Coping with Chemotherapy
Chemotherapy Is an Individual Experience
Every person experiences chemotherapy differently, both physically and emotionally. Each person experiences side effects from chemotherapy differently, and different chemotherapy drugs cause different side effects. Fortunately, as the science of cancer treatment has advanced, so has the science of managing treatment side effects.
Whatever you experience, remember there is no relationship between how the chemotherapy makes you feel and whether you derive benefit from it.
Many people feel fine for the first few hours following chemotherapy. Usually, some reaction occurs about four to six hours later. However, some people don’t react until 12 or even 24 to 48 hours after treatment. Some people experience almost all of the side effects described below, while others experience almost none.
There are many treatments to help you deal with side effects. Please let your doctor know how you are feeling, so that they can address your concerns and help make you more comfortable.
Before Starting Chemotherapy
Before starting chemotherapy we suggest that you take care of some of your basic health needs. If time permits, have your teeth cleaned before rather than while you are having chemotherapy. If you need major dental work, try to postpone it until after chemotherapy. If you need your teeth cleaned while receiving chemotherapy, please let your doctor or nurse know beforehand. Please discuss any concerns with your doctor or nurse.
If it is possible for you to have a family member, friend or support person accompany you to your chemotherapy sessions it will be helpful.
To varying degrees, all people with cancer struggle with the challenges of coping and adjusting to these life changes. At OjaiCARES, we have a number of programs to support you through the process, such as one on one peer support, support groups and individual counseling that are available to all cancer patients.
Remember, always call your doctor if you have a temperature over 100.4 F (38.0C)
Around the third day following a chemotherapy treatment, some people may experience flu-like symptoms such as muscle aches and pains. If you experience these aches, you can take over-the-counter medications such as Tylenol or Advil. If necessary, contact your doctor for stronger medication.
Medications called antiemetics or anti-nausea drugs are used to prevent and treat nausea and vomiting due to chemotherapy. Not all chemotherapy drugs cause nausea. Many anti-nausea drugs are available, and your doctor or nurse will recommend what is expected to work best for you.
If possible, have your prescriptions filled before your treatment day. Please call your doctor or nurse if your medications do not give you adequate relief or if you experience side effects with the anti-nausea medication.
Practical Hints for Nausea
- Before your chemotherapy appointment, eat a small, light meal. Most people do better if they have something in their stomach.
- Eat what sounds good to you. Generally starches such as rice, bread, potatoes, hot cereals and puddings are well tolerated.
- Try not to skip meals. An empty stomach will worsen all symptoms. If you don’t feel like sitting down to a meal, try nibbling on something that appeals to you.
- Drink plenty of fluids. Herbal teas, water, sports drinks and diluted juices are recommended more than soda.
- Avoid smells that are unappealing.
- Freeze meals so that you don’t have to cook. Ask your family and friends to help with meals, especially following chemotherapy when you are most likely to feel nauseous
Chemotherapy can make you feel tired. This fatigue may or may not worsen as you are treated with more cycles of chemotherapy.
Most people have to make some adjustment in work and family responsibilities; the degree of change is very individual. Try to balance activity and rest. As much as possible try to maintain your everyday activities; it can be very beneficial to both your physical and emotional recovery. The fatigue will gradually go away after you recover from chemotherapy.
Practical Hints for Fatigue
- Plan your activities, such as grocery shopping, for a time when you feel the best.
- If you have children, rest when they are napping. When you feel most tired, consider hiring a babysitter for a few hours so that you can relax or take a nap.
- Take naps early in the day so you do not disturb your sleep pattern at night.
- Consider exercising every day or several times a week. Good forms of exercise include swimming, walking and yoga. Call OjaiCARES for information on free exercise classes at 805.646.6433
Many people feel that hair loss is one of the most difficult aspects of chemotherapy treatment. Not all chemotherapy drugs cause hair loss, so talk to your physician or nurse about what to expect.
Most often, hair loss begins about two to three weeks after starting chemotherapy. Some people will lose relatively little hair, while others may lose the hair on their head, eyelashes and eyebrows, as well as other body hair. You may want to cover your head with a wig, scarf, hat or turban, or you may not want to cover your head at all. Do what makes you most comfortable. Many people choose different head coverings for different situations.
We have many resources to assist you during this time. Please visit OjaiCARES at 960 East Ojai Avenue, Suite 105 for additional referrals and resources for wig and head covering boutiques.
If you decide to buy a wig, try to buy one while you still have your own hair because you can better match color and style. You may want to ask your doctor for a prescription for a “cranial prosthesis” (i.e., a wig), as some insurance companies will only pay for a wig with a prescription for a cranial prosthesis.
Your hair will begin to grow back after you stop chemotherapy. It usually takes from two to three months to see the change from no hair to some hair. Your new hair may be slightly different in color and texture than your old hair. Often, the new hair will be baby soft and curly, but will generally return to its original texture after some time.
