Chemotherapy Do?
Is Chemotherapy Used With Other Treatments?
Chemotherapy is the treatment of cancer with
drugs that can wipe out cancer cells. These drugs often are called
Does Chemotherapy Work?
Normal cells grow and die in a controlled way. When cancer occurs, cells in your
body that are not normal keep dividing and forming more cells without control.
Anticancer drugs destroy cancer cells by stopping them from growing or
multiplying. Healthy cells can also be harmed, especially those that divide
quickly. Harm to healthy cells is what causes side effects. These cells usually
repair themselves in time after chemotherapy.
Because some drugs work better together than alone, often
two or more drugs are given to you at the same time.
This is called combination chemotherapy.
Can Chemotherapy Do?
|Help cure the cancer. Cancer is considered cured when the
patient remains free of evidence of cancer cells.|
|To control the cancer. This is done by keeping the cancer
from spreading; slowing the cancer's growth; and killing cancer cells that may
have spread to other parts of the body from the original site.|
|To relieve symptoms that the cancer may cause. Relieving
symptoms such as pain can help patients live more comfortably.|
Chemotherapy Used With Other Treatments?
Sometimes chemotherapy is the only treatment a patient receives. More often,
however, chemotherapy is used in addition to surgery, radiation therapy, and/or
biological therapy to:
|Shrink a tumor before surgery or radiation therapy. This
is called neo-adjuvant therapy.|
|Help destroy any cancer cells that may remain after
surgery and/or radiation therapy. This is called adjuvant chemotherapy.|
|Make radiation therapy and biological therapy work
|Help destroy cancer if it recurs or has spread to other
parts of the body from the original site.|
Can I Expect During Chemotherapy?
Where Will I Get Chemotherapy?
How Often and For How Long Will I Get Chemotherapy?
How Is Chemotherapy Given?
How Will I Feel During Chemotherapy?
Can I Take Other Medicines While I Am Getting
How Will I Know If My Chemotherapy Is Working?
Some people with cancer want to know every detail about
their condition and their treatment. Others prefer no information at all. The
choice of how much information to seek out is yours, but there are questions
that every person getting chemotherapy may ask.
This list is just a start. Always feel free to ask your
health care team as many questions you want. If you do not understand their
answers, keep asking until you do. Remember, there is no such thing as a
"stupid" question, especially about cancer or your treatment. To make
sure you get all the answers you want, you may find it helpful to draw up a list
of questions before each doctor's appointment. Some people keep a "running
list" and jot down each new question as it occurs to them. It may be
helpful to take someone along for note taking.
Will I Get Chemotherapy?
Chemotherapy can be given in many different places: at home, a doctor's office,
a clinic, a hospital's outpatient department, or as an "inpatient" in
a hospital. The choice of where you get chemotherapy depends on which drug or
drugs you are getting and your own and your doctor's wishes. Most patients
receive their treatment as an "outpatient" and are not hospitalized.
Sometimes, a patient starting chemotherapy may need to stay at the hospital for
a short time so that the medicine's effects can be watched closely and any
needed changes can be made.
Often and For How Long Will I Get Chemotherapy?
How often and how long you get chemotherapy depends on:
|The kind and stage of cancer you have.|
|The goals of the treatment.|
|The drugs that are used.|
|How your body responds to them.|
You may get treatment every day, every week, or every
month. Chemotherapy is often given in cycles that include treatment periods
alternated with rest periods. Rest periods give your body a chance to build
healthy new cells and regain its strength. Ask your doctor to tell you how long
and how often you may expect to get treatment. Your treatment schedule is very
important for the drugs to work right.
Sometimes, your doctor may need to delay a treatment based
on the results of certain blood tests. (See the sections on Fatigue, Infection,
and Anemia.) Your doctor will let you know what to do during this time and when
to start your treatment again.
Is Chemotherapy Given?
Chemotherapy can be given in several different ways: intravenously (through a
vein), by mouth, through an injection (shot), or applied on the skin.
I Feel During Chemotherapy?
Most people receiving chemotherapy find that they tire easily, but many feel
well enough to continue to lead active lives. Each person and treatment is
different, so it is not always possible to tell exactly how you will react. Your
general state of health and extent of cancer you have, and the kind of drugs you
are receiving can all affect how well you feel.
You may want to have someone available to drive you to and
from treatment if, for example, you are taking medicine for nausea or vomiting
that could make you tired. You may also feel especially tired from the
chemotherapy as early as one day after a treatment and for several days. It may
help to schedule your treatment when you can take off the day of and the day
after your treatment. If you have young children, you may want to schedule the
treatment when you have someone to help at home the day of and at least the day
after your treatment.
I Take Other Medicines While I Am Getting Chemotherapy?
Some medicines may interfere or react with the effects of your chemotherapy.
