What You Really Need to Know about Cancer

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Wednesday, October 8, 2014

Chemotherapy Side Effects: Speaking from the experience, Part-2

Guest Post by: David B. Brown

This article is a continuation of Chemotherapy Side Effects: Speaking from the experience, Part-1

Chemotherapy Side Effects: Bleeding

Chemotherapy Side Effects Bleeding
Bleeding in general is a problem due to low platelets and the inability of the blood to coagulate.  This is probably most noticeable with nose bleeds.  I learned quickly not to blow my nose at all because a nose bleed was inevitable.  Mine were not as bad as others I have heard of – I could control them by breathing out my mouth and in by my nose.  In most cases they would get over in five or ten minutes.  The trick was not to forget – blowing your nose is something you often do without thinking.

Chemotherapy Side Effects: Digestive track

Chemotherapy Side Effects Digestive track
The doctors told me that the digestive track needed a lot of good blood, and that explains why most people have most of their side effect problems with some part of the digestive system.  Think about it – it starts with the lips and goes right on through to your waste discharges, so it is a very comprehensive problem.  Different people get hit in different ways, probably due to whatever organ is suffering the most at the time.

Probably the first thing noticed is a metallic taste that soon overwhelms your sense of taste.  Just why you still have taste at all is a puzzle, as well as why it should default to what I called firecrackers going off in your mouth.  Some who are over-weight have taken advantage of this to lose a couple pounds, but even if you can spare some pounds, your body still needs protein and carbohydrates to fuel the recovery from the chemo, so you just have to condition yourself to eat as best you can.  If you are having trouble, try ice cream, protein shakes, or whatever you can stomach.

There is no telling where the problem may manifest itself. 

It could be in some pain in the stomach, gas, or nausea.  Nausea should be attacked as soon as it is suspected – let your nurse know and they will give you something to get ahead of it – do not wait until you are sick to your stomach.  They gave me something in a very small pill and it seemed to stave off the problem.

The remainder of this article will consider some other digestive system issues.

Chemotherapy Side Effects: Acid Reflux

Chemotherapy Side Effects Acid Reflux
I felt that this had something to do with not being able to burp myself because I was laying down.  I would advise drinking plenty of water but no carbonated beverages.  I did not have this problem until close to the end of my last round of chemo, but everyone is different.  It actually showed itself as a pain in my throat – but nothing like a sore throat or anything else I had had before, so this was a bit scary.  They sent me to a nose and throat doctor and she concluded that it was something that could be treated with Nexium (or it’s generic).  And once my blood numbers came back, I slowly got off of it.

Chemotherapy Side Effects: Diarrhea

Chemotherapy Side Effects Diarrhea
This is a difficult issue to resolve because it could be caused by some undefined bacteria, and so they will typically not administer what you might consider to be the standard remedies.  Since something like this can be extremely serious, the rules that I had were that they had to test the stool for at least three days before they could give me anything for it.  So this one takes a lot of patience with the medical staff.  The samples are taken in what the nurses called the hat because of its shape.  It fit down over the toilet seat. My major problem was that I hated to afflict the nurses with something so obnoxious, but they took it in stride.  In both cases my system worked on through it and I do not think I needed to take anything for it directly – or it could be they slipped something into my IV.  I was not keeping up with that. 

Chemotherapy Side Effects: Constipation

Chemotherapy Side Effects Constipation
One tends to follow the other, especially if you over-medicate, so be very careful of the dosage on stool softeners or anti-diarrhea medications.  When the intestines are not getting enough good blood it is hard to say just how they will respond.  Any interruption in the diet can also trigger it and this is another reason to keep the normal amount of your typical food in your stomach.  The worst case I had caught me by surprise, and I cannot identify any cause for it.  It felt like my colon was being rasped.  It was so bad that I did not want to take a chance on it happening again, so I took two stool softeners in a short period of time, and they did their job all too well.  Balance is the key thing to strive for, but it is difficult when being assaulted by the extremes, one way or the other.  It is very important to watch your diet and make every attempt to keep your food intake as normal for you as possible.  Between the metallic taste and the boring hospital food, this can get to be a real problem, but it is important to at least keep this in mind as the goal.

