CHEMOTHERAPY
- Is Chemotherapy Effective?
- How will I feel during Chemotherapy?
- Which are the side-effects?
- Can these side-effects be dealt with, and how?
- What should I be careful of during Chemotherapy?
- What should I eat during Chemotherapy?
- For how long to chemo drugs remain in my body?
- Could my sexual life be affected during my chemo treatment period?
- Is fertility affected by chemotherapy? After how long can a woman get pregnant?
The regimen and treatment chosen is adapted to each patient’s medical history and clinical picture. We apply treatment schemes which have been shown through studies and previous experience to be effective in the majority of patients in a certain phase of the disease. The response to the drug or combination of drugs, always depends on each patient individually. If it does not prove effective, then in consultation with the physician, other regimens and combinations are studied and suggested, again according to each patient.
Some chemotherapy drugs have very few side-effects, and the patient’s everyday life is not affected. However, other forms of treatment may cause more side-effects, which are well known, they can be dealt with and your doctor will talk to you about them before you start your sessions.
Depending on the patient’s physical condition, some do not experience any side effects, and therefore feel and cope well. Others, do. In general, the day-to-day daily life of many patients is affected – even a little. But it’s worth pointing out that side-effects are not a permanent situation, they normally go away once chemotherapy is completed.
Chemotherapy can cause side effects, normally mild to medium, and certainly not everybody gets them. Most common are myelotoxicity which has symptoms of anemia (drop in hematocrit causing weakness and fatigue), leukopenia – neutropenia (drop in white blood cells causing susceptibility to infections) and thrombocytopenia causing bleeding predisposition. Another very common side effect is nausea and vomiting, which usually occurs in the first few days of chemotherapy.
Another side-effect, neurotoxicity, appears gradually after many cycles and mainly comes with symptoms like numbness in the fingers and, in more severe cases, we can see the patient easily dropping even small objects from the hands, and having instability. In general, chemotherapy can rarely affect other organs and show ototoxicity, skin toxicity (rash, etc.), cardiotoxicity, hepatotoxicity, nephrotoxicity, etc.
A toxicity that does not affect the body but is important for the patient is hair loss (alopecia) caused by some very important drugs e.g. anthracyclines, taxanes.
Most side effects caused by chemotherapy can be avoided, as patients are given medication exactly for this purpose: to prevent them. Prior to treatment, patients are often given intravenously, antiemetics (against vomiting), antiallergics, and other supportive drugs. Also, for precautionary reasons, upon completion of the chemo cycle, treatment is given in order to immediately address any side effects that may occur, such as nausea, vomiting or diarrhea.
The side effects from chemotherapy may be mild, and usually need no treatment. In some rare cases, however, they could be serious and will require treatment either at home or in the hospital.
Depending on the type of your chemotherapy treatment, some precautions may be recommended. Generally, in all chemotherapies and especially in the first cycle, we recommended you avoid people who may have some sort of infection, e.g. viruses, in case of leukopenia. Similarly, you might be advised to keep away from crowded places, where the chances of flu infections are quite significant, even more so for a cancer patient under treatment. Quite often, in treatments that may cause diarrhea, as do medications like Xeloda and Tyverb, you will be given appropriate dietary instructions.
It is important for the patient to be able to distinguish signs of toxicity e.g. anemia, bleeding or hemorrhagic rash due to thrombocytopenia, etc. and to inform his or her doctor immediately.
Generally the only advice we give to every patient undergoing chemotherapy is that on the day of treatment and a few days later when nausea and vomiting may occur, is “eat lightly”, don’t add unnecessary stress on your body with large portions of heavily cooked fried and spicy food, and alcohol of course.
Special caution must be taken when treatment with drugs like Xeloda and Tyverb could cause diarrhea.
As a cancer center which always has a holistic approach in all treatments, your feedback and cooperation is always useful. Ask us about whatever worries or makes you feel uncomfortable. Never forget: In this “war” you are not alone. We are together.
Practically and in general, about a month after having completed your end of the treatment, no drug can be detected in the body and therefore all any side effects and toxicity disappear e.g. haematological toxicity, nausea etc, or at least they do not worsen e.g. neurotoxicity. However, if some organs are affected by chemotherapy treatment and show to have suffered a certain degree of damage, they will need some time to return to their original state. There are also extremely rare cases of persistent or permanent damage, if the corresponding toxicity, e.g cardiotoxicity, was not treated in time.
Directly, no. Indirectly, it could be affected to the extent that certain side effects mentioned above, could have an impact on your psychology and your quality of life. But even in this case, there are always other options, counselling, acupuncture, etc, which can help effectively and in many ways.
Although most chemotherapeutic drugs cause transient infertility, patients should take precautions during their treatment. Women should not become pregnant, and men should not cause pregnancy to their partner during the period that they are under treatment. The drugs used in chemotherapy are likely to harm the foetus. An interval of at least one year after completion of therapy is generally recommended for pregnancy. Especially for breast cancer which is often hormone dependent, the above general advise should be individualized. Which means “talk about it with your personal doctor”.
It is important to note that sometimes infertility is permanent. For this reason, before starting treatment, the doctor will recommend, especially in young people, the storage of eggs and sperm.
SCALP COOLING
Many patients regard hair loss as the most frightening experience of the side effects of chemotherapy. The psychological factor is not insignificant, as it might have a dramatic effect on many people’s self-esteem.
The Paxman Scalp Cooling Orbis II system, which we off at the GOC, was created exactly for this purpose, i.e. not only to treat alopecia, but mainly to help patients maintain their self-confidence and prevent or ease the negative psychological impact of hair loss.