Give your doctor a list of all the medicines you take before you start
|the name of each drug|
|the reason you take it|
|how often you take it|
Note: Tell your doctor about all over-the-counter
remedies, including vitamins, laxatives, medicines for allergies, indigestion,
and colds, aspirin, ibuprofen, or other pain relievers, and any mineral or
herbal supplements. Your doctor can tell you if you should stop taking any of
these remedies or increase them before you start chemo. After your treatments
begin, be sure to check with your doctor before taking any new medicines or
stopping the ones you are already taking.
Will I Know If My Chemotherapy Is Working?
Your doctor and nurse will use several ways to see how well your treatments are
working. You may have physical exams and tests often. Always feel free to ask
your doctor about the test results and what they show about your progress.
with Side Effects
What Causes Side Effects?
How Long Do Side Effects Last?
Nausea and Vomiting
Central Nervous System Problems
Symptoms of Infection
Mouth, Gum, and Throat Problems
Effects on Skin and Nails
Kidney and Bladder Effects
Causes Side Effects?
The fast-growing, normal cells most likely to be affected are blood cells
forming in the bone marrow and cells in the digestive tract (mouth, stomach,
intestines, esophagus), reproductive system (sexual organs), and hair follicles.
Some anticancer drugs may affect cells of vital organs, such as the heart,
kidney, bladder, lungs, and nervous system.
You may have none of these side effects or just a few. The
kinds of side effects you have and how severe they are, depend on the type and
dose of chemotherapy you get and how your body reacts.
Long Do Side Effects Last?
Normal cells usually recover when chemotherapy is over, so most side effects
gradually go away after treatment ends, and the healthy cells have a chance to
grow normally. The time it takes to get over side effects depends on many
things, including your overall health and the kind of chemotherapy you have been
Most people have no serious long-term problems from
chemotherapy. However, on some occasions, chemotherapy can cause permanent
changes or damage to the heart, lungs, nerves, kidneys, reproductive or other
The side effects of chemotherapy can be rotten, but they
must be measured against the treatment's ability to destroy cancer. Medicines
can help prevent some side effects such as nausea. Sometimes people receiving
chemotherapy become discouraged about the length of time their treatment is
taking or the side effects they are having. If that happens to you, talk to your
doctor or nurse. They may be able to suggest ways to make side effects easier to
deal with or reduce them.
Below you will find suggestions for dealing with some of
the more common side effects of chemotherapy.
Fatigue, feeling tired and lacking energy, is the most common symptom reported
by cancer patients. The exact cause is not always known. It can be due to your
disease, chemotherapy, radiation, surgery, low blood counts, lack of sleep,
pain, stress, poor appetite, along with many other factors.
Fatigue from cancer feels different from fatigue of
everyday life. Fatigue caused by chemotherapy can appear suddenly. Patients with
cancer have described it as a total lack of energy and have used words such as
worn out, drained, and wiped out to describe their fatigue. And rest does not
always relieve it. Not everyone feels the same kind of fatigue. You may not feel
tired while someone else does or your fatigue may not last as long as someone
else's does. It can last days, weeks, or months. But severe fatigue does go away
gradually as the tumor responds to treatment.
How can I cope with fatigue?
|Plan your day so that you have time to rest.|
|Take short naps or breaks, rather than one long rest
|Save your energy for the most important things.|
|Try easier or shorter versions of activities you enjoy.|
|Take short walks or do light exercise if possible. You
may find this helps with fatigue.|
|Talk to your health care provider about ways to save your
energy and treat your fatigue.|
|Try activities such as meditation, prayer, yoga, guided
imagery, visualization, etc. You may find that these help with fatigue.|
|Eat as well as you can and drink plenty of fluids. Eat
small amounts at a time, if that is helpful. (It helped me.)|
|Join a support group. Sharing your feelings with others
can ease the burden of fatigue. You can learn how others deal with their
fatigue. Your health care provider can put you in touch with a support group in
|Allow others to do some things for you that you usually
I know that this is hard but let them do things for you.
It's their way of helping.
|Keep a diary of how you feel each day. This will help you
plan your daily activities.|
|Report any big changes in energy level to your doctor or
Many patients fear that they will have nausea and vomiting while receiving
chemotherapy. But new drugs have made these side effects far less common and,
when they do occur, much less severe. These powerful antiemetic or antinausea
drugs can prevent or lessen nausea and vomiting in most patients. Different
drugs work for different people, and you may need more than one drug to get
relief. Do not give up. Continue to work with your doctor and nurse to find the
drug or drugs that work best for you. Also, be sure to tell your doctor or nurse
if you are very nauseated or have vomited for more than a day, or if your
vomiting is so bad that you cannot keep liquids down.
