Chemotherapy, unpleasant but necessary<\/p>\n
Tantri Yuliandini, The Jakarta Post, Jakarta<\/p>\n
When someone finds out they have to undergo chemotherapy
\ntreatment, they are often overcome with dread, immediately
\nvisualizing loss of hair, frequent vomiting and drastic loss of
\nbody weight -- not unlike Campbell Scott's portrayal of a
\nleukemia patient in the 1991 movie Dying Young.<\/p>\n
This was one of the reasons why chemotherapy treatment remains
\nan unpopular cancer treatment here, said specialist Nugroho
\nPrayogo of Dharmais Cancer Hospital in Central Jakarta.<\/p>\n
In fact, chemotherapy is often needed to complement surgery to
\ndestroy cancer cells that are too small to be surgically removed.
\nSome types of cancer can even be treated with chemotherapy alone.<\/p>\n
Besides surgery, chemotherapy can also be used together with
\nother types of treatments like radiotherapy and immunotherapy.<\/p>\n
Chemotherapy is the use of anti-cancer or cytotoxic drugs to
\ndestroy cancer cells. In the process, the drugs interfere with
\nthe ability of a cancer cell to divide and reproduce itself so
\nthey will eventually die. There are over 50 different
\nchemotherapy drugs, some are given on their own, while others may
\nbe combined to produce a more effective treatment.<\/p>\n
The type of treatment prescribed depends on the patient's
\ngeneral health, the type of cancer, parts in the body where it
\nstarted, what the cancer cells look like under the microscope,
\nand how far they have spread.<\/p>\n
It may be given before an operation, known as neo-adjuvant
\ntherapy, to shrink a tumor and make it easier to remove; after an
\noperation, known as adjuvant therapy, to destroy cancer cells too
\nsmall to remove surgically; and the palliative therapy to shrink
\nsome types of cancer and prolong life.<\/p>\n
\"When a cure is not possible, chemotherapy may be given to
\nshrink and control a cancer, and try to prolong a good quality of
\nlife,\" Nugroho explained.<\/p>\n
The drugs can be administered by injection into a vein or
\nintravenously, some are given as tablets or capsules, injected
\njust under the skin (subcutaneous injection), and some are
\ninjected into the fluid around the spine (intrathecal injection).<\/p>\n
\"It is very rare that chemotherapy is injected into a muscle
\nor intramuscular injection,\" Nugroho said.<\/p>\n
But it is true chemotherapy drugs can also temporarily effect
\nsome of the normal cells in the body, and can cause unpleasant
\nside effects.<\/p>\n
Different chemotherapy drugs cause different side effects to
\ndifferent people, and some people may have very few.<\/p>\n
The main areas they may be affected by chemotherapy treatment
\nare those where normal cells rapidly divide and grow, such as the
\nlining of the mouth, the digestive system, the skin, hair, and
\nbone marrow.<\/p>\n
Chemotherapy may reduce the number of blood cells produced by
\nthe bone marrow, the spongy material that fills the bone
\ncontaining stem cells that normally develop into white blood
\ncells, the red blood cells and platelets.<\/p>\n
The reduction of these blood cells may make a patient become
\nvery tired and lethargic, bruise more easily, suffer nose bleeds,
\nand become more vulnerable to infections.<\/p>\n
Chemotherapy treatment drugs can cause feelings of nausea,
\nvomiting and loss of appetite. The drugs can also effect the
\nlining of the digestive system and cause diarrhea for a few days.<\/p>\n
Mouth ulcers may break out from the effects of some drugs,
\nusually happening about five to 10 days after the drugs are
\ngiven, and will clear up within three to four weeks.<\/p>\n
Hair loss is one of the most well known side effects of
\nchemotherapy. The amount of hair lost, if any, depends on the
\ntype of drug or the combination of drugs used, the dose given,
\nand the person's individual reaction to the drug.<\/p>\n
If hair loss happens it usually starts within a few weeks of
\nbeginning treatment.<\/p>\n
\"But many of the side effects of chemotherapy, such as nausea
\nand loss of appetite, can be easily countered using various
\ndrugs,\" Nugroho said.<\/p>\n
Chemotherapy treatment may also cause infertility, whether
\ntemporary or permanently depending on the type of treatment, he
\nsaid, explaining that in case of infertility it was sometimes
\nnecessary for male patients to bank some of their sperm.<\/p>\n
Because of the effects of chemotherapy to the body, it is
\nimperative the treatment is carefully planned. An initial health
\ncheck should be done by an oncologist, including a complete blood
\ntest, kidney function test, and liver function test, Nugroho
\nsaid.<\/p>\n
\"Don't be alarmed when the oncologist takes a blood test every
\nweek,\" he warned.<\/p>\n
Although the side effects of chemotherapy can be unpleasant,
\nthey must however be weighed against the benefits of the
\ntreatment, Nugroho said, adding that it must be remembered that
\nmost of the side effects will gradually disappear once treatment
\nis over.<\/p>\n
Tips on coping with common chemotherapy side effects<\/p>\n
Infection: Tell your doctor at once if you develop a
\ntemperature over 38 degrees Celsius, you need intravenous
\nantibiotics. Keep clean, always wash your hands thoroughly before
\npreparing food.<\/p>\n
Nausea: Your doctor may prescribe anti-sickness (anti-emetics)
\ndrugs which usually work well. Low doses of steroids can also be
\nhelpful in reducing nausea and vomiting. Avoid eating or
\npreparing food when you feel sick.<\/p>\n
Avoid fried foods, fatty foods, or foods with a strong smell.
\nEat cold or warm food if the smell of hot food makes you feel
\nsick, and eat several small snacks and meals each day.<\/p>\n
Have a small meal a few hours before treatment, not just
\nbefore treatment. Drink plenty of liquids slowly but avoid
\nfilling your stomach with fluid before eating.<\/p>\n
Diarrhea and constipation: If you have diarrhea, eat less
\nfiber and avoid cereals, raw fruits, and vegetables. Drink up to
\ntwo liters of fluids a day.<\/p>\n
If you are constipated, eat more fiber, raw fruits, cereals,
\nand vegetables. Have prune juice and hot drinks.<\/p>\n
Mouth ulcers: Eat fresh pineapple chunks to keep your mouth
\nfresh and moist. Clean teeth or dentures gently every morning,
\nevening, and after each meal using a soft-bristled or child's
\ntoothbrush. Gently use dental tape or floss daily.<\/p>\n
If your toothpaste stings or brushing your teeth makes you
\nfeel sick, try using a mouthwash.<\/p>\n
Avoid liquor, tobacco, hot spices, garlic, onions, vinegar and
\nsalty food.<\/p>\n
Hair loss: If your drugs are likely to cause hair loss, it can
\nhelp to have your hair cut quite short before treatment. The
\nweight of long hair pulls on the scalp and may make hair fall out
\nfaster. Use a soft baby brush to brush your hair. Avoid using
\nhair dryers, curling tongs, and curlers. Pat your hair dry gently
\nafter washing it.<\/p>\n
If it is likely that you may lose your hair, ask your doctor
\nabout wigs early on, so that the wig can be as close a match as
\npossible to your normal hair.<\/p>",
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