Chemotherapy Side Effects: Gas

I guess I could try to be funny and say “this one was life threatening.”  But not.  It did cause me some embarrassment at times.  Recognize that your lower digestive tract – your large intestines and whatever, are also going to be disabled.  So total digestion could be a real problem, and partial digestion results in a large amount of gas being generated.  I have heard others express this problem, so do not feel that you are alone.  But I can sympathize with your embarrassment – it seemed that the nurse (or someone) would always come in right after I relieved myself, and the volume would fill the whole room.  You might just warn them to stay out for a few minutes.

The remedy for this as well as general churning in the large intestine is simethicone ,  which one of the nurses told me was identical to GasX (and probably some other OTC remedies).  This is a chewable tablet and it comes in some other forms as well now that make it easy to take and very quick to work.  You might ask them if you can get an extra one in case you need it in the middle of the night, but you will have to pledge not to take more than one every four or so hours.  Usually they want to keep total record of everything that you are taking and when you took it.  But hospital bureaucracy can be a problem – sometimes they have to get the resident MD to approve, and that can take a while.

Chemotherapy Side Effects: Speaking from the experience, Part-1

Guest Post by: David B. Brown
chemotherapy side effects

The major objective of this article is to take the mystery out of what to expect when you go into chemo.  I had no idea of the side effects, and what I heard was not accurate, so for the most part I discovered it for myself.  If you want to do the same, no problem.  But I believe that the fear of the unknown is by far the worst side effect, and that is what this article is intended to eliminate.  We will not pull punches, so the choice is yours.  I apologize in advance for some of the nastier things, but that goes with the turf and is part of a complete treatment of the subject.

First, all chemo does not have to be accompanied by severe suffering.  I have a very close friend who had chemo for CML and while at times it was a bit uncomfortable, it was (and still is) tolerable to the point that she has assumed all of the normal responsibilities of a full time job and raising a child.  But what I will cover here is probably worst case analysis, since I had some of the most intensive chemo that is given.  So take heart that it does not have to be as difficult as what I outline below – check with your oncologist for guidance.

The side effects of the chemo itself generally do not come for a few days after the complete round of chemo is administered.  The blood needs time to die off from its being poisoned by the chemo.  The side effects come from the blood not supplying what various parts of your body need – few people have problems with the chemo itself per se – it has to do its job, so the problems are secondarily related to it – this is good to understand.  If the chemo did not kill the blasts (mutant blood cells) it would not be doing its job, so the side effects are a necessary evil.

Chemotherapy Side Effects: General Weakness and Lightheadedness

This was a problem for me from the outset even before my diagnosis.  The blasts (mutant blood cells) had taken over, and my body (and brain) could not get the nourishment they needed.  Chemo will not help this in the short run, so it is something you have to get used to and after a while you just adapt to it.  Getting up quickly can make you light-headed under these circumstances.  Get up very gradually and if you get to feeling like you might pass out (e.g., seeing stars) sit back down and relax – don’t push it.  You can black out on your feet and fall and hit your head.  So, recognized the problem and do not try to fight it.  Recognize how hard it is to get up and avoid getting down on your knees.

Chemotherapy Side Effects: Mouth Soreness.

Chemotherapy Side Effects: Mouth Soreness
The first thing that most people notice is the effect of lack of good blood in the digestive system.  Soreness in the mouth was the first sign for me that things were starting to degenerate.  I scratching the roof of my mouth with toast slightly before the low numbers hit, and that was a very BAD thing to do.  Avoid toast or anything rough, spicy or overly hot.  Eventually it got to a point where I could no longer fully close my mouth.  Some of the literature on the subject indicates the trade off between keeping your teeth clean and injuring your gums with a stiff toothbrush.  It is important to use a soft toothbrush and to not over-do it, although it is also important to keep your mouth clean – hence the trade off.  When it mouth soreness do not panic – it is normal.

