For someone recently diagnosed with cancer, facing the prospect of chemotherapy and the possibility of side effects can feel like a double whammy.

Good news: Advances in treatments designed to manage chemotherapy side effects have drastically reduced the discomfort associated with the use of this common cancer therapy.

The Downside Of Chemo

Chemotherapy drugs (which come in oral, intravenous and topical forms, depending on the drug and its use) are prescribed alone or with radiation and/or surgery in an effort to cure or control many types of cancer, including malignancies of the breast, lung and colon.

Unfortunately, most of these drugs kill not only cancer cells but also some healthy cells found in many parts of the body, including the hair follicles, leading to such side effects as hair loss. The type of chemotherapy drug used largely determines which-if any-side effects will occur. Following chemotherapy, noncancerous cells that were affected by the drugs recover, allowing hair, for example, to grow back. After 21 years of working with cancer patients, here's what I recommend to curb side effects…

Appetite Loss

Chemotherapy can affect the taste buds and mucous membranes of the mouth, causing strong-tasting foods to taste offensive or less than palatable. This can result in a diminished appetite and other nutritional problems. What to do…

  • Talk to an oncology dietitian. People receiving chemotherapy often need more protein and calories in a relatively smaller amount of food (known as nutrient-dense food) because they feel too tired to eat or have experienced taste and/or smell changes. An oncology dietitian can suggest nutrient-dense foods, such as chicken and other lean meats, fish or eggs. Be sure these foods are fully cooked and eaten immediately or chilled to prevent the growth of bacteria.

Also helpful: If your dietitian, nurse or doctor recommends extra protein, try adding nonfat, dry-milk powder to cereal, spaghetti sauce or other foods (as long as you're not lactose-intolerant). Also, eating five or six mini-meals each day can reduce the "work" of eating and make it easier to get the nutrition you need.


Fatigue is a common side effect of chemotherapy, especially for older adults who may have other chronic health conditions that also cause fatigue, such as arthritis or heart failure. What to do...

*Ask your oncologist or oncology nurse to refer you to a dietitian who works with cancer patients.

  • Set priorities. It may seem obvious, but far too many cancer patients put pressure on themselves to maintain their normal schedules—even if they don't feel up to it. For example, if you're the family cook and typically prepare big breakfasts, ask yourself, "Do I value cooking more than showering in the morning?" If so, shower at night and just wash your face and brush your teeth in the morning, so you can cook. Or delegate the task of cooking to someone else.
  • Ask for help. It's likely that many people know about your cancer and want to help but don't know how. If you're overwhelmed by multiple offers, appoint a friend or relative to coordinate help with meals, transportation, etc. If you don't have offers of help, contact people you may have met through volunteering, work and community activities.

Hair Loss

If hair loss occurs from chemotherapy, it is generally temporary. Still, it makes sense to plan ahead. What to do…

  • Get a haircut. As surprising as this might sound, you can ease the psychological pain of losing your hair by getting a short haircut or your head shaved before long strands start falling out. (Men and women can follow this advice.) This allows you-rather than the chemotherapy-to be in charge.
  • Choose appropriate head coverings. If you are comfortable with baldness, there's no reason to worry about head coverings. Just be sure to use sunblock on your head-as well as the rest of your body. Otherwise, go for a hat or a wig, depending on your own personal style. Head covers, including scarves and turbans, also are an option.

The American Cancer Society's Look Good... Feel Better program offers guidance on the use of head coverings. For more information, call 800-395-5665 or visit the Web site www.cancer. org. Or ask a hospital about boutiques that cater to cancer patients.


Nausea is among the most dreaded potential side effects of chemotherapy. What to do…

  • Ask your doctor about anti-nausea medication. A number of medications are available to prevent and treat nausea, including granisetron (Kytril) and ondansetron (Zofran).

Also helpful: Lemon or ginger-flavored foods, such as lemon gelatin, ginger ale and candied ginger, may reduce nausea.

  • Get some exercise. Mild aerobic exercise, such as walking, fights nausea by helping move food through the digestive tract. Ask your doctor or nurse about an exercise program that is suitable for you.

Skin Problems

Some chemo drugs affect skin cells, leading to cracking, itching or sensitive skin. What to do…

  • Use care when bathing. Take a brief daily shower, using a non-irritating, soothing soap, such as Tone, Camay or Dove, only where you need it, such as your groin area and armpits. For dry skin, apply a fragrance-free lotion or cream, such as Cetaphil or Eucerin.

For a line of skin-care products specifically formulated for people undergoing chemotherapy or radiation, contact Lindi Skin, 800-3804704,

Weakened Immunity

  • Wash your hands often. Because chemotherapy can weaken immunity, scrupulous handwashing-in addition to avoiding large crowds and sick people-is an important defense against contracting a viral or bacterial infection. Wash up before preparing food and eating, after using the toilet and whenever you come in contact with something that may have been touched by someone else, such as an elevator button, a doorknob or a pen at the bank or drugstore. For convenience, carry your own pen and an alcohol-based hand sanitizer.

Effective Cancer Treatment Many Hospitals Don't Offer

Treatment for blood cancers is underused, says Mitchell R. Smith, MD, PhD. Many patients with leukemia or non-Hodgkin's B-cell lymphoma go into remission after receiving radioimmunotherapy—a radioactive drug combined with antibodies that seek out malignant cells. The treatment requires only a few out-patient visits over one week to three weeks.

Why it may be underused: Few hospitals offer radioimmunotherapy because it requires a multispecialist team, including a physician licensed in the delivery of radioactive drugs. Cancer centers and teaching hospitals are most likely to provide it.

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