Besides local therapy, the best attempt to control cancer cells circulating in the body and lodged at places other than the breast is by using systemic therapy (therapy which effects all the systems in the body) which is in the form of injections or oral medication. This form of treatment is called chemotherapy.
This form of treatment is given in a cyclical manner, each set of drugs being repeated every 3-4 weeks.
Chemotherapy can also be used in combination with surgery, radiotherapy or both, either before or after.
Chemotherapy is used to kill cancer cells, but healthy cells and tissues can be affected leading to treatment related side effects or toxicity. Most, but not all, side effects can be lessened by medication and other methods of controlling symptoms. Unfortunately, some side effects of cancer treatment are difficult to control. You can learn to watch for warning signs, communicate with your doctor and take action quickly.
General side effects of Chemotherapy.
- Nausea and vomiting.
- Abdominal pain, cramps and diarrhea.
- Low blood counts including anemia (the medical term for a lowÂ red blood cell count) which can be a contributing factor toÂ fatigue, or a low white blood cell count, which can make youÂ more susceptible to a fever and infection.
- Hair loss.
- Skin reaction in the radiation area.
- Low platelets which can make you more likely to bleed.
Fortunately, there are drugs that can help ease these side effects, leaving you in relative comfort and fairly resistant to other diseases.
Side effects of Chemotherapy.
Although chemotherapy drugs are designed to affect cancer cells, they unfortunately also harm healthy blood cells that divide rapidly, including:
- Cells that fight infection (white blood cells).
- Cells that help the blood to clot (platelets).
- Cells that carry oxygen to all the parts of the body (redÂ blood cells).
- Hair root cells (resulting in hair loss).
- Cells that line the digestive tract (resulting in nausea orÂ vomiting).
These and other symptoms related to chemotherapy will usually go away gradually during your recovery or after you stop treatment.
Some tips that may help ease your symptoms.
Nausea: Nausea, vomiting and other types of stomach upset are common side effects of chemotherapy and radiation therapy.
- Get plenty of rest (some anti-nausea drugs are actuallyÂ designed to make you sleepy, so you can rest more easily).
- Relax and try to distract yourself with television, radio, orÂ other activities you enjoy.
- Wear loose-fitting clothing that won't bind or add stress toÂ your body.
- Rinse your mouth out often (to eliminate the bad taste andÂ avoid strong foods or odors, which can bring on nausea.)
About an hour after you have been sick, try taking small sips of fluids or sucking on chips of ice, put some mild foods back into your stomach, such as crackers or toast, having another person stay with you to give you the gentle encouragement you need to relax and help your stomach settle down.
Fatigue and anemia: Fatigue is common for cancer patients. Your fatigue may be chronic - that is, it won't go away and limit your activity. There may be weakness, exhaustion, leg pain, difficulty in climbing stairs or walking short distances, and shortness of breath after only light activity. Fatigue can also affect you mentally, making it hard for you to concentrate and easy for you to lose your patience or interest in your hobbies or pastimes.
Chemotherapy typically lowers the number of red cells in your blood (anemia) which carry oxygen throughout your body and give you energy. Since chemotherapy can disrupt your eating and sleeping habits, it will further contribute to your fatigue.
To lessen fatigue:
- Take short naps or breaks.
- Plan your day with frequent breaks for rest.
- Short walks or light exercise may help decrease the feeling ofÂ fatigue.
- Try easier or shorter versions of the activities you enjoy.
- Cultivate interests that are less strenuous, like reading orÂ listening to music.
- Eat as well as you can and drink plenty of fluids.
- Save your energy for the things you find most important, andÂ ask family and friends to help you with more difficult orÂ taxing tasks.
- Keep a diary of how you feel each day. This will help you planÂ your daily activities, and it will help your medical teamÂ regulate any anti-fatigue medication you may be taking.
Fever and infection: Because cancer treatments are so powerful, they almost always greatly reduce the level of white blood cells in your body which are the natural defense against infection. The risk of infection is much greater. A fever is a sign that your body has developed an infection. A very high fever can be dangerous and should be attended to immediately since it can lead to dehydration and seizures. Other symptoms of an infection are swelling, redness, and pain.
Most often, doctors treat the fever and the cause of the infection at the same time. A common course is to combine anti-fever drugs with antibiotics and other medicines to help replenish your body's white blood cells. Make sure that when you first notice one or more of these symptoms, you immediately contact your doctor and follow the prescribed treatment.
Hair loss Anywhere from seven to 21 days after beginning chemotherapy treatment, many people experience rapid and often total hair loss.
Hair loss is usually temporary and takes from six to 12 months to begin growing back.
Growth of the hair takes place in the hair follicles or roots. New hair cells form by division of cells in the follicle. The hair cells are joined together in long chains. The hair cells produce the protein keratin, which accumulates inside the cells. The hair cells eventually die leaving packets of the hard keratin linked together forming the hair. The newly forming cells in the follicle push the dead, keratin-containing cells ahead and so the hair grows.
Growth in the hair follicle follows a pattern or cycle. The cells divide and build the hair shaft for a period and the follicle then rests. The growing cells of the hair follicle are affected by the treatments for cancer.
Chemotherapy unfortunately does not distinguish between rapidly reproducing normal cells and abnormal cancerous cells. At any one time, about 85 per cent of the hair follicles on the scalp are actively dividing. Treatment that interferes with cancer cells is also likely to affect hair growth.
