Wednesday, December 24, 2014

Combatting the side effects of chemo

Last week I was asked by Healthline to share their new info-graphic on
the side effects of chemo.  Since it also happened to be my one-year
anniversary of finishing chemo (hurray for that!), I felt it was
especially appropriate.

Initially, when I checked out the info-graphic I thought, "Wow, this is
great information".  It really is!  Then I realized that I had
experience with most of the side-effects and my thoughts changed to,
"Wow, this is depressing" "chemo sucks".  Unfortunately, these side
effects exist.  Fortunately, there are ways to help combat (note: help,
not eliminate) them.  So while it is unfortunate that the current
cancer treatment is so incredibly harsh on the body, I feel it is
important to be educated so that you can work to reduce those side
effects, improve healing, and maintain a high quality of life during
cancer treatment and beyond.

Below you will find the very informative info-graphic with links to the Healthline
website.  Since I have had more than my fair share of experience with
chemo, I have added some tips and strategies I have learned to retain
health and minimize side effects during treatment and beyond.

Chemotherapy affects most of the body's systems

(taken from: Healthline

Chemotherapy drugs are powerful enough to kill rapidly growing cancer
cells, but they also can harm perfectly healthy cells, causing side
effects throughout the body.

The Side Effects of Chemotherapy on the Body

Cancer cells divide more quickly than healthy cells, and chemotherapy
drugs effectively target those cells. Unfortunately, fast-growing cells
that are healthy can be damaged too. There are many different
chemotherapy drugs with the potential for many different side effects.
These effects vary from person to person and from treatment to

Factors that play a role in side effects include other ongoing
treatments, previous health issues, age, and lifestyle. Some patients
experience few side effects while others feel quite ill. Although most
side effects clear up shortly after treatment ends, some may continue
well after chemotherapy has ended, and some may never go away.

Chemotherapy drugs are most likely to affect cells in the digestive tract, hair follicles, bone marrow, mouth, and reproductive system. However, cells in any part of the body may be damaged.

Circulatory and Immune Systems

blood count monitoring is a crucial part of chemotherapy. That’s
because the drugs can harm cells in the bone marrow, where blood is
produced. This can result in several problems. Red blood cells carry
oxygen to tissues. Anemia occurs when your body doesn’t produce enough
red blood cells, making you feel extremely fatigued. Other symptoms of
anemia include:

  • lightheadedness, pale skin, difficulty thinking, feeling cold, general weakness

Chemo can lower your white blood cell count, which results in
neutropenia. White blood cells play an important role in the immune
system: they help fight infection and ward off illness. Symptoms aren’t
always obvious, but a low white blood cell count raises the risk of
infection and illness. People with an immune system weakened by
chemotherapy must take precautions to avoid exposure to viruses,
bacteria, and other germs.

Cells called platelets help the blood clot. A low platelet count, called
thrombocytopenia, means you’re likely to bruise and bleed easily.
Symptoms include nosebleeds, blood in vomit or stools, and
heavier-than-normal menstruation.

Some chemo drugs can weaken the heart muscle, resulting in
cardiomyopathy, or disturb the heart rhythm, causing arrhythmia. This
can affect the heart’s ability to pump blood effectively. Some chemo
drugs can increase the risk of heart attack. These problems are less likely to occur if your heart is strong and healthy at the start of chemotherapy.

Jen's tips:  I worked closely with my nutritionist
to utilize nutrition and supplements to support my circulatory and
immune systems as best as possible.  Additionally, recommendations were
made to help protect my heart from the damaging effects of an
anthracycline based chemo regimen.   While there is no way to know for
certain if this nutritional advice was beneficial, I will say that I did
not get a single cold throughout my cancer treatment.  Additionally, no
immediate heart damage from treatment has been detected.  

Nervous and Muscular Systems

central nervous system controls emotions, thought patterns, and
coordination. Chemotherapy drugs may cause problems with memory, or make
it difficult to concentrate or think clearly. This symptom sometimes is
called “chemo fog,” or “chemo brain.” This mild cognitive impairment
may go away following treatment, or may linger for years. Severe cases
can add to anxiety and stress.

Some chemo drugs can cause pain, weakness, numbness, or tingling in the
hands and feet (peripheral neuropathy). Muscles may feel tired, achy, or
shaky. Reflexes and small motor skills may be slowed. It’s not unusual to experience problems with balance and coordination.

