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In Treatment For Breast Cancer: Managing Your Medical Care

Practical Tips While Undergoing Chemotherapy

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Do Not Expect Instant Results

  • It can be difficult to know whether treatment is working since there is nothing to see.
  • You will only know how the treatment is working in time when you undergo tests similar to those which diagnosed your breast cancer. This is usually after the completion of at least two treatment cycles.
  • On the other hand, if your cancer metastasized and the chemo is being used to reduce the size of the tumor first, a scan will be taken to see if there are changes.
  • Do not be surprised or depressed if the initial chemotherapy does not work. Treatment is a combination of art and science. There is no way to predict how any particular treatment will affect any particular person. Several chemotherapies may be used in combination. If one combination doesn't appear to be effective, the combination may be changed.

Learn When To Call Your Doctor 

For instance, call if the following occur. The symptoms may not signify anything important, but let your doctor decide when a symptom is harmless, or whether something should be done right away.

  • Symptoms which indicate there may be an infection. Symptoms of infection include a temperature of 100.5 degrees or higher, chills or sweating, a general sense that you feel poorly, a new cough, burning sensation when urinating, change in bowel habits and an ulcer on the skin.
  • Swelling in the arm or leg that becomes warm, red, and painful. Swelling may be a sign of a blood clot inside a blood vessel that can travel to your heart and then your lungs.
  • Dizziness, headaches, shortness of breath, heart palpitations, pale skin or a feeling of being cold. These symptoms could indicate anemia (a condition in which the blood doesn’t have enough red blood cells or hemoglobin or total volume).  

Stay Hydrated

Chemotherapy is toxic. The chemical poisons are flushed out through your kidneys and bladder. If you do not drink enough liquids, your kidneys and bladder will be exposed to higher concentrations of toxic chemicals. This is the reason people are given beverages to drink during treatment and told to keep fluid intake high.

Check your drinking water to be sure it is safe for people who are prone to getting infections. (See: Drinking Water Safety.)

Do What You Can To Avoid Getting An Infection

While undergoing cancer therapy, your immune system is lower than normal, which means that you are more prone to getting infections and that you have less resistance with which to fight an infection. Infections slow recovery. If your immune system is low (say, from chemotherapy) infections can pose a major risk to your health

Simple steps help avoid unnecessary infection. For example:

  • Wash your hands thoroughly and regularly with soap and warm water. 
  • Keep your hands away from your face. 
  • Use caution when buying, storing and cooking foods.
  • Check the local water supply to be sure it is safe for people with a lowered immune system. If it isn't, filter the water, boil it or drink bottled water. (And don't brush your teeth with it either.)

For additional tips, see: How To Avoid Infection

Avoid Getting Pregnant

 It is not advisable to become pregnant during chemotherapy. If you do become pregnant, let your doctor know right away. 

Talk with your doctor about how long to wait after the end of treatment before it is okay to become pregnant.

Try to Keep A Healthy Weight

More than half of women with breast cancer who undergo chemotherapy experience weight gain. This should be avoided because weight gain during therapy can diminish quality of life and may increase the risk of cancer recurrence. 

  • If nausea and vomiting make it difficult to eat or to maintain weight, click here. 
  •  While you may think only about weight loss during chemotherapy, it is not uncommon for people who undergo chemotherapy to experience weight gain. This should be avoided because weight gain during therapy can diminish quality of life and may increase the risk of cancer recurrence.  
  • Do not attempt weight loss during treatment. Wait until the post treatment recovery phase.
  • A combination of psychological support, nutritional counseling and exercise help to maintain or lose weight. 

SIDE EFFECTS TO CONSIDER  (and how to cope with them)

There may be no side effects to start, but they may appear as treatment continues. There is likely to be some degree of fatigue, pain or other unpleasant side effects. Side effects are a price for regaining health or at least minimizing the effects of cancer. Most people would say the price is small compared to the potential reward.

There may be no side effects to start, but they may accumulate. Some side effects may linger after treatment ends.

Nausea and Vomiting:

  • Chemotherapy can cause nausea, vomiting and dry heaves – sometimes even before a chemotherapy session.
  • There are steps to take both before and after chemotherapy to help reduce the possibility of nausea or vomiting, or the severity. For instance, relax before a session. Afterward, eat small, easy to digest, meals of foods that are easy on the stomach.
  • If you find you get queasy after treatment, it may because you have food in your stomach.
    • Try fasting for several hours before and after each treatment. 
    • If nausea continues, let your oncologist know. He or she can prescribe anti-nausea medication.
  • Ask your doctor about medications to control nausea or vomiting. 
  • Keep track of your symptoms to help a discussion with your doctor or other health care provider. We have a symptoms diary you can use to keep track. When you are ready to see a doctor, you can change your diary into an easy to read graph.