Practical Hints for Hair Loss
- It is not always necessary to buy a real wig. Synthetic wigs can look as good and are less expensive, easier to care for, lighter in weight and may be more comfortable to wear.
- Before possible hair loss, some people like to cut their hair short. The hair loss won’t be quite so shocking if there is less hair to lose.
- Put a towel over your pillow so that clean up in the morning will be easier while you are shedding your hair.
- Buy a drain catch for your shower. Other people choose to shave their head hair when hair loss begins.
- Refer to our wig information sheet for places to shop near you.
- When buying a wig, take a friend for emotional support and maybe even a laugh!
Appetite and Taste Changes
During chemotherapy, you may experience taste and appetite changes and a heightened sensitivity to odors. Don’t worry if you don’t have an appetite the first few days or a week following chemotherapy; it is not unusual. As you feel better, your appetite will improve.
Reflux — when food backs up into your esophagus — burping, or a burning sensation may worsen nausea. Please report these symptoms to your physician or nurse so that they can be treated. You may find that you can tolerate only certain foods. We encourage you to eat what appeals to you during this time, and to drink enough fluids: 8 to 10 eight-ounce glasses per day, more if you have a fever or diarrhea.
Recommendations for healthy nutrition include a diet low in fat (less than 20 percent fat) and high in whole grains, fruits and vegetables, and plant-based proteins. Some people want to begin dietary changes during active therapy; others prefer to wait until chemotherapy is completed. Some people prefer small, slow changes, while others benefit from a “major overhaul.” We encourage you to become informed and make healthy dietary and lifestyle changes.
Practical Hints for Taste and Appetite Changes
- Eat what appeals to you during this time.
- Eat foods that are warm rather than hot.
- Avoid places where food is being cooked, such as the kitchen at dinnertime.
- Avoid smells that are unappealing.
- To try drink 8 to 10 glasses of fluid a day.
Another side effect of chemotherapy can be mouth sores and discomfort when swallowing. Mouth sores occur because chemotherapy not only destroys cancer cells, but also rapidly dividing cells, such as those that line your mouth and esophagus. Please call your practitioner should you develop painful mouth sores or have difficulty swallowing. A special mouth rinse may be prescribed.
Practical Hints for Mouth Sores
- Brush your teeth with a soft toothbrush three times daily.
- Rinse your mouth with a solution of one teaspoon baking soda and one teaspoon of salt, diluted in a glass of lukewarm water, three or four times daily.
- Most commercial mouthwashes contain alcohol. You can ask your health care provider about mouthwashes that are not irritating to your mouth.
- Ulcer-ease is a commercial product that may provide temporary relief from sores.
Neuropathy, which literally means disease or dysfunction of the nerves, can happen to some people. Some of the most common symptoms of the type of neuropathy caused by chemotherapy include tingling and burning, numbness or pain in the affected areas, loss of your sense of position — knowing where a body part is without looking at it — and loss of balance. The most commonly affected areas are the tips of fingers and toes, although other areas are sometimes affected as well.
Tell your doctor about any symptoms that you experience. Early detection and treatment are the best way to control your symptoms and prevent further nerve damage.
Practical Hints Regarding Neuropathy
- Tight shoes and socks can worsen pain and tingling, and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes.
- If you have burning pain, cool your feet or hands in cold, but not icy, water for 15 minutes twice a day.
- Massage your hands and feet, or have someone massage them for you, to improve circulation, stimulate nerves and temporarily relieve pain.
For women, chemotherapy may temporarily stop your periods or result in permanent menopause. The effects depend on the type of chemotherapy administered, your age and how close you are to naturally occurring menopause.
With menopause, you may experience symptoms such as hot flashes, decreased libido, vaginal dryness, mood changes and sleeping disturbances. If you experience any of these symptoms, talk to your doctor or nurse to get information and treatment for the symptoms.
If your periods continue during treatment, they are likely to change in duration, flow and regularity. The changes may be temporary, lasting only while on chemotherapy, or the changes may lead to menopause.
Practical Hints for Menopausal Symptoms
- Your doctor may recommend prescription medications for hot flashes.
- Wear light cotton pajamas to help prevent overheating when sleeping.
- Use vaginal moisturizers on a regular basis or other water-based lubricants as needed, especially during and before sexual activity. These products will help with vaginal dryness and irritation.
- Try an opened vitamin E capsule or olive oil or coconut oil spread on the vagina to increase lubrication.
- There are prescription medications that give a local dose of estrogen to the tissues in the vagina to treat vaginal dryness.
Please remember that we are here to make this time less difficult for you and call us with any questions or concerns.
For additional information or resources, please visit:
960 East Ojai Avenue
Ojai, CA 93023
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.