Chemotherapy Tips

Tips Through Chemotherapy

Breast cancer chemotherapy varies based on receptor type, hormone status, stage, age, type, and many other factors. I received dose-dense AC-T (adriamycin or Doxorubicin, cyclophosphamide or Cytoxan, and taxol or Paclitaxel) and that is my frame of reference. Immunotherapy and HER-2 targeted medications are also common. Chemotherapy days are long days. You need to have your blood counts monitored closely while on the medications, and your blood counts may dictate if you're getting chemotherapy that day or an adjusted dose. Be prepared that the medicines you are given to help tolerate the chemotherapy medicines may effect you that day and the next few days. The antihistamines may make you drowsy during the infusion while others liked prednisone may make you amped up the next day. You will likely also get Neulasta, a neutrophil (type of white blood cell) boosting injection the day after chemotherapy. 

Recommendations throughout chemotherapy:

• Drink plenty of water and stay hydrated. Lemons squeezed in water can help combat the metallic taste.

• Eat when you can. Small meals and snacks can be helpful. The book Cancer fighting Kitchen by Rebecca Katz is very helpful for dealing with side effects (nausea, changes in taste, etc). 

• Chemotherapy will likely cause hair loss. Usually this occurs 1-3 weeks after your first infusion and includes all head, body, pubic, eyebrows, and nose hairs. My eyebrows and eyelashes fell out last, but everyone is diffent. You can shave it off prior to loss, wear a head covering, or consider using a cold cap. Cold capping (Amazon affiliate link) uses the power of cryotherapy to prevent blood flow to the scalp and decreases metabolic activity of hair follicles, protecting them from injury. Use a moisturizer in your nostrils like Aquaphor or coconut oil to prevent nose bleeds. 

• Stay ahead of side effects (nausea, vomiting, diarrhea, constipation, fatigue, lack of appetite, etc.) and keep your oncology team informed before it becomes an emergency. 

• Talk to your oncology about herbal remedies for side effects. For example, ginger can help alleviate nausea and vomiting, mint can aid in constipation. Always ask your provider first and when in doubt, err on the side of caution. You can check any known interactions and side effects of herbs at Memorial Sloan Kettering's Searchable Herb Database. 

• Get into a routine. You will have good days and tough days. After your first infusion, you'll start to notice a pattern of side effects and anticipate changes in energy level. Your first day and a half after chemotherapy may be pretty good and then it may be the toughest day and then it slowly improves until the cycle repeats again. Trying giving yourself some structure and normalcy. A daily reading, journaling, walk, or mealtime with family can anchor your days. 

• Rest when you need to, move when you can. Daily naps are life. Movement is key to keep the body going and prevent side effects (especially to the heart, brain, muscle, and nerves) and combat fatigue. Try to exercise for at least 150 minutes a week of moderate physical activity. 

• Lean on your community of family, friends, neighbors, and coworkers. It's brave to ask for help. Meal train, household help, grocery shopping, rides are beautiful ways that others can show their support. Let them. 

• Celebrate the wins and milestones. Every infusion felt like an accomplishment. Make a "win-wall" proudly listing your accomplishments by sticky notes or create a paper chain with each chain being a chemo and then cut it down. Celebrate the little and the big; getting dressed and going for a walk around the block is a big win!

​

Recommendations for the day of chemotherapy:

• Bring a buddy. Chemotherapy days are long days. The medication can make you sleepy and fatigued (or wired). It helps to have another set of ears and hands.

• Chew ice like a champ. The "Red Devil"or Doxorubicin (it has a red color) can cause mouth ulcers in addition to nausea (also known as mucositis). Chewing ice or drinking really cold ice slushy water (the formal term is cryotherapy) for 10 minutes before and during the infusion was shown to decrease mucositis, likely by  constricting the blood vessels in the mouth so the fragile mucosal membrane of the mouth has less exposure to toxic agents.

• Wear cold mitts and booties (Amazon affiliate link). Taxol or Paclitaxel is a chemotherapy agent derived from the Pacific Yew tree. Among its list of side effects, it commonly causes neuropathy (numbness, tingling, burning usually on the extremities although I even had it around my lips) by causing inflammation and degeneration of nerve cells. Using cryotherapy to decrease blood flow to the tips of the digits by wearing ice packs in mitts and booties during the infusion has been shown to prevent neuropathy. The Paclitaxel infusion is longer than the Doxorubicin infusion, so bring extra ice packs to change out those in your mitts and booties so your digits can stay sufficiently cold the whole time. Eating foods rich in omega-3 fatty acids after Paclitaxel infusion may also help prevent neuropathy. Diet and supplement changes must be discussed with your nutritionist and oncologist.

• Pack like you're going camping when you go to your infusion. It will last a few hours. Bring a freezer of beverages, cold packs, and snacks, reading material, headphones, a journal.  

• Snack carefully. You may develop a food aversion if you snack while you are getting an infusion. Your body may associate that particular food or beverage with the toxin. I developed an aversion to ice chips since I chewed them so much to prevent mucositis. It got better.

• Listen to music during chemotherapy to help to mitigate or alleviate symptoms of nausea. Depending on the seating in your infusion center, your chair may be private or semi-private. Put your noise cancelling head phones on if you don’t want to participate in a semi-social setting during infusions.

• Try a visualization, healing mantra, and healing beats. Imagine that the medicine is a golden healing light flooding your heart and spreading through your little blood vessels and capillaries to reach every single one of your cells to eradicate cancer cells, heal, and renew your body. Practice a mantra: I am calm. I am strong. I am well. Listen to singing bowls, nature sounds, binaural beats or a meditation to help relax your body during a stressful time. 

​

Chemotherapy effects everyone differently. No two cancer patients are the same. Be gentle with yourself. You are doing the best you can, and you are doing a great job. I am rooting for you.