What can I do if I have nausea and
|Drink liquids at least an hour before or after mealtime,
instead of with your meals. Drink frequently and drink small amounts.|
|Eat and drink slowly.|
|Eat small meals throughout the day, instead of one, two,
or three large meals.|
|Eat foods cold or at room temperature so you won't be
bothered by strong smells.|
|Chew your food well for easier digestion.|
|If nausea is a problem in the morning, try eating dry
foods like cereal, toast, or crackers before getting up. (Do not try this if you
have mouth or throat sores or are troubled by a lack of saliva.)|
|Drink cool, clear, unsweetened fruit juices, such as
apple or grape juice or light-colored sodas such as ginger ale that have lost
their fizz and do not have caffeine.|
(To take out the fizz add one teaspoon of sugar to the fizzy drink and stir.)
|Suck on mints, or candies. (Do not use tart candies if
you have mouth or throat sores.)|
|Prepare and freeze meals in advance for days when you do
not feel like cooking.|
|Wear loose-fitting clothes.|
|Breathe deeply and slowly when you feel nauseated.|
|Distract yourself by chatting with friends or family
members, listening to music, or watching a movie or TV show.|
|Use relaxation techniques.|
|Try to avoid odors that bother you, such as cooking
smells, smoke, or perfume.|
|Avoid eating for at least a few hours before treatment if
nausea usually occurs during chemotherapy.|
|Eat a light meal before treatment if you can.|
Chemotherapy drugs can cause some side effects that are painful. The drugs can
damage nerves, leading to burning, numbness, tingling or shooting pain, most
often in the fingers or toes. Some drugs can also cause mouth sores, headaches,
muscle pains, and stomach pains.
Not everyone with cancer or who receives chemotherapy
experiences pain from the disease or its treatment. But if you do, it can be
relieved. The first step to take is to talk with your health care team about
your pain. They need to know as many details about your pain as possible. You
may want to describe your pain to your family and friends. They can help you
talk to your caregivers about your pain, especially if you are too tired or in
too much pain to talk to them yourself.
Hair loss (alopecia) is a common side effect of chemotherapy, but not all
drugs cause hair loss. Your doctor can tell you if hair loss might occur with
the drug or drugs you are taking. When hair loss does occur, the hair may become
thinner or fall out entirely. Hair loss can occur on all parts of the body,
including the head, face, arms and legs, underarms, and pubic area. The hair
usually grows back after the treatments are over. Some people even start to get
their hair back while they are still having treatments. Sometimes, hair may grow
back a different color or texture (My hair grew back thicker).
Hair loss does not always happen right away. It may begin
several weeks after the first treatment or after a few treatments. Many people
say their head becomes sensitive before losing hair. Hair may fall out gradually
or in clumps. Any hair that is still growing may become dull and dry.
How can I care for my scalp and hair
|Use a mild shampoo.|
|Use a soft hair brush.|
|Use low heat when drying your hair.|
|Have your hair cut short. A shorter style will make your
hair look thicker and fuller. It also will make hair loss easier to manage if it
|Use a sun screen, sun block, hat, or scarf to protect
your scalp from the sun if you lose hair on your head.|
|Avoid brush rollers to set your hair.|
|Avoid dying, perming, or relaxing your hair.|
Some people who lose all or most of their hair choose to
wear turbans, scarves, caps, wigs, or hair pieces. Others leave their head
uncovered. Still others switch back and forth, depending on whether they are in
public or at home with friends and family members. There
are no "right" or "wrong" choices; do whatever feels
comfortable for you.
If you choose to cover your head:
|Get your wig or hairpiece before you lose a lot of hair.
That way, you can match your current hair style and color. You may be able to
buy a wig or hairpiece at a specialty shop just for cancer patients. Someone may
even come to your home to help you. You also can buy a wig or hair piece through
a catalog, internet or by phone.|
|You may also consider borrowing a wig or hairpiece,
rather than buying one. Check with the nurse or social work department at your
hospital about resources for free wigs in your community.|
|Take your wig to your hairdresser or the shop where it
was purchased for styling and cutting to frame your face.|
|Some health insurance policies cover the cost of a
hairpiece needed because of cancer treatment. It is also a tax-deductible
expense. Be sure to check your policy and ask your doctor for a
Losing hair from your head, face, or body can be hard to
accept. Feeling angry or depressed is common and perfectly all right. At the
same time, keep in mind that it is a temporary side effect. Talking about your
feelings can help. If possible, share your thoughts with someone who has had a
See Tips for You for the Look Good
Feel Better program in your area.
