Coping with chemotherapy

Chemotherapy can bring a host of side effects, depending on what treatment you’re on and how you react to it. Here are some of the common side effects of treatment and helpful tips to manage them.

Nausea

Nausea and vomiting can happen at any point during treatment, from within 24 hours to up to five days later (which is known as delayed nausea). Prevention is easier than cure, so be sure to take any anti-nausea medication you’re prescribed. If you find these aren’t working for you, let your team know, as medications can be changed to suit you better. A clinical trial, PantoCIN, is underway to see if a cheap, widely available drug can help prevent delayed nausea and vomiting. PantoCIN is open at 10 sites around New Zealand.

Avoiding certain foods, such as fatty, spicy or strong smelling foods, may help, as will avoiding alcohol and lots of coffee. Some people find that ginger, peppermint, water crackers or using travel sickness bands help too.

Hair loss

Hair loss is the side effect most associated with chemotherapy treatment. Hair loss usually starts two weeks into treatment and people may lose hair from just their head or from their whole body. Some people find it easier to cut their hair short or shave it before it starts to fall out, and you may like to pick out a wig before you start treatment so you feel more prepared going into it. The Ministry of Health offers subsidies for headwear, which includes wigs and head coverings. Remember that it’s very likely your scalp hasn’t been exposed to the elements in a long time, so be sure to protect it from heat, cold and the sun. Breast Cancer Foundation NZ funds scalp cooling systems, which prevent severe hair loss for many patients, in Rotorua and Nelson. Some people find DIY scalp cooling options like Icekap or Penguin cold caps.

Mucositis

Mucositis happens when some cancer treatments break down the cells that line the gastro-intestinal tract. cells in the mouth are replaced every few days, meaning they’re likely to be damaged by chemotherapy - this commonly causes mouth ulcers. Ulcers can appear five to 10 days after chemotherapy is given. As with nausea, it’s a good idea to avoid certain foods, such as spicy or very hot foods, or hard or crunchy foods. Keeping the mouth moist can help relieve pain and irritation, so drink plenty of fluids or have ice blocks – and gargle with a salt water and baking soda mouthwash.

Nail changes

You may find your nails become weak and brittle during the course of treatment. While most nail changes are cosmetic, be on the lookout for any signs of infection in the nailbed and report these to your medical team. If you experience weak nails, cut them short and keep your hands and nails moisturised. You may also like to get them done with gel polish. Using Polybalm ointment during treatment can help prevent nail damage – this currently needs to be ordered from overseas.

Neutropenia

Neutropenia is when you have a low level of white blood cells, and so are more prone to infection and illness. White blood cells are generally at their lowest between seven and 10 days after receiving chemotherapy, and these levels will need to have improved before your next chemotherapy cycle. Your medical team will monitor these levels through blood tests, but it’s very important to be on the lookout for any signs of infection or fever and to report these to your medical team straight away.

You can find out more on managing the side effects of chemotherapy, by watching our webinar ‘Managing chemo and radiation side effects’.