Monday, April 27, 2009

How to Counter the Side Effects of Chemo

Toward the end of my chemo treatment, my husband and I decided to celebrate my progress (any excuse for a celebration), so we went to eat at Red Lobster. Their cheese biscuits are one of my favorite parts of a meal there. This time, though, the biscuits tasted like lard. No cheese, no yummy breast taste. Just lard.

Such were the wonders of chemo that nobody told me about.


I learned a great deal on my own, so to spare you that charm,
here are some of the side effects of the chemo I had—four rounds of dose-dense Adriamycin (Doxorubicin) and Cytoxan (cyclophosphamide) every two weeks—and some suggestions for how to deal with those effects. AC, as this regimen is called, is fairly common for hormone-negative cancers, including triple-negative,  that have not spread to the lymph nodes.

Chemo, in general, kills fast-growing cells, which are often cancer cells. That’s the good side of those toxins being pumped into you. However, your body has other fast-growing cells that are also affected—in your hair, the lining of your mouth, and digestive tract. Killing these changes your body. And I was not prepared for most of that.

I went through chemo fine, for the most part, given that I was going through chemo. I kept active, ate healthy, and spent marvelous time with my friends and family. But, as with all other aspects of this lovely journey, I could have been better informed.
Losing your hair. This chemo effect is the most understood and expected. My doctor told me it would happen in the third week of chemo and, sure enough, that’s when my hair literally began coming out in chunks. Some women prepare for this ahead of time by getting their head shaved before the hair falls out. I wanted to be normal and natural for as long as I could. So, one warm June day, my hair came out like dead grass in an abandoned lot, and I literally pulled the rest out. Yes,  I pulled my hair out, and I will never be able to use that metaphor again. My husband shaved the rest.

Losing your hair is so emblematic of having cancer that the more you can address this head-on (no pun honestly intended), the better. Some women paint their heads; others have friends who also shave theirs in a gesture of solidarity. I just got a couple of pretty cool wigs and simply smiled when people complimented me on my new ‘do.

Whatever makes sense for you.

A friend did tell me that, because I am tall, I would look elegant in long scarves and could make a great fashion statement. I wanted to tell her to make her own damn fashion statement, but I know she was honesty trying to be supportive, so I said nothing. (I found, though, that I could not keep scarves on; they just kept sliding off my stupid bald head.)
Changes in your mouth. I did not expect this in the least. Because the cells on the lining of my mouth were killed, I lost a good deal of my sense of taste, which is why those biscuits tasted like lard. My acupuncturist suggested buying some Japanese plum sauce, which has a tangy taste and sort of shook up what taste buds remained. (She also told me the other day that my tongue had looked like raw meat at the time. It did feel especially raw.) I also found that chocolate malts tasted quite good.

The bigger mouth problem, though, was mouth sores. Lots of them. Doctors call this oral mucositis and recommend
a variety of things to help it, including “miracle” or “oncology” mouthwashes and antibiotics. I found an over-the-counter version that had hydrogen peroxide. Other than making me foam at the mouth like Cujo, it worked fine. I suspect that a good salt-water rinse would work as well.Digestive tract pokiness. One result of the loss of some of the cells in your digestive tract is that your digestion slows down. This is for sure the nastiest side effect of chemo, and no doctor has ever talked to me about it, but chemo patients talk about it all the time. Serious constipation. Serious. I took a natural laxative, Senna Plus, which worked OK. I often had to overdose, plus I also resorted to plain old-fashioned charmers like Milk of Magnesia.  The Mayo Clinic offers some good information on laxatives here.

I started taking a green drink every morning, a healthy tonic I still take. Green drinks are generally high in fiber and rich in antioxidants and vitamins. So they’re good for getting your digestion going and fighting the cancer. Oprah’s medical guru, Dr. Oz (really, Oz?) has a recipe online for his green drink
here.

I actually do two green drinks. In the morning, I have a powdered version that has spirulina, sea grass, organic greens, plus vitamins and minerals, like
Barlean’s Green.  In the evening, my husband makes me a fresh juice of carrots, kale, cabbage, and parsley, with apples and lemon for taste. Full of antioxidants and heavy on cancer-fighting cruciferous veggies.

The green drinks together, I think, helped move my digestion along.

I also found that I needed to increase the amount of magnesium I took, which is often a cause of constipation in folks without chemo, especially if they are taking calcium.


And exercise is essential.  I walked two miles most days, and that helped.  The more I walked, the better.Digestion tract speediness. Nausea is another effect we expect, although one oncologist told me that anti-nausea drugs added to the chemo cocktail have eliminated this problem. As if. My husband and I believed this, and we went out for lunch after my first chemo—at the suggestion of a helpful nurse I could strangle. Like a couple of certifiable idiots, we went to a great Italian restaurant where I ate spaghetti with meat sauce. I was sick for hours until I threw up the entire meal. I did not want meat sauce for years after, nor did I want to even walk into that restaurant, as though it were at fault.

I learned to eat small meals on chemo days, usually bland things like soups and toast or crackers.  I had plenty of liquids, and I went to the acupuncturist beforehand. I usually had mild nausea for about 24 hours after chemo, but nothing serious.

My sense of smell, which has always been acute, remained lively, so the smell of even bland things like mashed potatoes often turned me off. We resorted to eating as many fresh foods as we could, which is also a highly healthy way to go.

Three years later, I still think about those lardy biscuits. My taste buds got back into shape within a month or two of chemo. Now, the biscuits taste as they should—creamy, crunchy, and cheesy. I know, though, that behind all those goodies, there is lard. And that is one lesson of chemo I am choosing to ignore.

I will do the green drinks, I will eat healthy most of the time, and I will keep my weight down. Occasionally, though, I want a cheese biscuit or six, lard and all.


Read more about chemotherapy for TNBC, plus my experience with the disease, in my book, Surviving Triple-Negative Breast Cancer.

3 comments:

mechanical said...

Hi, My mother is newly dx with TNBC. She is having Third stage TNBC with node positive. Surgery has removed her entire left breast. The Enco has started the TAC as her chemo drug. Pls let me know the effective ness of TAC and is there any other treatment available for TNBC.

Patricia Prijatel said...

Mechanical:

Your mom is lucky to have your support--that is an important aspect of recovery. And TAC has been successful in treating TNBC in several tests. AC is typical if the disease has not spread to the lymph nodes, and TAC is favored if it has spread. Some researchers say taxanes should be used on all TNBC, whether it has spread or not. Here are a few posts on this topic:

On TAC specifically (although stage 1 or 2):http://hormonenegative.blogspot.com/2009/03/tac-improves-disease-free-survival-for.html

On Taxanes plus Avastin:
http://hormonenegative.blogspot.com/2010/05/taxanes-plus-avastin-successful-against.html

And an overview of a teleconference on TNBC, in which treatment is discussed:
http://hormonenegative.blogspot.com/2010/04/recap-of-tnbc-teleconference.html

I will add your mom to my prayers. Keep in touch and let me know how she is doing.

Pat

mechanical said...

She has completed 12 days after her first Chemo doze. She is not having any problem and her counts are in acceptable Limit.