Managing Side Effects of Cancer Treatment--Part II

by Pradeep K Jaisingh 9/15/2009 6:43:00 PM

In continuation with the last post, let us talk about managing the side effects of the cancer treatment.

1. Loss of appetite:
Many cancer patients receiving chemotherapy experience a loss of appetite and also a perceptible change in their taste and aroma of food making it unappetising. Some foods may taste or smell too stong, bitter and other foods may tase very medicinal and therefore unappealing to most patients.

This is a significant problem while patients are receiving the treatment as it further adds to the already challenging situation wherein the patient is fighting with other emotional aspects like depression etc. The other very important factor is that loss of appetite may result in inadequate nutrition and thereby compromising the immune function leading to enhanced risk of infection and a general feeling of weakness and lethargy.

The way to deal with these issues is to try and eat smaller portions at more frequent intervals going upto 6 to 7 times a day ensuring proper nutritional balance with adequate calories and protein at each serving. Fresh juices, soy milk, fruits like peaches, melon, plum etc, milk shakes, yoghurt etc. are good additions to the diet. In general do not try to go for foods with very strong smell, flavors. Go with your instincts and eat what looks appetising to you.

Your oncologist / nutritionist may be able to also recommend some appetite stimulants as well. Do share your diet plans with your doctor and make sure you are taking enough nutrition.

2. Nausea / Vomiting
It is by far the most common and dreaded side effect of chemotherapy and created widespread angst and discomfort amongst patients. Many of the chemo drugs so far caused varying degree of damage to the gastrointestinal tract resulting in a nauseated and unpleasant feeling at the back of the throat and creating a vomiting sensation and many a times actual vomiting. The intensity and frequency of nausea and vomiting varies from patient to patient for the same drug.

The good news is many of the new generation chemo drugs have significantly reduced the nausea and vomiting side effect of chemotherapy. However, some drugs still cause it and many patients still respond differently.

Discuss your specific nausea/ vomiting pattern with your oncologist. Your doctor will also be able to prescribe some medicines that reduce the nausea and vomiting sensation. Drink plenty of juices like watermelon, sweet lime etc. Stay hydrated with energy / sports drinks and water.

Avoid pungent foods and also foods that could cause acidity like fried and spicy food, chips and similar snacks.Ginger has been found to be quite helpful in reducing the effect of nausea and vomiting amongst patients and therefore should be used in different forms in the food.

3. Hair Loss
Hair loss or alopecia is a common side effect wherein chemo drugs damage the hair follicles and cause partial to total hair loss. Though the hair loss is temporary, it still has very significant psychological impact on patients particularly in women patients.The extent of hair loss varies from patient to patient and so does the re-growth time frame though 6-8 weeks after the treatment is the general average.

Radiation therapy also causes hair loss in the targetted area.

How does one deal with the hair loss and the resulting image / appearance problem?

A hairpiece or a wig is certainly an option for many patients but should be ordered before the hair loss starts and could be designed to match one's hair style and color.

Hats/ caps/scarves and other traditional or commonly used headgear is another category of recommended options.

Overall, I think that some side effects are inevitable even with the rapid progress that has been made by the researchers in minimizing the toxic side effects of various drugs and other treatment options. Above mentioned suggestions will certainly help to a certain extent.

Once again, Good Luck and all the very best.
"Every Life Matters"

Pradeep K Jaisingh

Managing Side Effects of Cancer Treatment

by Pradeep K Jaisingh 8/6/2009 5:39:00 PM

Cancer treatments invariably lead to some side effects or the other and that is a very major concern area for most patients. The treatments ( both chemotherapy regimens as well as radiation therapy) basically aim to destroy fast growing and multuplying cancer cells but in the process they also end up affecting healthy cells as well.

Minimizing side effects of the chemotherapy drugs ( while increasing their efficacy againgst the tumours) is a constant challenge for the researchers and medical oncologists and there has been significant progress on both counts. Many of the new chemo drugs have much lower toxicity and also result in fewer side effects.
On the radiation oncology front also, there has been an ongoing pursuit of maximizing the radiation doses to the tumour and minimizing the radiation exposure to the surrounding healthy tissues. The current technology like IGRT ( Image guided radiation therapy) aims to precisely attain just that objective through on-board imaging facilities while delivering the radiation. Cyberknife is another invention that has great capabilities of delivering precise radiation even to brain tumours.

Side effects are quite different for different types of cancers and different patients receiving same treatments respond very differently and develop highly varying degree of side effects ranging from substantial to none whatsoever. Patient's overall health, their living habits and related factors also play a part.

It is, therefore, very important to discuss in detail with your oncologist regarding your specific situation and what possible side effects are expected and what are his / her recommendations for minimizing the same and also what possible precautions could be taken to manage the resulting side effects as some of them are inevitable.

Amongst the most common side effects are nausea, hair loss, weight gain or weight loss, lower blood counts, appetite loss, dry mouth, physical abilities deterioration/ stamina loss , swelling in the limbs and sexual dysfunction etc. Each one of these side effects can cause significant distress to the patients and affect their self-image leading to psychological and emotional issues impacting their and their family members' lives in a substantial manner.

In the next issue of my blog, I will cover how to manage some of these issues so that the overall impact on you and yours is minimized.

Good luck and God bless. My thoughts and prayers are always there for each one of you whether you are directly or indirectly affected by this dreaded disease.
Remember " Every Life Matters"

Pradeep K Jaisingh


International Oncology Services Pvt. Ltd.



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Cancer Diagnosis-------Should you take a second opinion?

by Pradeep K Jaisingh 5/28/2009 8:47:00 PM

Cancer Diagnosis-------Should you take a second opinion?