Chemotherapy can reduce the bone marrow's ability to make red blood cells, which
carry oxygen to all parts of your body. When there are too few red blood cells,
body tissues do not get enough oxygen to do their work. This condition is called
anemia. Anemia can make you feel short of breath, very weak, and tired. Call
your doctor if you have any of these symptoms:
|Fatigue (feeling very weak and tired).|
|Dizziness or feeling faint.|
|Shortness of breath.|
|Feeling as if your heart is "pounding" or
beating very fast.|
Your doctor will check your blood cell count often during
your treatment. She or he may also prescribe a medicine that can boost the
growth of your red blood cells. Discuss this with your doctor if you become
anemic often. If your red count falls too low, you may need a blood transfusion
or medicine to raise the number of red blood cells in your body.
|Get plenty of rest. Sleep more at night and take naps
during the day.|
|Limit your activities. Do only the things that are
essential or most important to you.|
|Ask for help when you need it. Ask family and friends to
pitch in with things like child care, shopping, housework, or driving.|
|Eat a well-balanced diet. |
|When sitting, get up slowly. When lying down, sit first
and then stand. This will help prevent dizziness.|
Nervous System Problems
Chemotherapy can interfere with certain functions in your central nervous system
(brain) causing tiredness, confusion, and depression. These feelings will go
away once the chemotherapy dose is lowered or you finish chemotherapy. Call your
doctor if these symptoms occur.
Chemotherapy can make you more likely to get infections. This happens because
most anticancer drugs affect the bone marrow, making it harder to make white
blood cells (WBCs), the cells that fight many types of infections. Your doctor
will check your blood cell count often while you are getting chemotherapy. There
are medicines that help speed the recovery of white blood cells, shortening the
time when the white blood count is very low. These medicines are called colony
stimulating factors (CSF). Raising the white blood cell count greatly lowers the
risk of serious infection.
Most infections come from bacteria normally found on your
skin and in your mouth, intestines and genital tract. Sometimes, the cause of an
infection may not be known. Even if you take extra care, you still may get an
Report any signs of infection to your doctor right away,
even if it is in the middle of the night. This is especially important when your
white blood cell count is low. If you have a fever, do not take aspirin,
acetaminophen, or any other medicine to bring your temperature down without
checking with your doctor first.
Anticancer drugs can affect the bone marrow's ability to make platelets, the
blood cells that help stop bleeding by making your blood clot. If your blood
does not have enough platelets, you may bleed or bruise more easily than usual,
even without an injury.
Call your doctor if you have any of these symptoms:
|small, red spots under the skin.|
|reddish or pinkish urine.|
|black or bloody bowel movements.|
|bleeding from your gums or nose.|
|vaginal bleeding that is new or lasts longer than a
|headaches or changes in vision.|
|warm to hot feeling of an arm or leg.|
Your doctor will check your platelet count often while you
are having chemotherapy. If your platelet count falls too low, the doctor may
give you a platelet transfusion to build up the count. There are also medicines
called colony stimulating factors that help increase your platelets.
and Throat Problems
Good oral care is important during cancer treatment. Some anticancer drugs can
cause sores in the mouth and throat, a condition called stomatitis or mucositis.
Anticancer drugs also can make these tissues dry and irritated or cause them to
bleed. Patients who have not been eating well since beginning chemotherapy are
more likely to get mouth sores.
In addition to being painful, mouth sores can become
infected by the many germs that live in the mouth. Every step should be taken to
prevent infections, because they can be hard to fight during chemotherapy and
can lead to serious problems.
How can I keep my mouth, gums, and
|Talk to your doctor about seeing your dentist at least
several weeks before you start chemotherapy. You may need to have your teeth
cleaned and to take care of any problems such as cavities, gum abscesses, gum
disease, or poorly fitting dentures. Ask your dentist to show you the best ways
to brush and floss your teeth during chemotherapy. Chemotherapy can make you
more likely to get cavities, so your dentist may suggest using a fluoride rinse
or gel each day to help prevent decay.|
|Brush your teeth and gums after every meal. Use a soft
toothbrush and a gentle touch. Brushing too hard can damage soft mouth tissues.
Ask your doctor, nurse, or dentist to suggest a special toothbrush and/or
toothpaste if your gums are very sensitive. Rinse with warm salt water after
meals and before bedtime.|
|Rinse your toothbrush well after each use and store it in
a dry place.|
|Avoid mouthwashes that contain any amount of alcohol. Ask
your doctor or nurse to suggest a mild or medicated mouthwash that you might
use. For example, mouthwash with sodium bicarbonate (baking soda) is
If you develop sores in your mouth, tell your doctor or
nurse. You may need medicine to treat the sores. If the sores are painful or
keep you from eating, you can try these ideas:
How can I cope with mouth sores?
Ask your doctor if there is anything you can apply directly to the sores or to
prescribe a medicine you can use to ease the pain.
|Eat foods cold or at room temperature. Hot and warm foods
can irritate a tender mouth and throat.|
|Eat soft, soothing foods, such as ice cream, milkshakes,
baby food, soft fruits (bananas and applesauce), mashed potatoes, cooked
cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese, macaroni and
cheese, custards, puddings, and gelatin. You also can puree cooked foods in the
blender to make them smoother and easier to eat.|
|Avoid irritating, acidic foods and juices, such as tomato
and citrus (orange, grapefruit, and lemon); spicy or salty foods; and rough or
coarse foods such as raw vegetables, granola, popcorn, and toast.|
How can I cope with mouth
Ask your doctor if you should use an artificial saliva product to moisten your
|Drink plenty of liquids.|
|Ask your doctor if you can suck on ice chips, popsicles,
or sugarless hard candy. You can also chew sugarless gum. (Sorbitol, a sugar
substitute that is in many sugar-free foods, can cause diarrhea in many people.