Fatigue

Fatigue is common during chemotherapy for breast cancer. The main reason for fatigue is that your body is building tissues to repair the damage done by treatment.  The process demands energy. Fatigue may also be related to other aspects of the disease or the stress of having cancer. Fatigue can be particularly difficult because it is the side effect that most often interferes with daily life. Fatigue can be due to a number of causes.There are several techniques that can help such as:

  • Get plenty of sleep at night. 
  • Stay active during the day. 
  • Take a nap if needed. 
  • Plan your schedule around when you feel energized. 
  • For other ideas, see Fatigue

Pain

  • Pain does not have to be part of a health condition. If you have pain, speak with your doctor about alternatives for getting rid of it, or at least decreasing how much it hurts. If your doctor’s remedies don't work, seek out a doctor who specializes in treating pain.
  • You can receive what is known as Palliative care at the same time as you work to cure your condition,
  • For information about pain and dealing with it, click here.

 Early Menopause

  • Chemotherapy may cause early menopause. Symptoms of early menopause vary from woman to woman.
  • Common symptoms to watch for include hot flashes, a dry vagina, dry skin and mood swings.

Which Side Effects Appear Depend On The Particular Chemotherapy

There are different side effects which accompany different chemotherapies. Each side effect can either be eliminated or at least reduced in severity. To learn about the possible side effects for each drug used during treatment for lung cancer, visit the following websites:  

 Side Effects To Report

  • Report all unexpected side effects or side effects which are more severe than expected to your doctor. Side effects can be minimized, and in some cases, eliminated entirely.
  • Ask your doctor what side effects to report and when to make a report. For instance, should you only call during office hours, or 24 hours a day?
  • Keep track of side effects so that you can report to your doctor accurately when you see each other. Also keep track of questions to ask. Survivorship A to Z provides a Symptoms Chart to help you keep track of symptoms. We also provide a prioritizer which lets you keep track of your questions, and then lets you prioritize them with a push of a button before you see a doctor.
  • Keep your primary doctor informed about your treatment and side effects. While it may be the last thing you want to hear, other things may be happening in your body at the same time that wouldn't be noticed by your cancer doctor.

Additional Tips For Living With Chemotherapy

If your chemotherapy will be given in a doctor's office or other facility, it may make it easier for you if you take a family member or friend to the first treatment. After that, It may be easier if you go to treatments alone. Going alone makes going for treatment more like going to a standard doctor's appointment. You will likely find other women going through the same treatment with whom to have an informal support group.

Taking the following steps will help you feel in control. They also help maximize your body's ability to get through treatment.

Do what you can to:

  • Eat nutritiously  
  • Stay hydrated.
  • Only drink safe water
  • Exercise (yes, even during treatment - though you may have to take it easier.)
  • Practice good mouth care. 
    • If your dentist advised additional precautions to take during treatment, take them. For instance, your dentist may recommend a fluoride mouth rinse or a fluoride gel in addition to daily brushing.
    • An infection in your mouth can lower your body's ability to fight your health condition. Keep your mouth clean. Brush at least twice a day. Floss at least once a day. (If you haven't had one lately, schedule a dental check up). 
    • Check your mouth every day. Call your dentist immediately if you notice any changes or problems. Any of the following symptoms may indicate an infection:
      • Bleeding or a sticky, white film in your mouth 
      • Lumps 
      • Soreness 
      • Swelling 
      • Ulcerations
  • Minimize alcohol consumption. For example, men should limit drinking to two drinks a day. Women are limited to one drink a day. Ceck with your doctor to find out if there is a negative interaction between alcohol and your treatment or any drugs you are taking.
  • Minimize stress
  • Get appropriate rest  and sleep
  • Don’t keep emotions that surface to yourself.
  • If you smoke consider stopping. 
    • Smoking may interfere with the effectiveness of cancer therapy. Cancer patients who smoke have a lower survival rate than nonsmokers. By quitting, you can improve the body’s response to treatments, lessen complications and side effects, decrease the risk of recurrence and enhance survival.
    • Quitting during treatment may be very uncomfortable. It may include a variety of symptoms such as difficulty sleeping, depression, anxiety and irritability. On the other hand, it may help keep your mind off of the treatment.

Some cancer doctors recommend doing the following while chemotherapy is being administered to act as an anesthetic and to also provide hydration:

  • Suck on a sugar-free popsicle 
  • Eat ice cubes or ice chips. 

Do not take herbs, vitamins or nutritional supplements or use recreational drugs during treatment unless you get your doctor's consent.

Additional tips for living with chemotherapy are described in the document in "To Learn More." For instance, spread the word among your friends that cooking may be difficult for you. Cooking may be particularly difficult for you if you are cooking for your entire household and not just for yourself. Home cooked meals provided by friends are said to have the taste of love in them.

For more information, see:

For information about medical care after treatment, see: Breast Cancer:  Post Treatment 0 - 6 Months: Medical Care


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