One of the many FAQs that we have been asked at Survingbreastcancer.org is “How should I deal with side effects, i.e., to lessen their impact and eliminate them entirely?”
There are many potential side effects to chemotherapy. The shortened list includes nausea, vomiting, loss of appetite, dehydration, mouth sores, fatigue, diarrhea, constipation, water retention, “chemo brain” and hair loss.
Of course, you should always notify your oncological team to any side effects that you may be experiencing.
In this blog I’d like to address six of the most commonly experienced side effects that I and my cohort have faced, and typically how we have dealt with them:
1. Hair Loss. Hair loss is quite common and can be quite an emotional tug. This occurs in most cases within 6 weeks from the start of chemo, depending on the treatment, and should start to return shortly after the cessation of chemotherapies. There are a few notable ways to lessen the impact, but typically if you are going to lose your hair it may behoove you to take a graduated approach. I’ve found that cutting my hair quite short after the start of chemo was a very helpful first step. Cutting my hair short was something I would never do otherwise, so this was my chance to try out a fun pixie cut with no risks! Shortly after starting Adriamycin and Cytoxan (AC) treatment, (aka the “red devil”) clumps of my hair started to fall out.
At this phase, I wasn’t sad to lose my hair, rather I was frustrated at how annoying it felt every time I put on a shirt and whisps of hair would fall out; every time I ran my fingers through my hair, more whisps would fall out. Imagine those tiny little hairs after a haircut falling out everywhere, shedding like a cat - annoying right? So, feeling empowered to take control of the situation, I shaved my head. Don’t spend tons of money either on this type of haircut. I literally went to a barber shop and asked them to shave it all off. The barber was initially confused, and asked if I wanted any sort of etching or designs. As innocent as the question was, I explained that I was sick and I was taking it all off!
Other less drastic remedies include:
Use mild moisturizing shampoos and conditioners – avoid harsh chemicals
Use a soft brush
Wear a scarf, wig, or hat.
I chose to rock the bald look and it helped me to accept my condition. Note: I also shared my diagnosis and treatments on YouTube and other Social Media so this choice may not be for you.
While everyone associates losing hair on your head as the only place you will lose it, don’t be surprised if you start to lose hair on your legs, under your arms, as well as your nose hairs, eyelashes and eyebrows, etc.
Take care of your scalp by lubricating and protecting it from the sun. I found tea tree and castor oil to help my hair follicles grow faster!
2. Fatigue is a common side effect and typically starts when commencing chemotherapy. Ongoing exhaustion and/or overall weakness can prevent one from performing normal/routine tasks and activities. And just as importantly, it can contribute to the emotionality of dealing with cancer. What follows is a list of ways to mitigate fatigue:
Rest is more than appropriate and should become part of your everyday routine.
Naps are highly encouraged
Additionally, an exercise regimentation is strongly recommended (be sure to consult with your medical team to determine the limitations of your work outs. Walking and swimming are two of the best. (See our previous blog on exercise.) As counterintuitive as it sounds, getting 30 minutes of exercise a day helps combat the systems of fatigue.
Don’t be afraid to ask for help, i.e. grocery shopping, housecleaning, errands etc. Proper nutrition/diet goes a long way to alleviate fatigue (see our nutrition blog).
Also, lean on your support group, parents, significant others, or roommates to be your advocates. I have a hard time saying no and I love being social, having friends over and entertaining. However, my caregiver got to play the “bad cop” reminding people that I am fighting cancer and sometimes the answer had to be “she needs her rest.”
Personally, I came to really appreciate this. It took the pressure off of me knowing that my caregiver had my best interest and realized when I was easily becoming over taxed.
3. Nausea and/or Vomiting is another side effect and is attributable to chemo damage to healthy cells in your stomach and gastrointestinal tract. The following recommendations may offset both:
Avoid hot spicy foods. Eliminate or greatly reduce the garlic, chili oils and hot peppers, and cool down your exotic foods. I have gone so far as to request mild Indian, Thai and Mexican foods, which is something I never thought I’d do. Bland foods are easier to handle. Easy examples include:
Saltine crackers
Toast
Cereals
This is a case where bland is better.
Another trick I found helpful was to suck on hard candies and utilize ginger in my juices and smoothies. I also found it important to reduce the size of your meals. Eat smaller portions and more often more often.
