Chemotherapy
Chemotherapy

Side Effects from chemotherapy vary. Among the more common side effects are feeling tired (fatigued, lethargy), nausea, diarrhea or constipation, and body hair loss (due to the effect of the drugs on the DNA of hair follicles). Every cancer patient responds differently to the combination of chemotherapy drugs.

"Chemotherapy" has been used for more that fifty years, but many changes have occurred in the types of drugs used, dosage, and frequency. Chemotherapy is sometimes recommended prior to surgery to shrink the tumor to make it more feasible for the surgeon to remove the entire tumor during surgery. There are more than fifty different chemotherapy drugs and the drugs are used in different proportions and combinations based on the specific cancer diagnostic information. In general, chemotherapy drugs affects the DNA of the cells by interfering with cell duplication. These drugs affect both the cancerous and the healthy cell DNA. The healthy cells that are particularly susceptible to chemotherapeutic drugs are those which multiply quickly, like the skin (including body, facial, and head hair), gastrointestinal tract, and bone marrow. (Burhansstipanov, 1997)

What is very important to remember is that these side effects are temporary and gradually go away after the chemotherapy treatments end.

Examples of side effects, of which most chemotherapy patients experience at least a few, include the following:

  • Fatigue (e.g.,
  • lethargy)
  • Weakness
  • Nausea
  • Lack of appetite
  • Vomiting
  • Weight Loss
  • Fever
  • Chills
  • Fluid retention
  • Diarrhea
  • Constipation
  • Blood clotting problems
  • Headache
  • Muscle aches
  • Burning or painful
  • sensation during urination
  • Vaginal infections
  • Tingling, burning sensation in hands or feet
  • Hair loss
  • Skin changes (redness, dryness, itchiness, acne)
  • Brittle nails
  • Sores in the throat and mouth

How You Can Help the Cancer Patient Before the Chemotherapy Appointment

  • Coordinate transportation to and from the chemotherapy sessions. This means to have someone drive the patient both to the chemotherapy appointment and from the appointment.
  • Have fruit juice or another non-alcoholic liquid drink ready for the patient to have on hand during the chemotherapy treatment.
  • If the chemotherapy session is to be fairly long (and especially if the cancer patient is also diabetic), pack a healthy snack for her to eat if she feels hungry during her therapy.
  • Pack extra water and blankets in the car/truck. If possible, also have some apple or carrot juice handy in case the patient needs something.

How You can Help the Cancer Patient During the Chemotherapy

  • Try to vary the experience to make is more comfortable or acceptable to the woman. For example one woman said that it was very helpful when her grandchildren occasionally accompanied her to her chemotherapy sessions. The children brought toys and played near her feet during the treatments. Seeing the children play helped the patient keep focused on why she was completing the chemotherapy sessions ... so continue to see her grandchildren play and grow.

Linda B’s Editorial. When you go in for a chemotherapy appointment, there are usually fairly comfortable chairs around the room, a television and/or radio and reading lamps. There are usually other people in the same room all receiving chemotherapy. The providers connect the bottle of chemotherapy drugs to the patient through an IV (intravenous tube) so that the medicine goes directly into the blood stream. Chemotherapy "sessions" may be as short at 1 hour one day a week, or can be 9 hours three times a week. Different types of drugs are used to treat different stages of cancer. The length of each session and type of drugs used for chemotherapy depend on the stage of cancer and type of cancer cell (e.g., histologic grade and stage). This means the person sitting next to the "loved one" may also be a breast cancer patient, but may be receiving totally different medications within their chemotherapy.

  • Take turns and have other family members, friends, healers come visit during the sessions.
  • Invite a tribal story teller to come visit and share traditional stories with the patient of strength, courage and/or battles with unusual enemies / contestants / or rivals.
  • If her chemotherapy sessions are longer than 30 minutes, remind her to drink some juice (e.g., apple or carrot).
  • If she is diabetic, remind her to eat a "healthy snack" to keep her blood sugar at a healthy level. Remind the providers that she is diabetic so that they can keep an eye on sudden changes in her behavior (i.e., monitor her reaction to treatment).
  • If the chemotherapy room has a VCR, bring in movies or tapes of her favorite shows to help distract her from simply sitting.
  • Several of the Native women have commented that they enjoyed being able to sew or do other crafts while receiving their chemotherapy. Check the room and make certain that she has a table to set her tools on. Also check to make certain that there is sufficient light for her to see. If not, bring in an extra light with you to have set next to her to illuminate her beadwork, basket reeds, sewing, etc.
  • Ask the patient how she would like to be entertained during the chemo. Provider her with options and allow her the self-respect to choose how she wishes the treatment to proceed.
  • Some women enjoy visiting with the others who are also receiving chemo.
  • Some want to have a healer visit with them.
  • Some want a family member.
  • Some occasionally want to be left alone during their treatment.
  • Bring a blanket. During chemotherapy, cold, clear liquid medication is slowly dripped into the patient’s blood stream. Most patients feel "cold" after the first 30 minutes or hour treatment. We have asked healers to bless personal Indian blankets for the women to have with them during their treatments for both spiritual strength and physical warmth.

