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Coping With Chemotherapy: Chemotherapy drugs can be lifesaving--but often come with side effects.

Nearly 1.7 million new cases of cancer are diagnosed in the U.S. each year, according to the National Cancer Institute. Many are treated with chemotherapy, but the drugs used may cause side effects that impact your quality of life. Fortunately, both medical and non-medical interventions can help cancer patients get through chemotherapy more comfortably. "The side effects caused by chemotherapy drugs are much easier to reduce and prevent than they were in the past," says Luis Isola, MD, associate professor of medicine, hematology, and medical oncology at Mount Sinai. "It's important to communicate with your doctor about any side effects you experience, so they can be addressed."

What Chemo Does Cancer cells divide quickly, and chemotherapy drugs are designed to prevent this division and/or kill the cells. Most cancer patients are given more than one chemotherapy drug, in treatment cycles that may last several days. Breaks are scheduled in between cycles to give your body the opportunity to recover and manufacture new, healthy cells to replace those destroyed by the chemotherapy.

Side Effects Unfortunately, chemotherapy also destroys healthy cells that grow and divide rapidly. "This includes cells found in the lining of the intestinal tract, in bone marrow, where production of all blood cells occurs, and in hair follicles," Dr. Isola explains. "This is why some people undergoing chemotherapy may experience side effects like nausea and vomiting, anemia, fatigue, and hair loss. Fortunately, newer chemotherapy drugs attack cancer cells more specifically, and many are devoid of these types of side effects."

In addition to these more common side effects, chemo drugs may cause mouth sores, a dry mouth and skin, diarrhea, decreased libido, changes in your sense of taste and smell, pain, and flu-like symptoms. Chemotherapy also may increase your risk of bruising, bleeding, and infection--and some people receiving chemotherapy report cognitive impairment that has become known as "chemo brain." Imaging tests have shown that in some patients the parts of the brain that deal with memory, planning, and putting thoughts into action are smaller after chemotherapy. The problem is particularly common in women whose breast cancer is treated with chemotherapy.

Managing Side Effects There is no specific treatment for chemo brain, but stress-relief measures such as yoga and meditation may help. "Sticking to a set daily routine and methodically working your way through a to-do list can help you accomplish the tasks you need to complete," Dr. Isola adds. "Tracking any memory problems in a daily journal will help you pinpoint those times when you're most likely to feel the mental fog set in, so that you can avoid scheduling important tasks when you aren't as alert."

As far as other side effects are concerned, Bethann Scarborough, MD, assistant professor of geriatrics and palliative medicine at Mount Sinai, notes that in recent years new medications have been approved to treat the nausea associated with chemotherapy. Other medications can improve your blood cell counts, which helps reduce fatigue and combats anemia. Almost all of the possible side effects apart from hair loss can be reduced with drugs.

Chemotherapy-related nausea may ease if you eat several smaller meals throughout the day, rather than two or three large meals. "Both cancer and treatments for cancer can change the way food tastes and smells, so try different foods or different textures of food if your appetite is affected," Dr. Scarborough adds. "Taking anti-nausea medications regularly can be very helpful to prevent nausea and vomiting from becoming severe--many patients take two or three anti-nausea medications to control nausea."

Fatigue is a common side effect from chemo and radiation therapy, but physical activity can help boost your energy. "If your condition allows for it and your doctor approves, staying active may be as simple as walking around your home or neighborhood once or twice a day," says Dr. Scarborough. "A small amount of caffeine in the morning may help provide an energy boost during the day, too."

Another troubling side effect of both chemo and radiation therapy is a dry mouth, which can increase the likelihood of mouth sores. "If mouth sores are not a problem, sucking on a sour, sugar-free candy can help relieve a dry mouth by stimulating saliva production," Dr. Scarborough says. "Otherwise, some people find that swishing a little bit of water in their mouth helps. Mouth sores should be checked by your doctor."

Emotional Support is Key Dr. Scarborough adds that talking with other patients can play a major role in alleviating chemotherapy side effects. "Support groups or individual counseling can be very effective in helping cancer patients and their loved ones navigate treatment side effects, family concerns, work issues, and the anxiety and depression that can accompany cancer," she says.


* Report side effects to your doctor--a simple anti-nausea medication or sleep aid could ensure you are able to continue with your chemotherapy.

* Share information, concerns, and needs with family members and friends so they can provide the assistance that will be most helpful.

* Reach out to cancer support groups for emotional support and advice from people going through similar experiences. Your local hospital may have a group; the American Cancer Society's Cancer Survivors Network also offers support programs (

Caption: Fatigue is a common side effect of chemotherapy.
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Title Annotation:CANCER
Publication:Focus on Healthy Aging
Date:Nov 1, 2017
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