General Health Tips During Treatment
Following any cancer diagnosis, there is often a sense of shock or disbelief, and an inability to face the reality of what is happening. This may be followed by anger, bargaining, or guilt, followed by depression. Ultimately, there is an acceptance that enables a person to continue to fight and maintain a positive attitude despite what might seem to be overwhelming odds.
What can you do?
- Stay away from people who have colds or the flu
- Get the rest you need and pace yourself
- Talk about your feelings to deal with any sadness, anger, or fear you may have
- Work as a team with your health care providers. Knowing how to help yourself can make you feel more
in control
You may find your daily routine affected as you begin your chemotherapy treatment. We’ve gathered some information to help prepare you for some of the most common issues:
The workplace
Many people can continue working while receiving chemotherapy. However, you may need to change your work schedule for a while if your chemotherapy makes you feel very tired or you have other side effects. It may be necessary to take extended sick leave or to miss work for doctors’ appointments and therapy. Talk with your employer about your needs and wishes. You may be able to agree on a part-time schedule, find an area for a short nap during the day, or perhaps you can do some of your work at home.
Fatigue
Fatigue from cancer feels different from fatigue of everyday life. Fatigue caused by chemotherapy can appear suddenly. Not everyone feels the same kind of fatigue. You may not feel tired, while someone else does. It can last days, weeks, or months. Not only does severe fatigue go away as the tumor responds to treatment, but there are always ways for you to cope.
- Plan your day so that you have time to rest
- Take short naps or breaks, rather than one long
rest period
- Save your energy for the most important things
- Take short walks or do light exercise if possible
- Try activities such as meditation, prayer, yoga, or visualization
- Limit the amount of caffeine and alcohol you drink
Report any changes in energy level to your doctor.
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Nausea
Many patients fear 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, less severe. These 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. Work with your doctor and nurse to find what works best for you. Small changes can make a big difference during this time.
- Eat and drink slowly and in small amounts
- Eat many small meals instead of a few large meals
- Chew your food well for easier digestion
- Drink cool, clear, unsweetened fruit juices
- Prepare and freeze meals in advance for days when you don’t feel like cooking
- Breathe deeply and slowly when you feel nauseated
- Avoid sweet, fried, or fatty foods
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Pain
Chemotherapy drugs may sometimes damage nerves, leading to burning, numbness, tingling, or shooting pain, most often in the fingers or toes. Not everyone with cancer or who receives chemotherapy experiences pain from the disease or its treatment. But if you do, it can often be relieved. The first step to take is to talk with your doctor, nurse, and pharmacist about your pain. You need to tell your doctor, nurse, pharmacist, and family or friends:
- Where you feel pain
- What it feels like—for example, sharp, dull, throbbing, steady
- How strong the pain feels
- How long it lasts
- What eases the pain, what makes the pain worse
- Which medicines you take for the pain and how much relief you get
There are many different medicines and methods available to control cancer pain. You should expect your doctor to seek all the information and resources necessary to make you as comfortable as possible.
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Hair loss
Hair loss is a common side effect of chemotherapy, but not everyone experiences it in the same way or to the same degree. Hair usually grows back after the treatments are over, though sometimes it may grow back a different color or texture. Hair may fall out either gradually or in clumps, while any hair that is still growing may become dull and dry. Losing hair from your head, face, or body can be hard to accept. Feeling angry or depressed is common and perfectly all right. Keep in mind that it is a temporary side effect. You may want to change some of your habits during treatment.
- Use a mild shampoo
- Use a soft hair brush
- Use low heat when drying your hair
- Have your hair cut short to look thicker and fuller
- Avoid using brush rollers to set your hair
- Avoid dying, perming, or relaxing your hair
Some people choose to wear turbans, scarves, caps, or wigs. Others leave their head uncovered. There are no right or wrong choices; do whatever feels comfortable for you.
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Anemia
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:
- 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/he may also prescribe a medicine that can boost the growth of your red blood cells. Things you can do if you are anemic (see Fatigue):
- Get plenty of rest
- Sleep more at night and take naps during the day
if you can
- Limit your activities
- Ask for help when you need it
- Ask family and friends to pitch in with things like childcare, shopping, housework, or driving
- When sitting, get up slowly. When lying down, sit first and then stand. This will help prevent dizziness
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Infections
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 that fight many types of infections. Your doctor will check your blood cell count often, and may recommend medicines that help speed the recovery of white blood cells. Raising the white blood cell count greatly lowers the risk of serious infection. Though most infections come from bacteria normally found all around us, there are some steps you can take to reduce the risk.