it wasn’t as bad as I thought. I didn’t get as sick as I thought I was going to get. It wasn’t fun, but it was worth it all. Um, my husband went with me and when I did the chemo he would stand behind me, you know, with his hands on my shoulders. And it was really neat because I got sick and he got sick at the same time. Um, when I started losing my hair, he lost his hair too. And everything I went through when I’d go in to get my chemo, I guess it was just like the smell of the, it could have just been the alcohol that they, you know, clean before they start your chemo. Ah, I don’t know what was the key, my husband would get sick as soon as we went in. His face would turn gray, but he stayed there. And the doctor would say, "Mr. Trijillo you don’t need to stand there behind her, you know." And he would say, "I know I don’t have to, I want to." So I had a lot of support, and ah, it was good to know that so many people loved me and that were behind me and that were pulling for me and, um, I just thank the Lord that, I feel like I am healed.Evelyn Trujillo (Yaqui)

CI went back (to work) first part of March and I still had two more treatments, and I was still, well I wasn’t bald but I still had to wear that wig and the people that I work with were really nice and were understanding and that helped a lot. And the supervisor came down. To be around people and not to be home, if you get sick, it uh, it helped to be around people. Carolyn Spotted Horse (Crow)

And my brother ... was something else, ... he says, "Well Sis, how are you doing on your with your chemotherapy," and I say,"I’m doing fine. Some days I’ll come home and I’ll go to sleep for about three days, and there are other times I’ll come home and I’ll clean my house and I’ll go shopping." It just depended you know. And he says, "are you bald yet?" And I say, "no," and he says, "oh shucks, I always wanted a bald sister." And I say, "no, the wig is still up in the closet, you know."

Ruth Demitt (Athabascan/Tanacross)

How you can Help the Cancer Patient After Her Chemotherapy

  • Pack a bucket in the truck / car, in case the patient suddenly becomes ill and needs to vomit during the drive home. This need to vomit may have very little warning. The embarrassment following vomiting is a little less if the substance can be contained in the bucket rather than throughout the truck / car. The bucket can also be emptied outside rather than remaining in the vehicle for the entire ride home.
  • Have a place set up for her to lie down during the drive home. She may suddenly feel tired and need to lay down. Have a couple of pillows and blanket in the car for her use.
  • Have one small pillow available for the patient who has had some lymph nodes removed and needs to keep her arm elevated to prevent swelling (this is called, "lymphedema"). Again, we are having elder Indian women make our pillows and having a traditional Indian healer bless the pillows so that the woman can derive some spiritual strength from the pillow.

General Supportive Care throughout Chemotherapy

  • Plan to have others help with all meals, household chores, including writing monthly bills throughout the woman’s chemotherapy (see Appendix "A" for examples of sign up sheets for family, friends, and co-workers).
  • Many people get sores in their mouths during chemotherapy. Acidic foods are too painful to eat (e.g., vinegar dressings, orange juice). See the NCI booklet by Marion Morra on Eating Tips for Cancer Patients for specific suggestions (Call 1-800-4-CANCER to obtain a free copy).
  • Gentle herbal teas with honey (to help with sore throat) may be tolerable for the patient.
  • If the patient is losing weight during chemotherapy, try a variety of recipes to find food that is acceptable. there is a very strong metallic taste that remains in the mouth and affects the taste buds .. so foods which are normally palatable, may simply taste metallic or have no flavor at all.
  • Frozen yogurt fruit shakes (with real fruit, like banana, if possible) are sometimes acceptable ... frozen yogurt does not contain "lactose" ... Many Indian people are "lactose-intolerant" (e.g., body makes a lot of gas after eating or drinking milk products that contain "lactose").
  • Coordinate someone who can help clean the house throughout the chemotherapy. This needs to be someone the patient trusts (See Appendix "B").

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