Jen's tips:  Despite perceiving myself as
relatively high-functioning cognitively throughout treatment, I
definitely experienced "moments" of slower cognitive and motor
processing.  These "moments" seemed exacerbated by fatigue and improved
with exercise, and were always worse the first few days post-infusion.
 To reduce symptoms of chemo brain, I recommend adequate sleep and
exercise.  To help compensate for forgetfulness, task lists became
imperative and are something I still find helpful today.  

I continue to experience peripheral
neuropathy primarily in my hands causing my hands to get cold easily.  I
don't let this slow me down; I just purchased some Bar Mits so I can continue to ride my bike in frigid weather.  

Digestive System

of the most common side effects of chemotherapy involve the digestive
tract. Mouth sores and dry mouth can make it difficult to chew and
swallow. Sores also may form on the tongue, lips, gums, or in the
throat. Mouth sores can make you more susceptible to bleeding and
infection. Many patients complain of a metallic taste in the mouth, or a
yellow or white coating on the tongue. Food may taste unusual or

These powerful drugs can harm cells along the gastrointestinal tract.
Nausea is a common symptom, and may result in bouts of vomiting.
However, anti-nausea medications given in conjunction with chemotherapy
drugs can help alleviate this symptom.

Other digestive issues include loose stools or diarrhea. In some people,
hard stools and constipation can be a problem. This may be accompanied
by pressure, bloating, and gas. Take care to avoid dehydration by
drinking plenty of water throughout the day.

Side effects involving the digestive system can contribute to loss of appetite and feeling full
even though you haven’t eaten much. Weight loss and general weakness
are common. Despite all this, it’s important to continue eating healthy

Jen's tips:  I found maintaining excellent oral hygiene to be the most effective strategy for combatting mouth sores.  While undergoing
chemo make sure to brush your teeth after every single meal.  Use a
soft-bristeled toothbrush and run warm water over it prior to using (to
further soften the bristles).   Propolis is a good, natural mouth rinse.

As for digestive health, when I finished
chemotherapy in 2011 I frequently had digestive issues (diarrhea).
 After completing chemo once again in 2013, my Nutritionist recommended a
high quality Probiotic
which I have used with excellent success.  This is one of the most
expensive supplements that I take, but having a healthy digestive system
is worth it!  

Hair, Skin, and Nails (Integumentary System)

chemotherapy drugs affect the hair follicles and can cause hair loss
(alopecia) within a few weeks of the first treatment. Hair loss can
occur on the head, eyebrows, eyelashes, and body. As troubling as it can
be, hair loss is temporary. New hair growth usually begins several
weeks after the final treatment.

Some patients experience minor skin irritations like dryness, itchiness,
and rash. You may develop sensitivity to the sun, making it easier to
burn. Your doctor can recommend topical ointments to soothe irritated

Fingernails and toenails may turn brown or yellow, and become ridged or
brittle. Nail growth may slow down, and nails may crack or break easily.
In severe cases, they can actually separate from the nail bed. It’s important to take good care of your nails to avoid infection.

Jen's tips:  Many of the chemotherapy
regimens for breast cancer cause hair loss.  There is simply no way
around it unless you are able/willing to shell out big bucks for cold caps or
something similar.  Even if you cut your hair short prior to chemo, it
is traumatizing and a bit (in my opinion) disgusting when hair starts to
fall out in clumps.  A lint roller works great to pick up loose hair.
 Coconut oil helps soothe the scalp as it becomes tender when hair falls
out.  In fact, I would lather coconut oil over my entire body,
especially my hands and feet, to soothe my dry, itchy, sensitive chemo
skin.  Tea tree oil is the magic potion for finger/toe nails.  I
developed toe nail fungus for the first time in my life.  Tee tree oil
twice daily for a couple of months did the trick.  Tea tree oil also has
healing properties and I use it on cuts, abrasions, and saddle sores.

Sexual and Reproductive System

drugs can have an effect on your hormones. In women, hormonal changes
can bring on hot flashes, irregular periods, or sudden onset of
menopause. They may become temporarily or permanently infertile. Women
on chemotherapy may experience dryness of vaginal tissues that can make
intercourse uncomfortable or painful. The chance of developing vaginal
infections is increased. Chemotherapy drugs given during pregnancy can
cause birth defects. In men, some chemo drugs can harm sperm or lower
sperm count, and temporary or permanent infertility is possible.

Symptoms like fatigue, anxiety, and hormonal fluctuations may interfere
with sex drive in both men and women. So can worrying about loss of hair
and other changes in appearance. However, many people on chemotherapy continue to enjoy an intimate relationship and an active sex life.