If diarrhea is a problem for you, check the labels of sugar-free foods before
you buy them and limit your use of them.)|
|Moisten dry foods with butter, margarine, gravy, sauces,
|Dunk crisp, dry foods in mild liquids.|
|Eat soft and pureed foods.|
|Use lip balm or petroleum jelly if your lips become dry.|
|Carry a water bottle with you to sip from often.|
When chemotherapy affects the cells lining the intestine, it can cause diarrhea
(watery or loose stools). If you have diarrhea that continues for more than 24
hours, or if you have pain and cramping along with the diarrhea, call your
doctor. In severe cases, the doctor may prescribe a medicine to control the
diarrhea. If diarrhea persists, you may need intravenous (IV) fluids to replace
the water and nutrients you have lost. Often these fluids are given as an
outpatient and do not require hospitalization. Do not take any over-the-counter
medicines for diarrhea without asking your doctor.
How can I help control diarrhea?
|Drink plenty of fluids. This will help replace those you
have lost through diarrhea. Mild, clear liquids, such as water, clear broth,
sports drinks such as Gatorade, or ginger ale, are best. If these drinks make
you more thirsty or nauseous, try diluting them with water. Drink slowly and
make sure drinks are at room temperature. Let carbonated drinks lose their fizz
before you drink them.|
|Eat small amounts of food throughout the day instead of
three large meals.|
|Unless your doctor has told you otherwise, eat
potassium-rich foods. Diarrhea can cause you to lose this important mineral.
Bananas, oranges, potatoes, and peach and apricot nectars are good sources of
|Ask your doctor if you should try a clear liquid diet to
give your bowels time to rest. A clear liquid diet does not provide all the
nutrients you need, so do not follow one for more than 3 to 5 days.|
|Eat low-fiber foods. Low-fiber foods include white bread,
white rice or noodles, creamed cereals, ripe bananas, canned or cooked fruit
without skins, cottage cheese, yogurt without seeds, eggs, mashed or baked
potatoes without the skin, pureed vegetables, chicken, or turkey without the
skin, and fish.|
|Avoid high-fiber foods, which can lead to diarrhea and
cramping. High-fiber foods include whole grain breads and cereals, raw
vegetables, beans, nuts, seeds, popcorn, and fresh and dried fruit.|
|Avoid hot or very cold liquids, which can make diarrhea
|Avoid coffee, tea with caffeine, alcohol, and sweets.
Stay away from fried, greasy, or highly spiced foods, too. They are irritating
and can cause diarrhea and cramping.|
|Avoid milk and milk products, including ice cream, if
they make your diarrhea worse.|
Some anticancer medicines, pain medicines, and other medicines can cause
constipation. It can also occur if you are less active or if your diet lacks
enough fluid or fiber. If you have not had a bowel movement for more than a day
or two, call your doctor, who may suggest taking a laxative or stool softener.
Do not take these measures without checking with your doctor, especially if your
white blood cell count or platelets are low.
What can I do about constipation?
|Drink plenty of fluids to help loosen the bowels. If you
do not have mouth sores, try warm and hot fluids, including water, which work
|Check with your doctor to see if you can increase the
fiber in your diet (there are certain kinds of cancer and certain side effects
you may have for which a high-fiber diet is not recommended). High fiber foods
include bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh
and dried fruit, nuts, and popcorn.|
|Get some exercise every day. Go for a walk or you may
want to try a more structured exercise program. Talk to your doctor about the
amount and type of exercise that is right for you.|
Skin and Nails
You may have minor skin problems while you are having chemotherapy, such as
redness, rashes, itching, peeling, dryness, acne, and increased sensitivity to
the sun. Certain anticancer drugs, when given intravenously, may cause the skin
all along the vein to darken, especially in people who have very dark skin. Some
people use makeup to cover the area, but this can take a lot of time if several
veins are affected. The darkened areas will fade a few months after treatment
Your nails may also become darkened, yellow, brittle, or
cracked. They also may develop vertical lines or bands.
Some symptoms may mean you are having an allergic reaction
that may need to be treated at once. Call your doctor or nurse right away if:
|you develop sudden or severe itching.|
|your skin breaks out in a rash or hives.|
|you have wheezing or any other trouble breathing.|
How can I cope with skin and nail
|Try to keep your face clean and dry.|
|Ask your doctor or nurse if you can use over-the-counter
medicated creams or soaps.|
Itching and dryness
|Apply corn starch as you would a dusting powder.|
|To help avoid dryness, take quick showers or sponge
baths. Do not take long, hot baths. Use a moisturizing soap.|
|Apply cream and lotion while your skin is still moist.|
|Avoid perfume, cologne, or aftershave lotion that
|Use a colloid oatmeal bath or diphenhydramine (Benadryl)
for generalized pruritis (hives).|
|You can buy nail-strengthening products in a drug store.