They prescribed something that is quite effective and quite available: a solution of salt and baking soda.  Just a couple tablespoons of each in a liter of water.  You swish your mouth out with it and gargle a little, and it was best not to rinse it out too much when you were finished.  As soon as I increased my frequency of using this mouth wash the problem seemed to abate somewhat, but it did not disappear until my platelet and neutrophils count came back up.  You learn to live with it by not chewing so hard, which is good anyway because the last thing you want at this point is to bite your tongue or have to go to the dentist with a broken tooth (something that they probably would not allow in any event).  I did not have it as bad as some who have bleeding from the mouth.  It was something that the medical people checked every day.  The nurse encouraged me to get in the habit of using the solution whenever I went into the bathroom, day or night.

The lips are not spared either.  Here some type of a lip balm is beneficial – the thick kind that comes in those little bottles.  You do not want anything thin that will run off, or the chap stick type that could create additional problems.

Saline fluid build-up.

The gentle salt/baking soda mouthwash whenever you go to the bathroom is a good idea.  When on chemo in the hospital this can be quite often – at times once every 15 or 20 minutes.  The frequent bathroom visits were caused mainly by the saline solution that they gave me with the chemo to flood my system.  The saline was necessary, especially with the induction treatments.  Later on I was able to talk them out of having me hooked up to the saline around the clock, but that was way into the consolidation treatments, so that was not permitted at early on.  It is necessary to keep the chemo from damaging your kidneys and perhaps some other organs.

As the days progress you will see your legs swelling up due to the excess and you might gain five to ten pounds because of it.  Don’t worry – it is just a temporary thing.  I would guess that the circumference of my legs almost doubled.  They encouraged me to keep walking, and that surely helped.  But there would be no relief until they cut the saline.  It was quite an experience being so overweight that I could not put on my socks or reach my feet while showering.  With swollen legs comes swollen feet – and my normal shoes did not fit.  Fortunately I had a pair of slip-ons that were not for any definite size.

Thursday, October 2, 2014

How safe is chemotherapy during pregnancy?

chemotherapy safe during pregnancy Breast cancer is diagnosed in about 1 pregnant woman out of 3,000 in US. There is always concern about administration of chemotherapy during pregnancy that would bring potential harmful effects to unborn baby, and there are few hypothesis which reveals chemotherapy can lead to deformities or congenital deformities in baby. When cancer is diagnosed in pregnant woman, some woman refuse to start chemotherapy or just delay the treatment. But, for some type of cancer, treatment cannot be delayed or declined. Suppose, if the women is diagnosed with acute lymphoblastic leukemia, and she refuses to start chemotherapy, there is a possibility that she would die with the previable fetus in utero.

A recent study shows that administration of chemotherapy after first trimester (first 3 months) of pregnancy is safe. Dr Frederic Amant, KU Leuven and University Hospitals Leuven in Belgium, the lead Author of the study says that, they cannot discern any problems in the children when chemotherapy was administered after the first trimester of the pregnancy. He also added that fear about the risk of chemotherapy administration should not be a reason to delay or terminate the treatment.

Why chemotherapy is safe after first trimester?

chemotherapy safe during pregnancy Chemotherapy is contraindicated at the first trimester of the pregnancy. The main reason is, during this period baby’s organs starts to grow rapidly and chemotherapy can effect development of organs. And sometimes doctors refuse to give chemotherapy near the delivery (about 32 to 33 weeks of pregnancy) date because it can decreases white blood cell count, decreased white blood cell count can lead to increased risk of infection in mother and baby during delivery.

Even though, administration of chemotherapy is safe after first trimester of pregnancy, it is difficult to convince the patient to use chemo drugs even the patient’s condition is worse. But, at the end of the day, doctors can’t prescribe against the will of the patient. 

