Patient Perspective: What Really Happens to Chemotherapy Patients
Chemotherapy Side Effects
Chemotherapy. It’s the dreaded "C" word next to cancer. The medicines employed to combat cancer cells have side effects that can be rough, sometimes gruesome—but the majority of these nuisances are temporary. The alternative, allowing the cancer to grow and spread, is far worse. The kind of chemotherapy one receives depends on the type of illness. The side effects vary, and every patient’s experience is unique.
If you or a loved one is facing cancer, or you’d like to understand how chemotherapy affects the body, read on. This article is not meant to scare you; my intention is simply to share the honest truth. On a positive note, I endured chemo and despite the side effects, it allowed me survive cancer. Being infused with strong chemicals, medicines that literally saved my life, wasn’t as bad as I’d expected... but it was no picnic, either.
Loosening, discoloring, or blackening of the finger and toe nails.
Only certain medicines may cause this. One of the more cringe worthy side effects involves losing one's finger or toe nails. The nails typically do grow back. Since my chemo had the potential for this side effect, I used ice to keep my fingertips cool and wore sandals so my toes were exposed in the air conditioned chemo clinic. It made a difference and my nails didn’t loosen. However, they did grow ridges, developed funky pale stripes, and were thin and brittle for a while afterward.
Mosquitos hate you.
Some of my fellow patients experienced the unexpected ability to repel mosquitos. They wouldn’t get bitten. Unfortunately, I didn’t experience this oddly useful side effect.
Not every chemo med causes hair loss, but if it does, it doesn’t just involve the cranium. Yes, I will say it; pubic hair falls out too. So do eyelashes, eyebrows, leg hair, armpit hair, and nose hair. The scalp is usually sore during the hair shedding process, but the pain subsides after the hair has fallen out. When I lost my nose hair, I had nothing to protect the nasal passages, which alternated between being uncomfortably dry and steadily leaking. If expecting hair loss, patients find it much easier to crop their hair short before it occurs. Avoid using a razor or shaving close since the smallest nicks or cuts can result in an infection and may interfere with hair regrowth. Chemo patients are highly sensitive to possible infections and germs, so that brings us to;
Immune system suppression.
As the fast growing cancer cells are being killed off, there is collateral damage. The body’s fast growing cells in areas like hair follicles, nail beds, and bone marrow- which produces white blood cells for your immune system- will be affected as well. These cells rebound after treatment, but during chemo a patient must be extremely careful about germs. Chemo’s damage to fast growing cells ties into the next issue;
Our private parts aren’t private to the effects of chemo. As we just learned, fast growing cells are damaged and we have these cells in our sexual organs. For women, the lining of the vagina can become dry and sore, the tissue thins and feels as if it has shrunk. For men, chemo can temporarily reduce sperm count and hamper the ability to have an erection. Sex can be difficult and painful during treatment and patients do not feel very sexy. Since chemo affects how we look, our self-image can take a downturn and this psychological aspect also stifles the enjoyment of sex. I’m very happy to assure you that, like hair follicles and nails, our private parts recover. It’s not normal to experience any permanent damage to genitals from chemo. This leads to:
No more periods?
Interruption of the menstrual cycle. Some medicines affect a woman’s ovaries and for those with hormone positive breast cancer, suppressing estrogen is purposeful. But not enjoyable. Being forced into menopause brings on hot flashes, dry skin and sore joints from reduced estrogen levels. In most cases for younger women, their ovaries rebound. Women 40 and over get to be shoved into early menopause. Things do balance over time, the human body is amazingly resilient. Trust me.
Touchy, strange sense of smell.
Things that once smelled pleasant don’t during chemo. Somehow, I managed to find certain odors nearly intolerable while simultaneously having a dulled sense of smell. When I sat down to dinner, I couldn’t smell it, but the exhaust from a car or the scent of someone’s perfume would make my stomach drop.
Your schedule is now under cancer’s control, at least during treatment. Depending on what medicines one is receiving, a patient can be stuck in a chemo chair for as long as eight hours.
Hardened or burned veins.
Cancer meds are STRONG. To avoid damaging the blood vessels by delivering chemo via a traditional I.V. tap, many patients opt for a port. This handy little bionic body part is installed, outpatient style, under your skin and it is a vein saver. Getting a port is a Good Idea.
Some chemo meds affect the ability to work, some don’t. A patient on a stronger chemo regimen is often deeply exhausted, with sore joints and muscles. They simply can’t keep focused, and this brings us to:
. . . what was I writing? Oh, chemo brain.
