From ways to battle nausea to scalp-cooling caps.
The side effects of chemotherapy can be deeply daunting for patients, leading to a host of new problems when they begin treatment. And it can be tough to find reliable, trusted guidance about how to address all those issues. Luckily, New York’s Memorial Sloan Kettering Cancer Center is a world-class cancer hospital, with world-class, cutting-edge info for anyone, anywhere dealing with a diagnosis. MSK’s Dr. Diane Reidy-Lagunes hosts a podcast called Cancer Straight Talk from MSK, which brings together patients and experts for straightforward, evidence-based conversations. Its mission? To educate and empower patients and their family members.
In a recent episode, Dr. Reidy-Lagunes sat down with MSK oncodermatologist Dr. Mario Lacouture and clinical nurse Sheryl Scott to discuss the most effective ways of preventing or mitigating the side effects of chemotherapy and radiation. They provide tips for living with fatigue, keeping or regrowing hair, soothing skin rashes, protecting nails, reducing nausea, and more.
Click below to listen to the full episode, or read on for some ultra-useful tips.
Why does chemotherapy or radiation cause side effects?
Chemotherapy and radiation are designed to kill rapidly growing cells, of which cancers are made up of. Skin, hair, and nails are also comprised of rapidly growing cells, making them vulnerable to chemo and radiation as well.
What are the most common side effects of cancer treatment, such as chemotherapy or radiation?
The most common side effects of chemotherapy and/or radiation are fatigue and dry skin rashes. Nausea, vomiting, diarrhea, constipation, brittle nails, hair loss, and hair thinning are also common.
50% of people undergoing cancer treatment will experience some type of dermatologic condition, and in up to 20% of patients, these side effects limit their ability to receive treatments. By treating these conditions early, they can be prevented or mitigated to the point where treatment can continue and quality of life is not impaired.
What helps fatigue after cancer treatment?
-Hydration helps treat fatigue. Drink plenty of fluids. Think of hydrating as the rinse cycle to wash out all the toxins after treatment.
-Exercise and bodily movement also help with fatigue. Start slowly, such as walking to the mailbox, then work your way up to more purposeful exercises.
-Don’t fight fatigue. If you need a nap, take a nap. It is often the best thing you can do for your body.
-Balance your lifestyle. Even if you have the energy, don’t plan too many activities in one day or you will pay for it the next. Find a balance between active and rest periods.
How nauseous does chemotherapy make you?
Not all chemotherapies cause nausea, but if they do, it will typically start around the third day of treatment. However, the anti-nausea drugs used in cancer centers today are very effective. Vomiting is rarely a side effect anymore. Additionally, chemotherapies are now categorized into the amount of nausea they can cause, making it very easy to identify which anti-nausea medications are needed pre-chemo, and then patients are also sent home with anti-nausea medications to take as needed. Food can also be very helpful in treating nausea.
Nausea from chemotherapy can be compared to nausea from morning sickness. In fact, in women with children, there is a direct relationship between how much morning sickness they experienced during pregnancy and how much nausea they experience during chemotherapy. Sharing this information with your doctor before treatment starts will help them tailor your treatment plan.
How do I prevent hair loss from chemotherapy?
–Scalp-cooling devices prevent hair loss by circulating a very cold liquid in a cap that the patient wears during chemotherapy. This shrinks the blood vessels in the scalp, preventing chemotherapy from reaching the hair follicles and increasing the survival of hair follicle cells.
-Clinical studies on scalp-cooling caps have shown between half to two-thirds of patients will retain an amount of hair in which they will not need a wig or any type of covering.
-Scalp-cooling devices are available at many cancer centers across the country, including MSK, and some insurances do cover it. Out-of-pocket, they can cost between $2,000 and $3,000, though more insurance companies are starting to cover it now, so it is worth asking your provider.
-A common side effect of scalp-cooling caps is a headache, both from the tightness of the cap and the cold they produce. It also adds one to two hours of time to the patient’s treatment process in order to prepare, apply and then remove the cap.
-Cold capping is not safe or effective at preventing hair loss for all types of chemotherapies. Talk to your doctor before starting treatment to see if it’s an option for you.
How do I grow my hair back after chemotherapy? What helps treat thinning hair?
–Minoxidil is a common medication used to stimulate hair growth. It is available as an oral tablet or in a topical cream such as Rogaine, though oral minoxidil has been proven to be more effective (and with reduced side effects such as an itchy scalp). When taken daily, minoxidil can stimulate hair growth up to 20% in three to six months.
-Antifungal shampoos, such as Ketoconazole, has an anti-androgen effect that blocks the hormone that causes most men to lose their hair. Though not as effective as minoxidil alone, it is often paired with minoxidil to offer dual treatment in people with thinning hair.
-If you do not respond to minoxidil, it is worth checking the zinc and vitamin D levels in your blood, as those micronutrients can affect hair growth and up to one out of 10 people have a deficiency in one of those.
Does hair grow back after brain radiation?
Hair regrowth is dependent on the dose of radiation the patient received. Patients should ask their radiation oncologists about what type of side effects to expect.
Minoxidil stimulates hair growth in about 20 to 30% of post-radiation patients.
Do you lose your eyelashes and eyebrows during cancer treatment?
Eyelashes and eyebrows may be lost during chemotherapy or radiation, though they are also usually the first hair to grow back after treatment ends, typically signaling the return of more hair soon.
There are many products on the market to help stimulate eyebrow and eyelash regrowth. The American Cancer Society has a program called Look Good, Feel Better which helps patients learn how to use these products.
Does cancer treatment cause skin damage?
Skin damage can occur on up to 90 percent of patients receiving chemotherapy or radiation treatment, however, there are three pieces of good news:
-Inexpensive oral antibiotics, taken preventively during the first two to three months of therapy, have been shown to reduce the incidence of skin rashes by more than 50%.
-If a rash does appear, it will not last the whole duration of treatment. It will peak within the first month and then diminish over time.
-In multiple studies, patients who developed a rash actually had a better response to the anti-cancer properties of their treatment versus those who did not.
What products help treat dry skin rashes from cancer treatment?
-Use fragrance-free soaps in the shower and fragrance-free detergents to wash your clothes.
-In the wintertime, use a humidifier indoors.
-Moisturize using fragrance-free products. It is important to use large amounts over all body areas and applied after the shower.
-Moisturizers should contain certain ingredients that allow for that dead skin to fall off and to retain the new skin underneath, such as ammonium lactate or salicylic acid.
When choosing a moisturizer, it’s very important to pick a vehicle of the moisturizer that works for you. Moisturizers are available in three main vehicles:
-Ointments are the best moisturizers, but they are very thick and greasy, so a lot of people do not like them. These usually come in tubs like Vaseline.
-Creams are the white products that come usually in a tube, and you can spread these more easily all over the body. Creams are good moisturizers to apply over moderate surface areas.
-Lotions are not the best of all moisturizers, but they are the easiest to apply over large areas of the body. These usually come in a bottle with a pump.
How do I treat nail changes from cancer treatment? What helps treat brittle nails or paronychia?
-Wash your hands often with an antibacterial soap, or even better, with a surgical-grade pink soap. Nails carry a lot of bacteria under them, so washing them often will prevent infection.
-If the nails start separating or if they are painful and discharging, soak them in a solution of white vinegar and water.
-If none if these help, see a dermatologist or your oncology nurse, as a bacterial culture of the nails should be obtained to determine an antibiotic to use.
Republished with permission from Memorial Sloan Kettering Cancer Center.