Drink plenty of water. I’ve gone so far as to measure my water intake and set goals that approached 120 ozs daily. Hydration is key!
If these natural remedies do not help and the nausea persists, talk to your medical care team. They may prescribe steroids to help manage this system. I was on Decadron (http://www.chemocare.com/chemotherapy/drug-info/decadron.aspx) , Compazine and Zofran which helped me tremendously!
Acupuncture and natural supplements may also help. More on these treatments in a follow up blog.
4. Mouth Sores are common inside the mouth and along the throat. These can be painful and make it difficult to swallow. The ways to mitigate and or remediate include:
Gargling with salt water
Avoiding hot spicy foods
Staying away from tomato based sauces
Refraining from tobacco and or minimizing alcohol
Use Non-alcohol based mouth wash
Change your tooth brush often
5. Gastrointestinal Irritation (Diarrhea/Constipation) can result from chemo damage to the lining of your stomach and intestines. Note: Severe diarrhea can be quite dangerous and one should get treatment ASAP to resolve. Typically, patients may experience watery stools at first and the following remedies may eliminate or reduce the severity:
Stay hydrated. As mentioned above drink plenty of water. Minimize milk and other dairy products. Try yogurt for their bacteria cultures. Avoid fatty food, choose easy to digest foods, eat smaller portions several times daily. A lot of times breast cancer patients mention that their diets have changed and that is because so much of our bodies are changing at warp speed as chemotherapies are working their magic. If you are in your first few weeks of a chemo regimen, it may take trial and error to see which combinations of foods agree with your stomach.
Here is a list of foods that can cause binding and lead to constipation:
Bananas
Red Meat
Dairy
Fried foods
Processed grains
Here is a list of foods that can cause loose stools and lead to diarrhea:
Dairy products
Greasy foods
Onions
Corn
Citrus fruits
6. Hot Flashes. As a premenopausal woman of 36 years old, I cannot leave off the list of chemo side effects, the dreaded hot flash! Chemotherapy destroys fast-dividing cancer cells and according to Breastcancer.org, can be harmful to your ovaries. As a result, younger women may notice that their menstrual cycle stops and they experience medically induced menopause. Unlike older women who enter menopause over the course of several years, younger women are thrown into this state in a matter of weeks! As such, menopause-like side effects associated with chemotherapy treatments can be surprising, and unpleasant. One of the most common are hot flashes.
While it is not clear what exactly causes hot flashes, studies suggest that it is most commonly due to chemical changes in the body. Therefore, if you are estrogen receptive positive (ER+) and your treatment plans requires the reduction or elimination of estrogen and/or ovarian suppression from Lupron or Zoladex, then it stands to reason that medical induced menopause and hot flashes are a common side effect.
Hot flashes (or night sweats) are sudden changes where you may feel red, hot, flush, or even experience severe sweating anywhere from 1 to 10 minutes. While there is no magic cure to eliminating hot flashes, here are a few tips on how to reduce their severity:
Notice what triggers hot flashes. A lot of times it can be linked to certain foods like spicy entrees, garlic, caffeine, or alcohol.
Dress in layers. Invest in tank tops or t-shirts that are made with wicking material, they are loose and wick away sweat to help you stay comfortable. I personally loved pj’s from Cool Jams.
Take a cool shower before bed; this will take away any sweat from the day so you are not freezing at night and also help you remain cool so you can fall asleep.
Finally, discuss with your medical care team! While they may not be able to prevent hot flashes, they may offer a prescription which could help, for example, Gabapentin.
There are many more tips and many more side effects one may be exposed to when experiencing chemotherapy. Post a comment below of what you are experiencing and I will be sure to include information in our upcoming blogs on chemotherapy.
In the meantime here is a list of helpful links that I found quite helpful:
12 Tips & Tricks to Get You Through Chemotherapy - My Cancer Chic
Ten tips for getting through chemo - Breast Cancer Care
11 Tips to Get Through Chemotherapy - Oprah.com
Tips for Managing Chemotherapy Side Effects: Nausea and Vomting
Ten Tips for Surviving Chemo | Breast Cancer Support - Ready for ...
10 Tips to Help You Through Chemotherapy – Health Essentials from ...
Tips for Handling Chemo Side Effects - Side Effects - Guide2Chemo ...