- Wash your hands often during the day. Be sure to wash them before you eat, after you use the bathroom, and after touching animals
- Stay away from people who have illnesses you can catch, such as a cold, the flu, measles, or chicken pox
- Avoid crowds by shopping when stores are least likely to be busy
- Be careful not to cut or nick yourself when using scissors, needles, or knives
- Use an electric shaver instead of a razor to prevent breaks or cuts in your skin
- Pat your skin dry using a light touch. Do not rub too hard
- Use lotion or oil to soften and heal your skin if it becomes dry and cracked
- Clean cuts and scrapes right away and daily with warm water, soap, and an antiseptic until healed
- Wear protective gloves when gardening or cleaning up after others, especially small children
- Do not get any immunizations, such as flu or pneumonia shots, without checking with your doctor first
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Bleeding/bruising
Anticancer drugs can affect the bone marrow’s ability to make platelets, the blood cells that help stop bleeding by making your blood clot. Without enough platelets, you may bleed or bruise more easily than usual. Call your doctor if you have any of these symptoms:
- Unexpected bruising
- 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
regular period
- Headaches or changes in vision
- Warm or 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.
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Diarrhea
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 on an outpatient basis and do not require hospitalization. Do not take any over-the-counter medicines for diarrhea without asking your doctor. You can take steps to help control diarrhea.
- Drink plenty of mild, clear liquids, such as water, clear broth, or sports drinks
- Avoid hot or very cold liquids
- Avoid coffee, tea with caffeine, alcohol, and sweets
- Stay away from fried, greasy, or highly spiced foods
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Constipation
Your reaction to chemotherapy may include constipation. If you become constipated there are steps you can take to ease the condition.
- Drink plenty of fluids to help loosen the bowels
- Check with your doctor to see if you can increase the fiber in your diet. 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 try a more structured exercise program. Talk to your doctor about the amount and type of exercise that is right for you
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Nerve tingling
Sometimes anticancer drugs can cause problems with your body’s nerves. You might feel tingling, burning, weakness, numbness, or pain in the hands and/or feet. Some drugs can also affect the muscles, making them weak, tired, or sore. Though these effects can be a passing annoyance, they may be serious enough to require medical attention. Be sure to report any nerve or muscle symptoms to your doctor. The symptoms may include:
- Tingling
- Burning
- Weakness or numbness in the hands and/or feet
- Pain when walking
- Weak, sore, tired, or achy muscles
- Loss of balance
- Difficulty picking up objects and buttoning clothing
- Shaking or trembling
- Jaw pain
- Hearing loss
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Pregnancy
Although pregnancy may be possible during chemotherapy, it is not advisable because Hycamtin may cause birth defects. Doctors advise women of childbearing age (from the teens through the end of menopause) to use some method of birth control throughout their treatment (for example, condoms, spermicidal agents, diaphragms, or birth control pills). Ask your doctor about these contraceptive options. If a woman is pregnant when her cancer is discovered, it may be possible to delay chemotherapy until after the baby is born. For a woman who needs treatment sooner, the possible effects of chemotherapy on the fetus need to be evaluated.
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Sexuality
If you were comfortable with and enjoyed sexual relations before starting chemotherapy, chances are you will still find pleasure in physical intimacy during your treatment. You may discover, however, that intimacy changes during treatment. Some people find that they feel closer than ever to their partners and have an increased desire for sexual activity. Still others find that their sexual interest declines because of the physical and emotional stresses of having cancer and getting chemotherapy. Be aware that your partner’s concerns or fears may also affect the sexual relationship. You and your partner should feel free to discuss sexual concerns with your doctor, nurse, or other counselor.
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Exercise
You may want to begin a modified exercise program depending on how you are feeling and the stage of your treatment. Check first with your physician, especially if your blood counts are low. You may have to modify the duration, intensity, and frequency of exercise. Some guidelines are:
- Exercise moderately for 20-30 minutes, 3 to 5 days
a week
- Choose activities you enjoy. Tai chi, walking, and yoga are all good choices
- Try a weight training program to increase muscle mass
- Walk the dog, take the stairs instead of the elevator, cycle to the store, or try gentle swimming (make sure your blood counts are OK before going into a public swimming pool)
- Try isometric exercises—they do not involve joint movement, and consist of contraction (squeezing) of the muscles without any movement of the limb
Avoid exercise if you are showing any signs of infection such as a fever. STOP IMMEDIATELY IF YOU EXPERIENCE ANY SHORTNESS OF BREATH OR DIZZINESS.
Remember, no one source can answer all your questions or replace the information provided by your doctors and nurses. This Web site is not intended to replace ongoing communication between you and your health care team.
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Important Safety Information
Use of Hycamtin
Hycamtin is used for the treatment of recurrent ovarian cancer.
Reasons Not to Use Hycamtin
Do not use if you have had an allergic reaction to Hycamtin, if you are pregnant, if you are breast-feeding, or if you have low blood counts.
Side Effects
Hycamtin can interfere with your body’s ability to make white and red blood cells. Your doctor may prescribe a supportive therapy to help your body make more blood cells.
Side effects often associated with Hycamtin included nausea (64%), vomiting (45%), diarrhea (32%), hair loss (49%), fatigue (29%), and shortness of breath (22%). Most of these side effects were mild to moderate.
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