Many cancer meds contribute to mental fog and difficulty concentrating. I can assure you, “chemo brain” is temporary. My brain cells may have been obscured for a while, but they were not killed off. A major part of a patient’s inability to concentrate is due to the multitude of physical discomforts. Can’t balance the checkbook when you’re trying not to puke.
Stomach issues and nausea.
Not all chemotherapies trigger the desire to vomit and many patients are given anti-nausea meds with the infusion. If anything, most patients have difficulties in the lower gastrointestinal tract; irregular bowls, gas, or constipation. My guts were pretty bipolar, some days I was drinking laxative tea and other days I needed more, uh, "bulk."
It puts the lotion on its skin- oh, hell.
Sorry. I tend to have a grisly sense of humor during these trying times. Anyways, the skin becomes sensitive and dry. Drinking plenty of fluids and using a moisturizer is beneficial. Importantly, the moisturizer and any cleansers you use must be all natural with no artificial, chemically ingredients. The body gets INCREDIBLY sensitive to perfumes and additives in beauty products. A common ingredient in soap is sodium lauryl sulfate, and it would painfully burn my skin. Why use fake crap anyways when the skin is so absorbent? I became a convert to natural soaps made by hippies.
Hey, I’m TALKING here! Don’t look at me!
Emotional swings. Reduced hormone levels in women and general discomfort of the body can make some patients very moody. There are both physiological and psychological effects from chemo. Staring death in the face will do that.
Can’t taste food, hurts to eat.
With chemo’s ability to damage fast growing cells, patients often develop sensitivity or soreness in the lining of the mouth. Many temporarily lose the ability to taste or everything will have a metallic flavor. After my first chemo infusion, the tissues inside my mouth became painfully sore. It felt similar to the sensation one gets after burning the mouth/tongue on hot pizza. During consequent infusions, I sucked on ice cubes and this actually reduced the sore mouth effect. I also lost the ability to taste during treatment and the texture of food seemed “wrong.” Soon after treatment, my mouth and tongue recovered.
It’s freezing in here!
The body’s thermostat may be thrown out of whack. Most people seem to feel cooler. Others contend with hot flashes, or alternate between both.
Neuropathy: numbed nerves and tingling in the extremities.
Not all people experience this. Many patients who develop neuropathy have reported that their dulled nerves recover after treatment. Taking the advice of a trusted friend, I tried acupuncture, which helped me completely avoid neuropathy. Also, the bag of ice I used to help protect my fingernails seemed to preserve the nerves in my fingers. Many fellow patients swear by L-Glutamine, an essential amino acid, reporting that it helped them avoid nerve pain and facilitated recovery. Be sure to discuss any supplement regimen with your doctor.
Possible issues to the cardiovascular system and clots.
This side effect is a particularly scary one and must be watched. If a patient is being given a med known to have potential effects on the heart, doctors will closely monitor things. People at risk or who already have heart disease are also carefully monitored. Cardio-oncology is a growing specialty in response to the need to protect our vital organs during treatment. I haven’t had trouble in this department and many patients I know haven’t either, but it’s good to be aware and cautious.
Cancer treatment is a highly individual thing. The side effects people experience vary and pre-existing conditions will influence how one feels during chemo. I didn’t list everything, but touched on the more common issues. It’s crucial to talk to your doctor and understand the treatments and their possible effects. Communicate your concerns and learn as much as you can. Take active control to avoid feeling helpless. You’re the boss, not cancer.
Here are some helpful things I’ve learned:
- Light walking or any kind of exercise is vital! This may seem like the last thing you’d want to do after an infusion, but, trust me, it’s a pain and sanity saver. Though it would seem otherwise, moving the body actually reduces the soreness and helps one recover more quickly. Be as active as you safely can, active bodies recover more quickly. Talk to your oncologist about physical activity, you want to recover quickly, but not push yourself too hard.
- Flush your system and stay hydrated. Drink a lot of fluids and electrolytes, especially the day of and after an infusion. If water tastes like crap (the taste bud thing), try adding lemon or drink natural, low-sugar beverages.
- Can you prevent hair loss? Many people have used cold caps with great results.
My Own Chemotherapy?
I faced a highly aggressive, hormone-positive invasive ductal carcinoma—a type of breast cancer. It must’ve been happy hour at the chemo clinic since I was served a sizable cocktail of potent poisons: Carboplatin, Taxotere, Perjeta, and Herceptin. Mixed in that mess were a rainbow of anti-nausea medications and cortisol-type steroids (the inflammation-reducing kind, not the anabolic weightlifting kind). Using the word “poison” is wrong and misleading, but that’s how it feels at the time. This stuff is potent, but it works.
Have you endured chemotherapy? Questions? Feel free to share your experiences in the comments. Your well being matters; your health matters.