Chemotherapy

Chemotherapy is a cancer treatment using specialised drugs that kill cancer cells. These drugs are given directly into the bloodstream and travel throughout the body (systemic treatment). This means that chemotherapy can be given for cancer that is or may be in several parts of the body.

Nutritionist from Heartbeat Tararua with local residents

Chemotherapy works on cells that multiply rapidly. These cells include cancer cells as well as some normal cells such as the cells that line the gut, hair follicles and the cells in the bone marrow ( where the blood cells are made). Because chemotherapy travels through the blood to the whole body, the side effects of chemotherapy can affect many different parts of the body. Chemotherapy is given in divided doses 3-4 weeks apart usually. This is to allow the normal cells affected by the chemotherapy time to recover but not enough time for the cancer cells to regrow.

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General Chemotherapy Side Effects:

Most chemotherapy drugs have the potential to cause some nausea and vomiting but this is rarely severe. There are many very good medications available to minimise this side effect and your doctors can try different combinations to find the one that works best for you.

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Not all chemotherapy drugs cause hair loss and if they do, the hair always re-grows once the chemotherapy treatment has completed. If you do experience hair loss as a result of your treatment, you are entitled to a $400 Government subsidy towards the cost of a wig or hats. Your nurse who administers your treatment has information and forms as to who in your areas supplies the wigs and how to get the Govt subsidy.  Look Good Feel Better (Cancer Society site) is a programme run in conjunction with the Cancer Society to help women cope with the appearance changes like hair loss caused by cancer treatment. Enrolment forms are available through staff in any of the treatment areas.

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Chemotherapy affects special cells in the bone marrow which grow into white blood cells. White blood cells protect us from infection. There are several different white blood cell and the most important one in preventing infection is called a neutrophil. Without the neutrophils on the job, the other white blood cells cannot do their work as well as they should. Anyone who is receiving chemotherapy who becomes unwell at anytime should see a doctor without delay. This is because if the number of neutrophils in the blood is low they may need antibiotics to help the body fight any infection present.
The sign of infection to take most notice of are:

• A temperature above 38
• A very sore throat
• A cough with coloured phlegm
• Vomiting and diarrhoea
• Burning when you pass urine
• A cut or sore that is not healing

You will be asked to have blood tests around the time the doctors expect your white blood cell count to be low. It is important that you have these blood tests on the dates written on the forms. The nurses who administer your chemotherapy monitor your results and will contact you if your counts are particularly low. Even if you have not heard from your nurse and you feel unwell, it is important to have a blood count as soon as possible to check your white count. For this reason it is usually best to go directly to your nearest Emergency Department where you blood count can be checked quickly and you will be assessed by a doctor. If you have been given a blue chemotherapy card, take this with you, as it tells the doctor who sees you exactly what treatment you are receiving. Further information (BC Cancer site) Drug Specific Information (Medsafe).

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Fatigue or tiredness is a common side effect of chemotherapy which may affect individuals differently in terms of the severity, duration and frequency. Fatigue is a tiredness that is not the result of exertion or exercise but occurs as a result of changes in the body that result from cancer or cancer treatments. Fatigue symptoms may range from a decrease in energy levels at some times, reduced concentration span and memory or lack of motivation and interest in usual hobbies and activities. Fatigue  may impact on your ability to work or perform complex tasks at certain times in the day or in general.  Fatigue does not generally go away with rest.

Things you can do to help

It is important to remain as active as you feel able.

• Plan short rest and activity times into each day.
• Some gentle exercise such as walking each day can benefit the fatigue associated with chemotherapy.
• Set some achievable goals each day. This probably isn’t the time to try and improve your level of fitness or set yourself increasing targets.  Exercise should make you feel better when you finish, not worse. Your body will tell you if you are overdoing it so listen to your body and rest when you feel you have done enough.
• Eat as well as you are able and drink plenty of fluid
• Save your energy for the things that are important to you and ask for assistance with things that are less important. People who can help are family, friends or professional support workers such as Social Worker or Cancer Society.

Other less common or temporary side effects which may result from some chemotherapy are:

• Sore mouth
• Constipation or diarrhoea
• Loss of appetite

If any of these side effects are more likely with your particular chemotherapy you will be given specific information to help manage the symptoms. If you are having difficulty with side effects from your treatment please contact your doctor or nurse where you are receiving treatment for advise.

It is important to try to eat some foods from all the major food groups while you are on chemotherapy treatment.

• Protein-meat, fish, eggs, milk, cheese
• Carbohydrate – bread, cereals, pasta, rice, beans
• Vitamins and Minerals –Fruit and vegetables

There is no evidence that very restrictive diets or excessive supplementation with vitamins and anti-oxidents is beneficial at this stage.

If you do not feel like eating, do not do nothing as your body needs nutrients for energy and wellbeing.

Try:

• Small frequent snacks rather than 3 meals per day
• Drink plenty of fluid -it can be anything you like
• Avoid hot, spicy or greasy foods
• Meal substitutes such as Complan or Ensure

Talk to your doctor or nurse if not eating is becoming a problem

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Last Updated 28/10/2007