Be aware that these products may bother your skin and nails.|
|Protect your nails by wearing gloves when washing dishes,
gardening, or doing other work around the house.|
|Be sure to let your doctor know if you have redness,
pain, or changes around the cuticles.|
|Avoid direct sunlight as much as possible, especially
between 10 a.m. and 4 p.m. when the sun's rays are the strongest.|
|Use a sun screen lotion with a skin protection factor
(SPF) of 15 or higher to protect against sun damage. A product such as zinc
oxide, sold over the counter, can block the sun's rays completely.|
|Use a lip balm with a sun protection factor.|
|Wear long-sleeve cotton shirts, pants and hats with a
wide brim (particularly if you are having hair loss), to block the sun.|
|Even people with dark skin need to protect themselves
from the sun during chemotherapy.|
Some people who have had radiation therapy develop "radiation recall"
during their chemotherapy. During or shortly after certain anticancer drugs are
given, the skin over an area that had received radiation turns red — a shade
anywhere from light to very bright. The skin may blister and peel. This reaction
may last hours or even days. Report radiation recall reactions to your doctor or
nurse. You can soothe the itching and burning by:
|Placing a cool, wet compress over the affected area.|
|Wearing soft, non-irritating fabrics. Often find cotton
underwear is most comfortable.|
Some anticancer drugs can irritate the bladder or cause temporary or permanent
damage to the bladder or kidneys. If you are taking one or more of these drugs,
your doctor may ask you to collect a 24-hour urine sample. A blood sample may
also be obtained before you begin chemotherapy to check your kidney function.
Some anticancer drugs cause the urine to change color (orange, red, green, or
yellow) or take on a strong or medicine-like odor for 24-72 hours. Check with
your doctor to see if the drugs you are taking may have any of these effects.
Always drink plenty of fluids to ensure good urine flow
and help prevent problems. This is very important if you are taking drugs that
affect the kidney and bladder. Water, juice, soft drinks, broth, ice cream,
soup, popsicles, and gelatin are all considered fluids.
Tell your doctor if you have any of
|Pain or burning when you urinate (pass your water).|
|Not being able to urinate.|
|A feeling that you must urinate right away
|Reddish or bloody urine.|
|Chills, especially shaking chills.|
Some people feel as though they have the flu for a few hours to a few days after
chemotherapy. This may be especially true if you are receiving chemotherapy in
combination with biological therapy. Flu-like symptoms — muscle and joint
aches, headache, tiredness, nausea, slight fever (usually <100ˇF), chills,
and poor appetite — may last from 1 to 3 days. An infection or the cancer
itself can also cause these symptoms. Check with your doctor if you have
Your body may retain fluid when you are having chemotherapy. This may be due to
hormonal changes from your therapy, to the drugs themselves, or to your cancer.
Check with your doctor or nurse if you notice swelling or puffiness in your
face, hands, feet, or abdomen. You may need to avoid table salt and foods that
have a lot of salt. If the problem is severe, your doctor may prescribe a
diuretic, medicine to help your body get rid of excess fluids.
Well During Chemotherapy
What If I Don't Like Eating?
Can I Drink Alcoholic Beverages?
Can I Take Extra Vitamins and Minerals?
It is very important to eat well while you are getting
chemotherapy. Eating well during chemotherapy means choosing a balanced diet
that contains all the nutrients the body needs. Eating well also means having a
diet high enough in calories to keep your weight up and high enough in protein
to rebuild tissues that cancer treatment may harm. People who eat well can cope
with side effects and fight infection better. Also, their bodies can rebuild
healthy tissues faster.
What If I
Don't Feel Like Eating?
On some days you may feel you just cannot eat. You can lose your appetite if you
feel depressed or tired. Or, side effects such as nausea or mouth and throat
problems may make it difficult or painful to eat In some cases, if you
cannot eat for a long period of time, your doctor may recommend that you be
given nutrition intravenously until you are able to eat again.
When a poor appetite is the problem,
try these ideas:
|Eat frequent, small meals or snacks whenever you want,
perhaps four to six times a day. You do not have to eat three regular meals each
|Keep snacks within easy reach, so you can have something
whenever you feel like it.|
|Even if you do not want to eat solid foods, try to drink
beverages during the day. Juice, soup, and other fluids like these can give you
important calories and nutrients.|
|Vary your diet by trying new foods and recipes.|
|When possible, take a walk before meals; this may make
you feel hungrier.|
|Try changing your mealtime routine. For example, eat in a
|Eat with friends or family members. When eating alone,
listen to the radio or watch TV.|
|Ask your doctor or nurse about nutrition supplements.|
|Speak with your dietician about your specific nutrition
Drink Alcoholic Beverages?
