Image Recovery Centers: Education Articles

Patient Guidelines for Managing Effects of Chemotherapy
By: Image Recovery Staff | March 19, 2002

Patient Guidelines for Managing Effects of Chemotherapy

What is Chemotherapy?

There are various treatments for cancer. These include surgery, radiation, chemotherapy and biotherapy. One or more of these treatments may be used to treat your cancer. Chemotherapy is the use of drugs. Usually more than one drug is used to treat your specific cancer. Chemotherapy is intended to kill cancer cells that may or may not be undetectable. Unfortunately, chemotherapy will not only kill cancer cells but will also kill any normal cells that are rapidly multiplying. Normal cells differ from cancer cells by their capacity to repair themselves. Therefore, chemotherapy will theoretically kill cancer cells and eliminate them to a level that your own immune system will destroy what is remaining.

When is Chemotherapy Used as Treatment?

Chemotherapy will be used anytime there is known or suspected cancer cells in the body’s circulation or microcirculation.

The goals of chemotherapy can be for cure, control or palliation. Cure would mean that the cancer treatments which include chemotherapy, would eliminate all of your cancer and it would not return.

A second goal may be control of the cancer. Chemotherapy would be used to keep the cancer from spreading. It would not eliminate the cancer altogether, but it can keep the cancer “in remission” for a period of time.

The last role of chemotherapy could be for palliation. This means that chemotherapy is used to prevent symptoms from occurring and is used to help one feel more “comfortable” although the cancer may still progress.

How Does Chemotherapy Work?

Chemotherapy is a “systemic” therapy. This means that the drugs will go throughout your body and theoretically kill cancer cells within your body. Certain chemotherapy drugs are known to kill certain types of cancer cells. Therefore, your chemotherapy drugs are selected with your specific cancer in mind.

How is Chemotherapy Given?

Most chemotherapy is given intravenously (IV). This means it is given directly into your blood system. This allows the drugs to be rapidly absorbed and begin to work on your cancer quickly.
Sometimes chemotherapy can be given by other ways, such as in pill form. Your doctor or nurse will explain the way in which your drugs are to be given to you.

How Long Do Treatments Last?

The length of your treatment will depend on the type of drugs you are receiving, the combination of drugs and your tolerance of the drugs. Usually treatments last from one to three hours. However, some treatments may be as long as five hours.

What Side Effects Will I Experience?

Side effects from cancer chemotherapy drugs will depend on the specific drugs, the dose of drugs and how you respond to the drugs. No two people experience the same side effects.

Specific information regarding side effects of your treatment will be provided to you by our cancer center staff. It is important to know that most side effects can be managed or eliminated. Most people are able to continue with their normal routines including work with some modification. Again your individual treatment plan and potential side effects will be discussed with you.

Remember, most side effects are manageable, thanks to our increased knowledge of how to deal with them. We will continue to work with you throughout your cancer treatments to make them safe, effective and create as little interruption to your life as possible. Your input into your treatments and how you are feeling is essential in helping you feel your best. Please let us know if you have any questions, concerns or symptoms you are experiencing.

Why Does Hair Loss Occur During Treatment?

The normal scalp has 100,000 hairs! Some people have thin hair; others are blessed with thick hair. Ten to fifteen percent of your hair is in the resting phase. Eighty-five to ninety percent is actively growing and is susceptible to chemotherapy and radiation. The degree of hair loss depends on the chemotherapy drug, the dosage of chemotherapy or radiation and how it is given.

Hair loss or alopecia occurs because anticancer drugs can also affect normal cells, including the cells responsible for hair growth. This effect, however, is not permanent and healthy cells grow back normally once chemotherapy is completed.

What Are The Symptoms of Hair Loss?

Chemotherapy: Hair loss, alopecia, will start approximately 2-3 weeks after your first dose of chemotherapy, but won’t be total until 1-2 months have elapsed. Hair loss is reversible even grow while you’re on chemotherapy. This doesn’t mean that the chemotherapy isn’t working. Unfortunately, some of this re-grown hair may also fall out. Hair on the head is most commonly affected, but hair loss may also occur on the face, arms, legs, underarms and pubic areas. The scalp may become tender and hair that is still growing may become dull and dry.

Radiation: Only hair that is in a treatment field will be affected with hair loss. Generally, the hair loss will begin approximately 2-3 weeks after the start of treatments. This hair will grow back after the treatments are completed. If a higher dose of radiation is delivered, there is a chance that the hair loss will be permanent. Please check with your Radiation Oncologist or nurse if you have questions and concerns about this.

Some Suggestions about Hair Loss: Hair loss, even when expected, can be very discouraging and depressing. Many cancer support groups can offer advice and services to help you understand and handle all the effects of cancer, chemotherapy and radiation.

1. If you know hair loss is possible, shop for a wig before hair loss is experienced. You can always buy it when the hair loss occurs. It’s easier to match hair color and style with your present head of hair.

2. Sometimes hat, scarves or turbans are more comfortable for indoor use. Get a variety.

3. If you have long hair you might consider getting a shorter haircut to minimize the trauma of hair loss. Shorter hair is easier to manage under a wig. A shorter style will make your hair thicker and fuller. It will also make your hair loss easier to manage if it occurs.

