We asked our team for the most frequent patient questions they hear. We're sharing those questions and our answers here to give our patients and their caregivers as much information as possible about the cancer treatment process. Unfortunately, there are not always quick and easy answers when it comes to cancer, and please also remember that every case is different and should be treated as such; but rest assured, we are always here to offer reassurance, listen to your concerns and to share the knowledge we have.
1. Am I going to go bald?
For those undergoing chemotherapy, hair loss can be a side effect. Hair loss occurs because the chemotherapy affects all cells in the body, not just the cancer cells. The hair follicles are especially sensitive, because those cells multiply rapidly — just like cancer cells. Hair loss does not occur with all chemotherapy. Whether or not your hair remains as it is, thins or falls out will depend entirely on the specific drugs and dosages. Hair loss may occur as early as the second or third week after the first cycle of chemotherapy, although it may not happen until after the second cycle of chemotherapy. Hair loss can be sudden or slow. You may lose all of your hair or just some of it.
The good news: Hair almost always grows back after treatment — and if you're up for a change, you're in luck, it may be a different color or texture than before.
Options for proactively managing hair loss during chemotherapy
Short hair – Cut your hair short if you are expecting hair loss during chemotherapy. Since hair often does not fall out evenly, some find losing short hair is less distressing. Some people shave their heads once the hair begins to fall out.
Wigs – If you are interested in purchasing a wig, the best time to do this is before you lose any hair. This helps the stylist create the best match. Many insurance companies will pay for a wig, so be sure you have it written as a prescription from your doctor (usually written as "cranial prosthesis"). The Northern Nevada chapter of the American Cancer Society has a free wig program.
Caps and Scarves – Some people find that the easiest, and most comfortable options, are caps and scarves. These range from those you may already own to custom items made exclusively for people who are undergoing chemotherapy.
2. Am I going to be sick?
The most common side effect of chemotherapy is nausea and vomiting, but it can often be controlled with anti-nausea medication taken as prescribed by your physician.
Mouth sores may also form during treatment, but there are ways to prevent that or manage it when it does happen, including rinsing with water frequently, keeping teeth clean, using saliva substitute, applying lip moisturizer often and sucking on hard candies.
3. Is this really going to do any good?
Millions of people undergo a variety of cancer treatments every day. And millions of them survive their cancers because of it. Dr. Perez is a highly trained and skilled oncologist. He will assess your particular cancer and devise the treatment plan that he believes will be most effective in treating your cancer. The type and stage of your cancer will have a large bearing on how effective a treatment will be. Rest assured, Dr. Perez will not prescribe a treatment he does not feel will improve your health.
4. How much is this going to cost me?
Cancer can be expensive, so it is not at all surprising that a chief concern among our patients is about the bottom line. There is not one simple answer, however, as costs depend on the individual insurance plan and deductible. Our billing department will work with you and your insurance company to determine your out-of-pocket expenses for treatment.
Another valuable resource: Cancer.org has a guide to managing the costs of cancer treatment.
5. How long will it take to administer the chemo?
Chemotherapy treatment varies in length and frequency and will depend on the treatment plan prescribed by Dr. Perez. Treatment sessions range from 30 minutes up to four hours.
6. Why am I so tired?
Cancer fatigue is a common side effect, although it is not known whether the fatigue is a result of the cancer itself or of treatment.
Additionally, cancer can increase your body's need for energy and alter your body's hormones.
Chemotherapy, radiation therapy, surgery, bone marrow transplantation and biological therapy may all cause fatigue as your body tries to repair the damage to healthy cells and tissue. Some treatment side effects – such as anemia, nausea, vomiting, pain, insomnia and changes in mood – may also cause fatigue.
While it may seem counter-intuitive, staying active and getting exercise during treatment can enhance your energy levels and improve your well-being.
7. Is there a special diet I should follow?
Nutrition is an important part of cancer treatment. Eating well before, during and after treatment can help you feel better, stay stronger, better tolerate side effects and lower your risk of infection.
"Eating well" means eating a variety of foods to get the nutrients your body needs to fight cancer. These nutrients include protein, carbohydrates, fat, water, vitamins and minerals. Getting a well-balanced diet can be a challenge when you have lost your appetite, are experiencing nausea, have mouth sores or are constipated as a result of treatment.
High-calorie, high-protein shakes are one efficient way to get nutrient-rich food into your body. The American Cancer Society has a few recipes on their site for shakes and soups.
8. How long after treatment can I go out in public?
Generally speaking, you can go out in public as soon after treatment as you feel up to it. Throughout your cancer treatment, when your immune system is compromised, you will want to avoid situations where you might come into close contact with people who could be sick, and make sure you wash your hands afterward.
9. What are the side effects of chemotherapy?
Chemotherapy can have unpleasant side effects, but it is still the most important and successful cancer-fighting tool we have. Because chemo drugs are designed to kill any fast-growing cells, some normal, healthy cells can be damaged — leading to side effects. When side effects are particularly bad, the chemo dosage may be reduced or the time between treatments increased. For most people, side effects go away after their treatment ends, but response varies for each person.
Side effects may include:
- Nausea and vomiting
- Hair loss
- Bone marrow changes
- Mouth and skin changes
- Fertility problems
- Memory changes
- Emotional changes
- Diarrhea and dehydration
- Low blood counts that can result in anemia, bleeding and serious infections needing hospital admissions
- Some may have an allergic reaction to chemotherapy with more serious effects
10. Will my cancer come back?
Some cancers can come back after treatment. The odds of this happening depend on many factors, including the type of cancer.
You cannot control whether or not your cancer comes back, but we know that knowledge may not keep you from worrying about it either. The America Cancer Society recommends the same sort of activities for preventing recurrence as they do for preventing cancer: healthy eating, regular exercise, maintaining a healthy weight and following up with your care team as advised.
You may find joining a support group of cancer survivors a good way to deal with anxiety over a recurrence: Here is a list of area support groups.