Small amounts of alcohol can help you relax and increase your appetite. On the
other hand, alcohol may interfere with how some drugs work and/or worsen their
side effects. For this reason, some people must drink less alcohol or avoid
alcohol completely during chemotherapy. Ask your doctor if and how much beer,
wine, or other alcoholic beverages you can drink during treatment.
Take Extra Vitamins and Minerals?
You can usually get all the vitamins and minerals you need by eating a healthy
diet. Talk to your doctor, nurse, registered dietician, or a pharmacist before
taking any vitamin or mineral supplements. Too much of some vitamins and
minerals can be just as dangerous as too little. Find out what is recommended
the Support You Need And Deserve
How Can I Get Support?
How Can I Make My Daily Life More Enjoyable?
Chemotherapy, like cancer, can bring major changes to a
person's life. While it can help cure your cancer, it can sometimes affect
overall health, cause stress, disrupt day-to-day schedules, and strain personal
relationships. It is no wonder, then, that some people feel tearful, anxious,
angry, or depressed at some point during their chemotherapy.
These emotions can be perfectly normal, but they can also
be disturbing. Fortunately, there are ways to deal with these emotional side
effects, just as there are ways to cope with the physical side effects of
How Can I
You can draw on many sources of support. Here are some of the most important:
Doctors, nurses, and other health professionals. If you have questions or
worries about your cancer treatment, talk with members of your health care team.
Tell them if you are feeling anxious or depressed, or if you are experiencing
other emotional or physical changes.
Counseling professionals. There are many kinds of
counselors who can help you express, understand, and cope with your feelings. If
you are depressed, you should consider seeking professional help. Feeling
hopeless, worthless, guilty, or that life is not worth living are signs of
depression. Depending on your preferences and needs, you may want to talk with a
psychiatrist, psychologist, social worker, sex therapist, or member of the
clergy. There are also medicines that can be used to treat depression. Many
cancer centers have "psycho-oncology" programs with psychiatrists,
psychologists, and social workers trained to work with cancer patients. Your
doctor, nurse, or social worker may be able to suggest who to contact.
Friends and family members. Talking with friends or family
members can help you feel a lot better. Often, they can comfort and reassure you
in ways that no one else can. However, you may need to help them help you. At a
time when you might expect that others will rush to your aid, you may have to
make the first move.
Asking friends and family for help. Many people do not
understand cancer, and may withdraw from you because they are afraid of your
illness and not know what to do to help you. Others may worry that they will
upset you by saying "the wrong thing." You can help by being open in
talking with others about your illness, your treatment, your needs, and your
feelings. By talking openly, you can correct mistaken ideas about cancer. You
can also let people know that there is no single "right" thing to say,
as long as their caring comes through loud and clear. Once people know they can
talk with you honestly, they may be more willing and able to open up and lend
their support. Accepting help may be hard. When you allow others to help, you
make them feel less helpless. In a sense, you are helping others deal with your
Support groups. Support groups are made up of people who
are going or have gone through the same kinds of experiences as you. Many people
with cancer find they can share thoughts and feelings with group members that
they do not feel comfortable sharing with anyone else. Support groups also can
serve as an important source of practical information about living with cancer.
Some studies suggest that not only can support groups help with how you are
feeling emotionally, but may also help you recover physically from your cancer.
Support can also be found in one-to-one programs that put
you in touch with another person very similar to you in age, sex, type of
cancer, and so forth. In some programs, this person comes to visit you. In
others, a "hotline" puts you in touch with someone you can talk with
on the telephone. Later, you may want to help others who are going through the
same experience you did.
Sources for information about support programs, counseling
advice, financial assistance, transportation to and from treatment, and
information about cancer include neighborhood organizations, local health care
providers, and your hospital, clinic, or medical center where you are being
treated. At public libraries and patient libraries at hospitals, a librarian can
help you find books and articles through a literature search.
Can I Make My Daily Life More Enjoyable?
|Share your feelings with friends and family.|
|Watch funny movies.|
|Listen to music.|
|Try new hobbies and learn new skills.|
|Exercise, if you can.|
|Do things that interest you.|
Just go for it!
Meditation and Prayer
Muscle Tension and Release
Many people with cancer are exploring complementary
therapies. These methods focus on the mind, body, and spirit. They do not take
the place of medical therapies, but add to them. They can reduce stress, lessen
side effects from cancer and cancer treatments, and enhance well-being. And they
can help you feel more in control; it is something you can do for yourself.
A few of the therapies available are described here. Many
more therapies exist such as art therapy, humor, journaling, reiki, music
therapy, pet therapy and others. You may want to check with your doctor before
using these techniques, especially if you have lung problems. A social worker,
psychologist, or nurse may be able to help you with these therapies. You may
also want to read books, listen to audiotapes, and watch videotapes about these
With training in biofeedback, you can control body functions such as heart rate,
blood pressure, and muscle tension. A machine will sense when your body shows
signs of tension and lets you know in some way such as making a sound or
flashing a light. The machine also gives you feedback when you relax your body.