- What exactly does the cooling of the sculp do?
- Is there always loss of hair?
- Why does chemotherapy cause loss of hair?
- How does sculp-cooling work?
- How much time is required for the proper use of Scalp Coοling;
- Will it work on me?
- Taking care of your hair through the PAXMAN experience
It’s a simple treatment that can prevent hair loss, which may be caused by certain medications used in chemotherapy. The use of scalp cooling has proven to be an effective way to combat hair loss. It’s new technology enhances preservation and protection of hair during treatment.
This helps patients feel better, regain control of their lives, safeguard their privacy and build up a more positive attitude whilst undergoing treatment.
No. Hair-loss does not happen with every chemotherapy treatment. Much depends on the specific drugs used, which are not the same for every patient. Our medical team will inform you accordingly once you have started your treatment and, having assessed your progress will offer you the option whether to use Scalp Cooling or not.
Chemotherapy works by targeting all the rapidly dividing cells in the body. Hair is the second fastest dividing element in the body and that is why many chemotherapy drugs cause hair loss. The hair follicles, which are in the growing phase, are “attacked” by the drugs used, and this is why approximately 2 weeks into treatment, we witness this phenomenon of hair loss.
The damage caused by chemotherapy to the hair follicle can be relieved by the cooling of the scalp. It works by reducing with precision the temperature of the scalp to a specific temperature, before, during and after the treatment. Then, through this technology, blood flows to the hair follicles and can prevent or minimize hair loss.
Paxman’s Scalp Cooling Orbis II system, which is based on an innovative design, offers a comfortable and tolerable choice compared to other similar cooling methods, exactly because of this new technology.
The devise is applied each time, 30 minutes before the infusion of the chemotherapy, during the session and up to 90 minutes after the completion of administering the drug.
Thousands of patients all over the world, have kept their hair during their chemotherapy, using the Paxman head cooling system, which is used in Cyprus, only by the German Oncology Center.
Successful cooling of the scalp depends on many factors, such as the type and stage of the cancer, the chemotherapy regimen, the age, type and condition of hair, and the general health of the patient. It’s important to understand that hair loss varies from person to person and hair preservation for everyone cannot be guaranteed.
Research has shown that cooling the scalp is a very effective method in a wide range of chemotherapy treatments. You may experience some hair loss some and probably thinning of your hair using this system, but don’t forget hair loss also has its natural cycle in life. If you do experience hair loss, the company which developed and manufactured the Cooling System advises you to continue using it.
- Be careful with your hair at all times!
- Do not be afraid to brush your hair. Prefer using a good quality brush as others will damage your hair.
- Avoid perming and dyeing your hair while receiving chemotherapy.
- Avoid using too much heat on the hair, dry it gently and do not use a hair straightener!
- Wash your hair with lukewarm water and a mild shampoo. Your scalp can become sensitive to fragrances and preservatives in cosmetic shampoos.
- A large comb helps to deal with tangled hair. Put enough conditioner on your hair while you are in the shower, and comb it gently. This also helps not to damage the hair roots.
In general:
- While using scalp cooling, you don’t need to go to the hairdresser, so as to ensure minimum pressure on your hair.
- However, if a visit to your hairdresser will make you feel better, by all means do it! But be sure to inform him or her about your treatment.
- After completing chemotherapy, if your hair is in good condition and there is no sensitivity to the scalp, then you can even dye it.
PORT-a-CATH
The port-a-cath (short for Port) is a small device that is placed under the skin, on the right side of the chest. It has a catheter that through a large vein reaches the right side of the heart called vena cava superior. Port-a-cath is used for intravenous fluids, blood transfusions, chemo drugs and other medicines. It is also used for blood sampling. The device can stay in place for weeks or even months, helping to avoid the need for multiple injections.
- Instructions for patients with a port-a-cath
Once the port-a-cath is implanted, in the area of the right breast, under the skin, you will have 2 small patches that cover the two incisions.
- The first patch change should be done 24 hours after implantation.
- Then the next gauze pad should be changed every two days or sooner if it is soiled, wet or detached.
- Once the incisions have healed, the patch can be removed.
Remember: Before changing the patch, wash your hands thoroughly with soap and water for more than 20 seconds. Carefully remove the existing patch and wipe the area clean.
Tell your doctor if you notice swelling or bruising in the area, pus or fluid, local redness, heat or sensitivity around the incision area, as well as if you develop a fever above 38 ° C, as all these may be signs of possible infection.
Furthermore, immediately after the implant you may feel discomfort or pain in the incision area but it goes away after 48 hours. You can take a mild painkiller if feel you need it. And if the pain persists or increases, don’t hesitate to call your doctor.
- For the first few days, avoid activities that require heavy work and dangerous contact sports. Do not lift any objects weighing more than 4.5 kg, until your incisions heal (usually within 10-14 days). After healing you can return to your normal activities.
- You can take a bath 2-3 days after implantation, and after healing you can also enjoy a swim.
- Do not drive for the first 24 hours after implantation. The compulsory use of a car seat belt can put pressure on your wounds. In the following days and until healing, you can drive as long as you place a small pillow or a folded towel between the belt and your body.
- You can travel by plane. Airport metal detectors do not damage the port-a-cath system and in most cases do not activate the detector alarm.
- In the future, watch out for: signs of infection, swelling, displacement of the needle outside the port-a-cath system (if it has been left inside), swelling, bleeding. In any such case, contact your doctor immediately and follow his or her instructions.
The port-a-cath system requires rinsing every 4-6 weeks if not in use. This is done to prevent the catheter from becoming blocked, because if it does, then it will no longer be functional and may need to be removed.
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