5 tips for managing the effects of chemotherapy
For cancer patients, treatment can feel as daunting as the disease, especially when it comes to the possible side effects of chemotherapy and immunotherapy.
But there are ways to mitigate side effects, giving patients as good a life as possible during treatment, said Megan Emmich, DO, medical oncologist at Cape Cod Hospital.
Chemotherapy and immunotherapy are both systemic treatments, meaning that while they are meant to target cancer cells, they affect the entire body, creating some unwanted side effects, she said.
Chemotherapy relies on medication to stop the growth of cancer cells and is administered either through infusion or oral medications. Immunotherapy, mostly given via infusion, uses antibodies to help boost a patient’s own immune system to fight cancer.
“Some patients’ treatment plans will have both chemotherapy and immunotherapy,” she said.
Dr. Emmich works with her patients to provide the tools and advice they need to navigate systemic therapies and stay ahead of side effects like nausea, hair loss and infection. For example, chemotherapy depresses the immune system, so patients have regular blood work to check that white and red blood cell counts, as well as platelets, don’t drop too low.
“If your white cells are too low, you could be susceptible to an infection,” she explained. “But there are medicines like growth-factor shots (injections) that can help boost the bone marrow to produce more white cells to stay ahead of infections.” “
She prescribes patients medications like Compazine and Zofran to stay ahead of nausea and/or vomiting, which can lead to dehydration. “I talk about being ahead of the curve,” she said. “I really hone in that we need to stay ahead of nausea right at the second that some of those symptoms are coming about.”
Patients can also make adjustments to their habits. For example, a low platelet count can mean a patient bleeds more easily. So, Dr. Emmich might recommend switching to a soft-bristle toothbrush.
Tips to Ease Side Effects & Find Support
If you or a loved one is going through chemotherapy or immunotherapy, here are five other things Dr. Emmich advises that can help mitigate side effects or provide support:
- Keep your care team on speed dial. “I really stress communication. I had a patient who said, ‘Hey doc, I wasn’t feeling well, but I didn’t want to bother you.’ We communicated that together, we are a team, it’s your job to tell us if you don’t feel well. There’s nothing too small,” she said.
- Ask for support. Many kinds of support services are available – emotional, physical, nutritional, financial. Your oncologist can refer you to Cape Cod Healthcare social workers to help find a support group or subsidized transportation to treatment. The nonprofit Cape Cod Wellness Collaborative offers cancer patients $250 gift cards that can be used for supplemental treatments like massage, reiki or acupuncture. The collaborative also has support groups, a meal program and partnerships with local yoga practitioners.
- Resist the urge to go online for answers. Start with your care team, not “Dr. Google,” Dr. Emmich warns. While there can be good information online and/or trustworthy disease-specific sites, it’s hard to sort. And she reiterates that no question is too minor to ask the care team.
- Take a buddy to appointments or ask for written information. The amount of information can be overwhelming, so take a friend or family member to an appointment to listen and take notes. Dr. Emmich also provides written “quick guides” that patients can take home and read and absorb information as they are able.
- Alert your doctor when treatment affects your lifestyle. If, for example, a patient is used to walking her dog two miles a day but no longer feels up to it, Dr. Emmich tries to figure out why and find a solution. “My goal with treating a patient on chemotherapy and immunotherapy is to make sure we’re safely and effectively treating their cancer, minimizing side effects/toxicities as much as possible and making sure they have a good quality of life,” she said.