Not all chemotherapy drugs affect the hair. The amount of hair that is lost depends on the drug or combination of drugs, the dose and your own individual reaction to the drug. Hair loss may be so slight as to be hardly noticeable and sometimes it is apparent as an overall thinning of the hair. Unfortunately with some of the drugs most or all hair will fall out.
Hair can be lost from the scalp and also the eyebrows, eyelashes and the moustache and beard areas in men. Hair from the armpits, chest and pubic areas may be lost as well. The first thing you may be aware of is that you lose hair when it is brushed, combed or washed. When you wake in the morning, you may notice hair on your pillow and sheets. Hair loss may occur at any time during treatment but is more likely to happen within the first few weeks.
Hair loss is temporary in most cases. After chemotherapy, your hair will regrow and this may happen even before your treatment has been completed. Most often, the first soft hairs reappear within a month or six weeks of stopping treatment and you can expect to have a reasonable head of hair three to six months later. Some changes may happen in your hair when it grows back. It may be little more curly, thicker or finer than it was before, or it may grow back a slightly different colour.
Taking care of your hair and scalp during treatment.
- The best advice is simple - keep your hair and scalp clean andÂ be gentle with it.
- Use gentle hair products. Comb or brush your hair gently usingÂ hairbrush with soft bristles. This is also helpful if yourÂ scalp feels tender.
- Use a satin, polyester or cotton pillowcase rather than nylon,which can cause irritation.
- Avoid using a hair dryer as this will dry the hair and make itÂ more likely to break.
- Avoid plating or braiding your hair as this pulls andÂ stretches the hair.
- If you have lost all your hair, you may find your scalpÂ becomes flaky. This can be removed by gently rubbing the scalpÂ with moist cotton wool. A mild anti-dandruff shampoo mightÂ help.
- If you have lost hair under your armpits, avoid using perfumedÂ deodorants. Use a small amount of baby powder instead.
- A gentle scalp massage can be invigorating and make you feelÂ much better.
You have lived with your hair for a long time and it is part of your personality, Losing your hair is not easy, whether you are a child or an adult. It is a part of your appearance and body image. You probably feel strongly about losing your hair and it will take a lot of courage to come to terms with this.
At times you may feel angry and depressed about losing your hair. It is bad enough to go through treatment and to lose your hair as well can seem like the last straw. It can also be a constant reminder that you have cancer.
Coping with hair loss.
- Talk about your feelings to a close friend or relative, yourÂ doctor or nurses or may be someone who has already experiencedÂ hair loss.
- You may also find it difficult to cope with other people'sÂ reactions to your hair loss. Other people are ill at ease withÂ you or feel too awkward to raise the subject; you may find it easier if you can start talking about your hair loss first.
- style="list-style:disc;"Try not to lose contact with the outside world during the timeÂ you are losing your hair. The support of friends and family canÂ make hair loss less traumatic.
- Think about having your hair cut short before your treatment.Some people find it helpful to cut their hair in stages so theyÂ have time to adjust to losing their hair. Losing short hair canÂ be less troublesome than long hair and it stops the weight ofÂ long hair pulling on your scalp.
- Seeing your hair on the pillow can be upsetting and a visibleÂ sign that something is happening. You may wish to wear aÂ hairnet, or a toweling turban tied around your head at night toÂ prevent hair falling on your bed.
- If your hair is thinning, careful styling can give theÂ appearance of thicker hair. Wiglets or partial hairpieces canÂ also be used to add body or to cover bald areas.
- A healthy diet assists the growth of new hair.
- Some people choose to wear a wig.
- An alternative is to collect attractive hats, scarves orÂ turbans. Scarves usually need to be at least 50 cm long toÂ cover the head. Cotton light-weight wools or blends are goodÂ fabrics to use whereas nylon or silk tends to slip off theÂ head.
- Toweling turbans are comfortable, especially in hot weather.
- Draw attention away from your hair by highlighting otherÂ features.For women, a little extra make-up around the eyes,cheek bones or lips will direct attention to your face as wellÂ as boost morale. Experiment with jewelry, chains can emphasizeÂ the neckline while striking earrings can enhance a shortÂ hairstyle or look good with a hat or scarf.
- It is important to do whatever feels comfortable and gives youÂ the most confidence whether that means wearing hats,scarvesÂ and wigs, or wearing nothing at all on your head.
Hair loss in children.
Children can also lose their hair during chemotherapy or radiation therapy and it can be difficult for children to face friends at school or playing sport. Teasing can be upsetting and traumatic and if this is a problem, the school teacher may be able to help.
Children may find a wig a bother and choose not to wear one. Baseball caps and beanies are popular headwear for children. Scarves are also popular and can be tied in lots of different ways. Try looking at what else is in style.
Tips for children.
Talking to parents, brothers, sisters or friends about your feelings is helpful. Talk to the doctor, nurse or social worker and find out what hair loss to expect during treatment. Talk to school teachers and explain to them about hair loss and cancer treatment.
Choosing a wig or hair piece.
Buy your wig before your hair falls out so you can get a good match to the color of your real hair. If you prefer, buy a turban or head scarf for those times when you do not want to bother putting on the wig - especially when you are at home.
Wigs can be made from real hair or synthetic materials. Human hair wigs tend to be more expensive and need to be dry cleaned and set once a month. Synthetic wigs are less expensive, easier to style, wash easily, dry quickly and need less care. Both look natural. Synthetic wigs only last about nine months, but this may be all you need. Try to get a wig that adjusts to any head size to take into account variations as you lose your hair.