4. Use mild shampoos and conditioners

5. Use soft hairbrushes

6. Use low heat when drying your hair

7. You may use a dye rinse on your hair

8. Don’t use permanent dye on your hair or get a permanent

9. Don’t use brush rollers to set your hair

10. Remember that a hairpiece needed because of cancer treatment is a tax-deductible expense and may be at least partially covered by your health insurance. Be sure to check your policy and ask us for a wig prosthesis prescription.

Losing hair from your head, face or body can be hard to accept. It’s common and perfectly natural to feel angry or depressed about this loss. Talking about your feelings can help. Remember that the hair lost during treatment may grow back thicker than ever.

Although not all chemotherapy drugs cause hair loss, many can damage your hair, changing its type and condition. Chemotherapy can make your hair fragile, requiring extra gentle care when wet or dry.

Note that there are no shampoos, conditioners or chemical treatments that will prevent hair loss.

Remember to postpone receiving chemical treatments (color, highlights or permanents) until 8 weeks after the completion of chemotherapy. Be sure to consult your physician first.

HAIR ALTERNATIVES

Wigs are available that look and feel as natural as your own hair. Depending upon your lifestyle, you may choose to wear head-wraps or hats when not wearing your wig. A little creativity and an open mind goes a long way.

The head-wrap is perfect as a stylish alternative to a wig, as well as a great way to accessorize any outfit.

The Image Recovery Centers® have a variety of beautiful headwear including wraps, hats, sleepwear and turbans.

Since chemotherapy and radiation can make you more susceptible to infecting and bleeding, it is important to use extra caution when cleansing the eye area. The best way to minimize eye infection and injury is to use disposable products (cotton balls) and avoid harshly rubbing the skin.

CHEMOTHERAPY, RADIATION AND THE SUN

We do not suggest that you stop enjoying the outdoors on sunny days. We do recommend that you follow a few guidelines. This is particularly important if you have had any radiation therapy - the area treated is much more susceptible to sunburn and skin damage. Chemotherapeutic agents will also potentiate sunburning and a sunburn can cause potentially permanent changes in the skin’s pigment. These skin changes can occur during the time the drug is being given or can reactivate a previous skin reaction caused by sun exposure. Photosensitivity can be caused by the following chemotherapy drugs: actinomycin D, bleomycin, dacarbazine, adreamycin, 5FY, metholrexate and vinblastine.

Often your skin will develop symptoms of burning, itching and swelling when it is exposed to an amount of sun that normally wouldn’t bother you at all.

When you engage in outdoor activities, use SPF 25 or greater.

Our sun protection skin care line has been specially formulated to hydrate and protect the skin.

Make-up can produce miracles with the right colors and proper application. It can be used to accentuate your best features, be used as a camouflage for dark circles under your eyes or to fill in brow when hair loss occurs. Makeup will change the way you feel about yourself and the way people treat you.

Camouflage makeup is available for bruises, scars, blotches, and any changes in tone which may occur.

Clothing can make a powerful statement about your personality, lifestyle and attitude.

Although clothing needs may change after surgery due to removal of tissue or the placement of tubes or bags outside the body, it should not interfere with your ability to be fashionable and look your best.

Side effects of chemo, radiation and prolonged illness may cause skin discolorations making you appear pale, sallow, jaundiced or ruddy. The proper use of colored clothing and makeup should make people notice you, not your clothing or changes in your skin.

SPECIAL CLOTHING NEEDS

The treatment of cancer can make selecting attire a challenge.

Steroids can cause the face to appear abnormally round and puffy. Loss of weight can cause the face to look thin and drawn. The important dressing consideration for women with a port-a-cath is to avoid any garment that might puncture or break the line (i.e. front clasping bras and pins).

Post-mastectomy products include a large variety of bras, breast forms and swim wear with the convenience of alterations if necessary.

MANICURES AND PEDICURES

Chemotherapy and radiation can cause damage to the fingernails and toenails, which can interfere with their appearance and growth.

Well-groomed nails are even and smooth. In addition to caring for your hands and feet, manicures and pedicures are the perfect time for you to rest and relax.

If you are wearing artificial nails remove them prior to starting cancer treatment. Keep in mind that your cancer therapy may have decreased your ability to fight infection and increased your susceptibility to bruising and bleeding. In general, when having a manicure or pedicure, whether it is done at home or professionally, be gentle with no use of sharp instruments or alcohol based products, which may be very drying.

Exercise is one of the simplest and most effective ways to reduce stress and impart a feeling of well being. Exercise increases muscle tone, alters its chemistry and increases its ability to burn calories. All three of the major forms of cancer therapy, chemotherapy, radiation and surgery, require special exercise considerations.

Before starting any exercise program be sure to consult your physician.

Exercise should become a part of your daily lifestyle. In general, begin slowly, such as walking. Your body will tell you what your limits are…LISTEN, don’t overdo.

Keep a journal with you. Include the following information:

1. Treatment Schedule - Dates/Times

3. Daily Records of: Fatigue, Pain, Nausea, Sleep, Mood, Appetite, Questions & Concerns