 The news of cancer diagnosis is an extremely serious and almost all cases a very difficult blow both for the patient as well as his/her family members. It can be devasatating emotionally and most people react in shock and in fact many of them go initially into denial and then it is generally followed by anger.

Many people wonder whether they should get a second opinion about their diagnosis?

I think, in general, it is a very good idea to go for a second opinion for a number of reasons.

First and foremost among them is that an accurate assessment of the specifics of your cancer is a major pre-requisite for the effective treatment plan that will give you the very best shot at dealing with your cancer.Unfortunately,in the field of oncology, that is not always easy. Even in a country like US with the world's best diagnostic and clinical infrastucture for cancer care, a study estimated that 1 in 5 cases of cancer is either mis-diagnosed or improperly staged. ( You must know that accurate staging of the cancer is as important as the correct diagnosis for the treatment to be effective).

In India while there is no such comparable study available to give relevant statistics, my assessment is that the figure is at least 2 in 5 or 40% . That really is a rather unfortunate and alarming situation but then we must not forget that in India an extremely large number of cancer go completely undetected or undiagnosed.

The other major reason for suggesting a second opininon is that cancer is rarely detected by an oncologist. In most cases it is detected by a general physician, a gynaecologist, a urologist or any other such specialists. They in turn then refer you to an oncologist---either a medical oncologist or a surgical oncologist or in some cases to a radiation oncologist. In a large number of cases most of these oncologists do not agree amongst themselves and therefore if you got referred to a surgeon, you will most likely be recommended a surgical removal of your tumour. On the other hand, a medical oncologist is very likely to recommend you a chemotherapy regimen . A radiation therapy course may be recommended by the both.

So, you see it gets really complicated and poses a big dilemma for the patient and the family members to decide on the future course of action.

My recommendation is that choose a comprehensive cancer centre for getting the second opinion. Approach a medical oncologist for an overall opinion but before that make sure that the medical oncologist is a properly qualified one. If he or she has had some international experience either in US or in Western Europe then that is really preferrable. Ask your medical oncologist whether they a tumour board at that cancer centre or not. A tumour board consists of specialists from all three branches of oncology mentioned earlier as well as the specialists from the diagnostic branch/ nuclear medicine area and also from pathology / lab. support areas.

Make sure that your case gets taken up in the tumour board. The suggested treatment plan from the tumour board will generally be the best way forward for you.

Presently, there are also options available for a tele-consult from an international cancer centre/ specialist in US and that might be a very cost effective option as well compared to the cost of going overseas. The NCCN( National Comprehensive Cancer Network---a non profit alliance for the world's 21 leading cancer centres) treatment guidelines are now widely available and the treatment plan suggested can easily be administered here.

So, overall if you or any of your family members ( or a near and dear one) has been diagnosed with cancer then please follow the suggestions given above because it is a matter of a precious life for "Every Life Matters".

Good luck and God bless.

Pradeep K Jaisingh 

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Cancer Treatment: Does Positive Mental Attititude Have a Role To Play

by Pradeep K Jaisingh 5/13/2009 11:09:00 AM

Cancer is a tough disease by any standards and both patients and physicians always wonder if there are things other than just clinical protocols and well defined regimens that might have any role to play in the overall effectiveness of the treatment. Specifically, people always ask about the role of the attitiude of the patient in his or her treatment. Some patients, diagnosed with cancer, develop a negative even hostile attitude towards life and their surroundings in general and find it very difficult to come to grips with their new reality. There are others though who respond to their cancer with a very positive approach and demonstrate an attitude of mental strength and hope.

So, the question is "Does it really help and how much?"

The answer is not a simple yes or no. One has to look at what really does one mean by Positive Mental Attitude or PMA ?
PMA is not about developing an attitude that their cancer is just a result of some bad phase or "karma" and it will go away just by some rituals or some sudden miracle that might happen. That kind of approach is plain wishful thinking and will not help at all.

PMA is first and foremost about acknowledging the seriousness of one's condition and then developing a whole new determination to do everything possible to find all facts and details about one's cancer, discussing in-depth with one's cancer specialist the very latest in clinical options and their pros and cons, agreeing to the treatment plan devised by the oncologist and adhering to in totality and following his/her advise on diet, lifestyle and other aspects and extending total co-operation to the discipline of the clinical regiment -- all with a firm belief that I am going to fight it and I am going to do everything within my power to face this very serious and tough disease and I am going to get better because of this. One may include anything and everything in it -- prayers, hope , music whatever you like. It all could work for you --at the very least it will improve and enhance your quality of life and make it easier and better on your near and dear ones who are helping you from your family and relations.

Remember, it is very very tough on them as well.

In our cancer support group 'Saarthak' a lady cancer survivor shared about her own approach to the side effects of chemotherapy and how it was leading to a state of depression for her. An army wife, she was used to a very active social life and enjoyed her weekend get-togethers and lunches/dinners at friends' places. When our oncologist suggested to her that unlike the advice given by her previous oncologist, she was free to resume her lifestyle while following her chemo-regimen, she responded so positively and not only she came out of her depression but developed a very strong resolve to fight her cancer.

Today, she is a three year cancer survivor and is doing extremely well while enjoying her old life style with friends and families. Additionally. she is a very active member of 'Saarthak' and is very willing to help other cancer patients.
Her positive attitude, certainly, seems to have made a difference to her and it can definitely work for many other.
That is certainly my hope and my belief.

God bless and let us ,together,do everything to save another life from cancer. Please join me because "Every Life Matters"

Pradeep K Jaisingh


International Oncology



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