Eventually, you can control your relaxation responses without having to depend
on feedback from the machine. Your doctor, nurse, or social worker can refer you
to someone trained in teaching biofeedback.
Distraction is the use of an activity to take your mind off your worries or
discomforts. Talking with friends or relatives, watching TV, listening to the
radio, reading, going to the movies, or working with your hands by doing
needlework or puzzles, building models, or painting are all ways to distract
yourself. Many cancer centers now have music or creative art therapists who can
be very helpful to you while you are getting treatment for your cancer. Ask your
nurse or social work department about possible resources in your area.
Hypnosis puts you in a deeply-relaxed state that can help reduce discomfort and
anxiety. You can be hypnotized by a qualified person, or you can learn how to
hypnotize yourself. If you are interested in learning more, ask your doctor,
nurse, or social worker to refer you to someone trained in the technique.
Imagery is a way of daydreaming that uses all your senses. It is usually done
with your eyes closed. To begin, breathe slowly and feel yourself relax. Imagine
a ball of healing energy-- perhaps a white light--forming somewhere in your
body. When you can "see" the ball of energy, imagine that as you
breathe in you can blow the ball to any part of the body where you feel pain,
tension, or discomfort such as nausea. When you breathe out, picture the air
moving the ball away from your body, taking with it any painful or uncomfortable
feelings. (Be sure to breathe naturally; do not blow.) Continue to picture the
ball moving toward you and away from you each time you breathe in and out. You
may see the ball getting bigger and bigger as it takes away more and more
tension and discomfort. To end the imagery, count slowly to three, breathe in
deeply, open your eyes, and say to yourself, "I feel alert and
The idea that touch can heal is an old one. The first written records of massage
date back 3,000 years ago to China. Massage therapy involves touch and different
methods of stroking and kneading the muscles of the body. A licensed massage
therapist should do the therapy. Talk to your doctor before beginning this
Meditation is a relaxation technique that allows you to focus your energy and
your thoughts on something very specific. This is especially helpful when your
mind and body are stressed from cancer treatment. For example, you may want to
repeat a word (over and over), or look at an object, such as a picture. Another
form of meditation is allowing your thoughts, feelings, and images to flow
through your mind. For patients who believe in a higher spiritual power, prayer
can provide strength, comfort and inspiration throughout the cancer experience.
Whether you pray alone, with family and friends, or as a member of a religious
community, prayer may help. A member of the clergy or your spiritual advisor can
help you incorporate prayer into your daily life.
Tension and Release
Lie down in a quiet room. Take a slow, deep breath. As you breathe in, tense a
particular muscle or group of muscles. For example, you can squeeze your eyes
shut, frown, clench your teeth, make a fist, or stiffen your arms or legs. Hold
your breath and keep your muscles tense for a second or two. Then breathe out,
release the tension, and let your body relax completely. Repeat the process with
another muscle or muscle group. You also can try a variation of this method,
called "progressive relaxation." Start with the toes of one foot and,
working upward, progressively tense and relax all the muscles of one leg. Next,
do the same with the other leg. Then tense and relax the rest of the muscle
groups in your body, including those in your scalp. Remember to hold your breath
while tensing your muscles and to breathe out when releasing the tension.
Exercise can help lessen pain, strengthen weak muscles, restore balance, and
decrease depression and fatigue. After getting approval from your doctor, you
may want to begin by walking 5-10 minutes twice a day and later increasing your
Get in a comfortable position and relax all your muscles. If you keep your eyes
open, focus on a distant object. If you close your eyes, imagine a peaceful
scene or simply clear your mind and focus on your breathing.
Breathe in and out slowly and comfortably through your
nose. If you like, you can keep the rhythm steady by saying to yourself,
"In, one two; out, one two." Feel yourself relax and go limp each time
you breathe out.
You can do this technique for just a few seconds or for up
to 10 minutes. End your rhythmic breathing by counting slowly and silently to
Visualization is similar to imagery. With visualization, you create an inner
picture that represents your fight against cancer. Some people getting
chemotherapy use images of rockets blasting away their cancer cells or of
knights in armor battling their cancer cells. Others create an image of their
white blood cells or their drugs attacking the cancer cells.
All you need is a quiet, comfortable place and some time each day to practice
breathing, stretching, and meditation. To learn about yoga you may want to take
a class and review books, audiotapes, or videotapes on yoga. Ask your social
worker, psychologist, or psychiatrist about yoga classes in your area.
I hope that this information will help you understand how
chemotherapy is used to treat cancer. Knowing what to expect when going for your
chemo treatments, may help you not feel as anxious. Remember to talk with your
health care team whenever you have questions. There are never stupid
If it makes you feel better Ask.