getting to grip(e)s with chemotherapy

by Nick Scott

chemotherapy | help and info | Chris's experience

If you're reading this, you probably know the score – cancer occurs because some of your body's cells have multiplied too quickly, and each cycle of chemotherapy travels through your bloodstream on a mission to take out these cancerous cells.

'Sounds good – where do I sign?' The stuff they tell you...

The drugs know what they're looking for – they only hunt down cells that are actively dividing.
Chemo has come on a bundle since the Eighties, and your treatment will be a carefully selected combination of drugs that are right for you and your condition.
Most side effects clear up completely in the months following treatment.

'Eh? That wasn't in the brochure!' The stuff they left out...

Throughout treatment and weeks after you're given the all clear, you'll be given more tests than a Volvo airbag. But that's not the worst of it...
Chemo is a bit of a bull in a china shop, taking out a few healthy cells along with the nasty ones. Hence those big recovery breaks between sessions.
Partly because of this, chemotherapy has a whole range of pretty grizzly side effects...

sores, pores and bellyaches

some of chemo's nasty side effects and how to combat them

The bald truth Chemo targets fast-dividing cells. Unfortunately, hair-follicle cells also reproduce pretty quickly, so it zaps them as well. Hair can therefore start to thin and fall out in clumps (yep, down there as well) as little as two weeks after treatment. Most people go for very short or completely shaved – far less tickly! Your hair should start to grow back about six weeks after your treatment finishes.
Gob-shockers Like your hair cells, those that line your mouth are among the good guys who just get caught in the line of fire. Proper oral hygiene with a soft toothbrush and fluoride toothpaste is a must. Go for sugar-free mints to disguise that filthy taste, and request painkillers if it hurts.
Dire rear Chemo can irritate your stomach and give you a nasty case of the runs – if it hits you, drink plenty of water and ask for something to bind it all together.
Block party Being the perverse monster it is, chemo might decide to slow down your intestine and bowel action instead. Try a drop of 'Poop-aid' – prune juice clears out those intestines like a power hose in a sewer pipe (refrigerate first and drink it on the rocks). If that tastes just too grotty, ask for some laxatives.
Gut feeling Your stomach and brain are like nightclub bouncers – always on the lookout for nastiness and ready to chuck out, no questions asked! There are plenty of anti-sickness drugs out there and they all work differently, so tell doctors and nurses which are doing the job so they can work out the best combination for you. Try eating less more often; if some foods make it worse, ask for some nutritional advice.
Soft cells Chemo can knock out the white blood cells that hunt down and kill bacteria, so ask your doctor or nurse about avoiding infection. It also slows the number of red blood cells your bone marrow produces, lowering the amount of oxygen that reaches every part of your body. Foods with plenty of iron can help anaemia, but if your count gets really low you may need a transfusion. Also, your treatment can knock out the 'platelets' which help your blood clot – so no fisticuffs, heavy scratching or nose picking – however much boredom sets in!
Knackers' yard Partly because of that oxygen problem, chemo and all the stresses involved can make you feel utterly exhausted. Milk it! Tell your loved ones how you're feeling so they can help you do things. In fact, a spot of exercise and activity may make you feel better than sleep – but keep it under your hat/wig.

You might have heard about some of chemo's possible long-term side effects such as early menopause and infertility. Grab a consultant for a chat if you're worried. And remember – believe it or not, chemo has its plusses. Here's three for starters!

Shiny is chic Footballers pay a three-figure sum for a head-shave.
Age is relative Years from now you'll feel younger than you did yesterday.
Experience is power Next time anyone tells you how ill they're feeling, respond with a smug, hollow laugh.

ward off the demons

how to survive a long hospital stay

Feet up! Make yourself at home. This strange, clinical place will seem a lot cosier and more familiar with your own stuff all around you.
Track down a few fellow sufferers. There's nothing like discussing things with someone who's in the same boat. As well as those in the hospital, you have a whole community at your fingertips, so click away! See the websites in help and info for some good starting points.
Butter up the night nurses. These guys can help you get some decent kip!
Dish out orders. The staff will assume everything's OK unless you say otherwise, so be assertive, whether it's a spot of nutritional advice, painkillers or just a few answers you're after.
Speak up! Consider recording a daily health bulletin on your answer service, including how you're feeling generally, so you have to repeat yourself less often.

view from the sidelines

advice for family and friends...

Everyone reacts to chemotherapy differently (why are these things never simple?). As well as hair-loss, weight-loss and fatigue, you may notice complete changes in the patient's behaviour and mood. Good old-fashioned patience and understanding should form the bedrock of your approach – but sometimes it doesn't hurt to think about the little things...

Many doctors and nurses suggest that young people avoid their favourite foods during chemo – not because of beef vindaloo's dubious nutritional value but in case they later associate the food with their treatment ordeal.

If the victim is feeling self-conscious about hair loss, get them a scarf, hat or wig. Avoid wool – it's an invitation to heat rash.

Lung toxicity can be a problem during chemo, so if the patient smokes get them to kick the evil weed – by doing so yourself, perhaps.

You may notice some severe lethargy in the sufferer. Obviously, don't treat them like some hormonal teenaged lazy-arse, but still try and gently encourage some activity rather than letting them just sleep.

Look out for any signs of minor illnesses – the patient's immune system may have gone on strike, and even a common cold might need extra medical attention.

broaching the subject

Do say: 'You look stronger.' (Nothing wrong with truthful encouragement)
Don't say: 'You look amazing!' (Probably not true)

Do say: 'Let me get you a cup of tea' (Specifics get the nod)
Don't say: 'If you need me, shout...' (Patients can get obsessed with not being any trouble...)

Do say: 'I hope it'll turn out fine' (A realistic approach will encourage more open conversation)
Don't say: 'You'll be fine' (A pretty empty cliché)

AND REMEMBER – The doctors can deal with the pain and discomfort. Your job is just as important – making sure misery and suffering don't add to the mix.

(May 2005)

Read on for details of relevant organisations, websites and reading. Or follow this link to read about the experiences of 17-year-old Chris as he underwent chemotherapy for Hodgkin's disease.