Wednesday, September 17, 2014

Getting Through Chemotherapy: Speaking from the Experience

getting through chemotherapy
When I was diagnosed with Acute Myeloid Leukemia (AML) caused by MDS five years ago, I figured my life was over.  In fact, I was actually started on a chemo plan that was more palliative than aggressively seeing remission.  Mainly because of my age (about 65) at that time, and the cause being MDS, my attitude was to just get it all over with as quickly as possible.  I had heard terrible things about chemo, and being nauseated for long periods of time was just unthinkable.

If this is how you are thinking, get over it!  If my attitude had not changed I would not be alive right now and writing this.  There was a point where I said that I no longer cared what the suffering would be, I was going to beat this thing.  It was at the point where I decided to make survival an adventure … and for sure I got my wish.

So the first thing is attitude – probably the most important thing.  But if you know what to expect that will also help.  I did not, and discovered it as things unfolded.  My brain was quite spacy (lightheaded) and I did not concern myself with details – just took things as they came.  But the fear of the unknown can be a terrible thing.

First I would recommend – get a port as soon as possible.  This will relieve you of much of the pain of the many transfusions and infusions that you will get.  The surgery to install the port was no pain at all in my case.  It felt good to get this behind me.  I do not think the type of port is important – just go with what they recommend since this is what they are best at.

getting through chemotherapy
Don’t get overly optimistic if the chemo itself has little effect – they will give you stuff to get you through this part.  It typically does not take effect until a few days afterward.  So, there is nothing to fear during the induction process.  Once it takes effect many of your good blood cells will be killed along with the cancerous cells (called blasts).  This is something that you just have to get through.

Your digestive tract from the lips to other end all require a rich source of blood to function.  The fact that you will not have this source is what causes the issues.  If the numbers get low enough they will give you a blood or platelet transfusion, so do not be alarmed – that is just part of the treatment.  But expect dry lips, sores in your mouth, nausea, and various combinations of diarrhea and constipation.  I am not saying this to scare you -- only to get you prepared so that you will not feel like your situation is any different from most.  Knowing that it is all to be expected gets rid of the stress and turns it into a matter of just having patience knowing that things will get better.  In retrospect it was not nearly as bad as people had hyped it up to be.

Recognize you are vulnerable, and as a former article that I wrote indicated, it typically is not the cancer that kills but an infection that accompanies it due to the low blood numbers.  Typically your white blood cells, for example, are busy killing all kinds of bacteria that are harmless to normal people since they are so easily controlled naturally.  Not so when you kill off so many white blood cells to the point of what the call neutropenia.  Similarly, since your platelet count is low you might bruise easily.

getting through chemotherapy
So be defensive.  Wear a mask when outside of your room, do not eat certain foods that might contain bacteria (fresh salads and some fruits), stay away from people in general, do not have visitors coming in – especially children, brush your teeth easily with a soft tooth brush and never floss, rinse out your mouth hourly with a salt-baking soda solution.  They will give you a list like this.  Don’t be afraid to take it even further.  For example, I carried a paper towel with me all the time and would not touch any suspicious surface (like door handles and knobs).  During the time when you are neutropenic you cannot let your guard down.

I went through my first induction round and recovery from it without an infection, but one of the doctors told me that it would happen, and he was right.  It is almost inevitable and it will result in a fever.  So, when this happens just take it in stride.  They will do all that they can to target the problem and to give you the correct antibiotics.  This is normal so don’t let it scare you.  You want to do everything you can to avoid it so that when it happens it will be controllable.  

Have faith – you are going to get through this.  It is going to take patience and endurance on your part, but you can do it, and with God’s help, you will.

Guest Post by: David B. Brown

Tuesday, September 16, 2014

How Music Therapy Helped Me Get Through Chemotherapy?

I was in the hospital with chemo and various infections to treat Acute Myeloid Leukemia (AML) caused by MDS (miss-shaped blood cells) for about eight months.  The last few months were in-and-out during what are called the consolidation rounds.  During that time I had my problems with sleep just as most cancer victims do.  This article suggests ways to address this based on my experience.