Jen's tips:  Whether you are in a
relationship or not, if you are even considering having children in the
future, I strongly recommend a consultation with a fertility specialist
prior to starting chemo.  Also, check out Fertile Hope
to see if you qualify for fertility preservation financial assistance.
 To combat/tolerate hot flashes I recommend first and foremost exercise
and healthy nutrition.  Other strategies that have worked for me include
wearing layers as my body temperature fluctuates throughout the day,
carrying a water bottle with me and taking a sip when I feel a hot flash
coming on, and keeping the bedroom mildly cool at night when hot
flashes are at their worst.  To combat the dreaded vaginal dryness, I
recommend coconut oil (yes, coconut oil has many, many uses:) and Firefly Organics lubricant.  'nuff said...  

Kidneys and Bladder (Excretory System)

kidneys work to excrete the powerful chemotherapy drugs as they move
through your body. In the process, some kidney and bladder cells can
become irritated or damaged. Symptoms of kidney damage include decreased
urination, swelling of the hands and feet (edema), and headache.
Symptoms of bladder irritation include a feeling of burning when
urinating and increased urinary frequency.

You’ll be advised to drink plenty of fluids to flush the medication from your system and to
keep your system functioning properly. Note: Some medications cause
urine to turn red or orange for a few days. This isn’t cause for

Jen's tips:  While it is well known that
maintaining hydration is vital for flushing the body of toxins and
supporting kidney health during treatment, exercise can have a profound
impact as well.  Clearly, I am a big advocate for exercise during
treatment.  I feel strongly that moderate exercise and quality nutrition
are powerful tools in tolerating chemo well.  Exercise helps improve
circulation and when combined with good hydration can help flush the
chemo toxins from the body more quickly.  The power of exercise
(cycling specifically) was driven home to me by an Exercise Physiologist
at Huntsman who told me that studies show due to the increased
circulation when cycling, patients on dialysis who rode a stationary
bike daily, had their dialysis time significantly reduced.  He said that
cycling in particular increases circulation more than any other
activity.  While I haven't personally seen this research, the Huntsman
EP is a smart guy and I believe him.  Think of the power this has for
flushing out chemo toxins!  

Skeletal System

people—and especially women—lose some bone mass as they age. Some
chemotherapy drugs can cause calcium levels to drop and contribute to
bone loss. This can lead to cancer-related osteoporosis, especially in
post-menopausal women and those whose menopause was brought on suddenly
due to chemotherapy.

According to the National Institutes of Health (NIH),
women who have been treated for breast cancer are at increased risk for
osteoporosis and bone fracture. This is due to the combination of the
drugs and the drop in estrogen levels. Osteoporosis increases the
risk of bone fractures and breaks. The most common areas of the body to
suffer breaks are the spine and pelvis, hips, and wrists.

Jen's tips:  Besides having another
recurrence, osteoporosis and debilitating bone fractures is one of my
biggest future health concerns.  There is solid research that shows
that weight bearing activities and
exercise are beneficial to reduce bone loss in post-menopausal women
with jumping activities being the gold-standard bone loss preventative
activity.  For this reason, I jump rope, wearing a weighted vest, twice
weekly.  Additionally, I do a 35 minute weight routine twice weekly and
trail run once weekly with the intent of maintaining bone integrity.
 Push-ups, planks, and side planks are done to help maintain shoulder
and wrist stability.  I also take Calcium and Vitamin D/A/K supplements
for bone health.  

Psychological and Emotional Toll

with cancer and dealing with chemotherapy can exact an emotional toll.
You may feel fearful, stressed, or anxious about your appearance and
your health. Some people may suffer from depression. Juggling work,
financial, and family responsibilities while undergoing cancer treatment
can become overwhelming.

Many cancer patents turn to complementary therapies like massage and
meditation for relaxation and relief. If you have trouble coping,
mention it to your doctor. They may be able to suggest a local cancer
support group where you can speak with others who are undergoing cancer
treatment. If feelings of depression persist, professional counseling
may be necessary.

Jen's tips:  It is completely
understandable to have feelings of sadness and depression while
undergoing cancer treatment and beyond.   These side effects should be
discussed with your physician and appropriate medical interventions
taken.  That said, as hard as it is to get out the door and exercise
when tired and achy from treatment, there is not a single time that I
return from a bike ride not feeling invigorated and full of life!