Chemotherapy & You
  A Monster .....No More

*What is chemotherapy ?
Chemotherapy is the application of chemical drugs to stop further growth of cancer cells as well as destroying them. They are almost always administrated in the form of a cycle. This is the process in which chemotherapy is given followed by a period of rest during which the body is allowed to recover

*How does chemotherapy work ?
Normally, cells in various body organs multiply and have a specific life span before dying. But this doesn't apply to cancer cells. Cancer (malignant) cells undergo abnormal growth and multiplication and take a very long time to die. Chemotherapy acts on these cells and prevent their growth and multiplication. However, it also affects other normal cells which result in some side effects.

*What are the targets of chemotherapy ?

1) Cure

2) Stop spread of cancer to other organs

3) Better quality of life

This depends on the stage of the tumor. The earlier the stage, the higher the probability of cure.
 

*Is it the only therapy for cancer ?
No. There are other effective forms of therapy. They include surgery, hormonal therapy, radiation and biological therapy.

*What are the forms of chemotherapy ?
Oral, IV shot and IV infusion are the available forms of chemotherapy.

*Do I have to be hospitalized to receive chemotherapy ?
It depends on the chemotherapy protocol or program decided by your physician. Some programs can be administrated over a couple of hours and usually received in an outpatient clinic. Others are administrated over 24 hours or more which will therefore require hospitalization.

*What about dietary habits during chemotherapy ?
Good nutrition is vital for your body especially during receiving these drugs. Patients on chemotherapy can easily get infected. A Good and adequate diet helps your immunity in fighting these infections. Fruits, vegetables and a high fiber diet in general is recommended. Animal proteins as chicken and fish are also needed in considerable amounts.

*Is their an exact duration for treatment ?
It depends on the stage of the disease, aggressiveness of the tumor as well as the response to treatment. The response varies from one disease to another.

*Is it possible to go to work during the period of treatment ?
Usually patients receiving chemotherapy go to work without any problems. Regular day activities are allowed as long as they are not feeling tired.

*How can we assess the response to chemotherapy ?
This is usually done by certain x-rays and laboratory work which are applied every two or three cycles. Decrease in the size of the disease on x-ray as well as a decrease in tumor markers both strongly suggest a good response to chemotherapy.

*Are there any side effects associated with chemotherapy administration ?
YES. As mentioned before, chemotherapy acts on growing cells which include cancer cells as well as normal body cells. The action of chemotherapy drugs on normal cells result in side effects which usually subside gradually after the end of therapy.

*What are the side effects of chemotherapy ?

NAUSEA & VOMITING: These are the most common side effects associated with administration of chemotherapy. Usually, patients start to feel nauseated eight hours after receiving therapy. This may last for 24 hours. The treating physician should set the patient on anti-nausea and vomiting medications to control such side effects.

HAIR LOSS: One of the most well known side effects of chemotherapy. However, it is worth mentioning that not all chemotherapy drugs cause hair loss. Hair loss doesn't only apply to scalp hair but also face, body and extremities. Hair loss is not permanent. Hair starts to grow gradually after two to three weeks following completion of therapy.
To care for your scalp and hair during chemotherapy:
- Use mild shampoos.                                                                              
- Have your hair cut short, a shorter style will make your hair look thicker and fuller.
- Use hat or scarf to protect your scalp from the sun if you lose a lot of the hair.
- Get hairpiece early during treatment so you can get use to it during the treatment period.

ANEMIA & FATIGUE: Due to suppression of the bone marrow by chemotherapy. The bone marrow is the place where blood cells are formed including the red blood cells which carry oxygen to various body organs. When the bone marrow is suppressed, the number of red blood cells decrease leading to decreased tissue oxygenation and this is what we call ANEMIA. Anemia causes fatigue, weakness, headaches and sometimes shortness of breath. Blood transfusion is usually done if the red blood cells are markedly decreased.
Here some things you can do to help yourself feel better if you develop anemia:
- Get plenty of rest. Sleep more at night and take naps during the day if you can
- Limit your activities, do only the things that are most important.
- Eat a well balanced diet

INFECTION: Due to decreased white blood cells as a result of bone marrow suppression as mentioned before. White blood cells are the bacteria fighting cells. When they decrease, the body become more prone to infection. Infection may occur in the mouth, skin, lungs, and even in the genital and urinary systems. If you developed any sort of fever, you should contact your physician to set you on a suitable antibiotic.

MOUTH INFECTION:
Here are some suggestions for keeping your mouth, gum and throat healthy:
- If possible, see your dentist before starting chemotherapy to have your teeth cleaned
- Avoid acidic, spicy, salty and dry food as much as possible
- It is preferable to eat food cold or at room temperature

DIARRHEA & CONSTIPATION: Some chemotherapy drugs cause diarrhea while others cause constipation. Anti diarrhea drugs as well laxatives (anti-constipation drugs) are usually prescribed to avoid such side effects.

PERIPHERAL NEUROPATHY: This is a sensation of tingling and numbness in fingers and toes. Few chemotherapy drugs cause neuropathy and it usually subsides in nearly 80% of patients following the completion of therapy.

*Is it possible to breast feed while I am on therapy ?
Generally, breast feeding is not recommended during receiving chemotherapy for the possibility of passage in the breast milk to the baby

*Is it possible to have sex while I am on therapy ?
YES. However, for men who are under chemotherapy, small amounts may be found in semen, so condoms are recommended during sexual intercourse.

*Is it possible to have children after receiving chemotherapy?
YES. Chemotherapy drugs used nowadays have minimal side effects on the reproductive system. In the past, impotence was one of the main draw backs of chemotherapy administration. Now, most of these drugs are replaced by others which are more potent and have no or minimal side effects on the genital tract.

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Revised: 07/28/05.