One problem is that the hospital environment is not conducive to sleep.  There is the old story about the nurse waking up the patient to be sure that she gets a sleeping pill.  This might be hyperbole (extreme emphasis to make a point) -- but then again, it could be quite true.  There are times that they have to wake you up especially if you are on chemo or some other transfusion – they have to monitor your vital signs.  I did have a head nurse that prevented them from waking up patients and put off these measurements, but this was an exception.  While they do have some flexibility, you can see how things could get extremely confused if they do not make their measurements when they are scheduled.  So, figure this is for the best.  Also, there will be a blood draw early in the morning so that they can base medication for the day on it – so count on getting awakened.

Then there is that excess liquids they want you to drink and the saline solution that they keep going 24x7.  Its purpose is to keep your kidneys from getting burned up by the chemo, so it is a necessary evil.  This could wake you up for a bathroom call every half hour or so – I know it did me.  Not much we can do about it except try to minimize the light to some extent – i.e., try not to totally wake up.  It is very possible to effectively relieve yourself without totally waking up – but we warn you that this is a highly individualized thing – it sure will not work for everyone.

If  all of this makes you worry about sleep, your concerns are justified.  Sleep deprivation is quite detrimental to remission and health after remission.  But this is one irony of being concerned with sleep – sometimes it is our concern that we cannot get to sleep that prevents us from getting to sleep.  This is just one more thing to add to the many things that we know you are worried about.

Read more about Side Effects of Chemo

Recognize that relaxation, meditation and prayer is right next to sleep as being effective – almost as effective as sleep.  Also, recognize that quite often when you wake up every ten minutes or so, you do not realize that you have actually been asleep.  So you might look at the clock and see the time passing by and think that you got no sleep at all, when really you did.  The anxiety that this causes is no less.

What I recommend is distraction.  I stumbled into this because my son got me an iPod just before I went into the hospital, and I loaded it up with a number of songs that were appealing and comforting to me.  In my cases these were spiritual songs, but I do not see this remedy as being limited to those who are religiously inclined.  I do recommend that the music that you choose be of a calming nature, but other than that, any music should work.  Be sure not to hit the random button – play the songs in the same order over and over.  You probably need at least 20; the more the better.  Be sure to have earphones that have an easy volume control so that you can get things just right (i.e., you do not want loud songs waking you up so keep things down).  I tried earpieces but had problems with my ears getting sore – probably due to the neutropenia – this was greatly relieved when I switched over to a light pair of earphones with an adjustable volume control.

How does it work?  For one thing it enables you to know when you dose off.  Most people who worry about sleep are really sleeping quite a bit more than they realize.  When you wake up (or are woken up) and you suddenly realize that – hey, I missed five songs – you will realize that you were sleeping through them, and that will be comforting within itself.  This is why you need to keep them in order … so that you can identify how long you have been out of it – sleeping even though you did not realize it.

An iPod is fairly inexpensive – if you have an iPhone (or any smart phone) or iPad, that will work as well.  There will be an iPod button (or some equivalent) that will make your phone perform like an iPod.  You need to set up a “playlist” – Google it if you have never done this.  (Also, most people have, so ask around.)  What this does is to enable a sequence of songs to be played one after the other without your intervention.  Obviously you do not want to have to get up every three minutes and change the record on the Victrola (remember I am 70).   This new electronic stuff is really nice in that regard.  You can create your own album of just what you want, click on it and lay back and relax.  Don’t worry about the battery wearing down – it is almost negligible.

Obviously you can download all you want from iTunes without it being too expensive.  However, I hate to close without giving a plug for some free downloadable MP3 files that I have created.  If you are into spiritual songs and four-part harmony. If you like mostly old 50s and 60s easy listening.  

Music is a recognized therapeutic approach.  We do not consider ourselves to be experts on it, but our experience has proven to us that this is a great way to get your mind off of your cares and if you are tired, onto sleep.  Please give it a try, and provide us feedback on it.

Have faith – you are going to get through this.  It is going to take patience and endurance on your part, but you can do it, and with God’s help, you will.

A guest post by: David B. Brown

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