Challenges and struggles in response to chemo and radiation therapy
Cancer is not a disease which will only affect a person physically. It is also something which will affect a person emotionally and psychologically. This has always been the hardest to handle and that’s why counseling is recommended for many oncology patients.
Getting to know that you have cancer is a really hard thing for the patient as well as for the loved once. Even though people are happy to get treated and healed. There are many times the treatment itself have greatly affected the patients, psychologically. It is hard to say whether it is the side effect of medications alone or a phase of psychological acceptance of the disease. Anyhow, what has become clear is that counseling for a patient should be carried out throughout the whole time of treatment and sometimes even after a full recovery. This might help a patient develop confidence, self esteem and resilience. Whether you admit it or not, all cancer patients are fighters… GREAT fighters. Their confidence goes down only because, at times, they don’t accept it.
Many psychiatrists believe that the transitional period after an intensive cancer treatment is the most likely period to cause psychological distress. For some patients this period may be as stressful, or even moreso, as it was to undergo the treatment itself.
Further, the people around the patient might expect the patient to be ‘completely normal’ after the successful treatment and may not appreciate what the patient has already gone through…and is still going through. But, many people do not understand that the cancer patients become more sensitive, anxious and uncertain about things around him. It is very easy to understand. A person who has lived for months in the sorrow, fear and uncertainty of leaving the loved once and all the other things takes some time to get back to who he was. Even though a doctor may confirm their full recovery many patients stay uncertain for a while.
How a cancer patient is affected psychologically depends on many factors. Some of these are:
Overall temperament in normal
Type of cancer
Family/ friends support
Memory and thinking after chemotherapy
Chemotherapy has many side effects. It does not only kill cancer cells, but it also affects many other normal cells in the body. Among these are the brain cells. About 20% – 60% of cancer patients who undergo standard doses of chemotherapy, experience some degree of cognitive dysfunction and memory problems.
The affected brain is casually often called ‘chemo brain’. The main cause of the chemobrain is presumed to be the neurotoxic effects of chemotherapy. The chemobrain causes diffused mental cloudiness and may affect a person’s cognition, social and occupational behaviours, sense of his own self and the quality of life. Moreover, it affects concentration, memory, comprehension and reasoning as well. And the common byproduct of these is our favorite “S” word; stress.
The studies have shown that many people undergoing this type of cancer treatment have problems with short term memory and difficulty recalling words. Some patients are not acknowledged about these changes and are alarmed at the presence of it and misunderstanding it as a spread or worsening of the disease. But, when people know what they are going through, even when scary, painful or difficult they often experience a much lower stress level and consequently are able to prepare and face these symptoms quite bravely.
The effects of chemobrain may exist during chemotherapy and even afterwards up to 10 years, in some cases. These changes may be subtle in most patients, while for some it can be more profound.
At the moment there are no specific treatments and preventive measures known, but, if the patients have problems with thinking or memory, which interferes with the daily work, he/she may seek help from a doctor.
There are different memory training exercises and programs and also many other treatments which will improve the brain function such as problem solving abilities and logical thinking. Finding a counsellor and being familiar with this situation is a brave step for the patient as well as the loved ones.
Other psychological issues after chemotherapy and radiotherapy
People, who suffer from cancer for a long time, deal with a lot of stress. Moreover, they face problems with sleep, concentration and appetite together with physical symptoms such as palpitations, due to the intensive treatment which they go through. Some oncologists also mention that they find patients fearful and hyper-vigilant.
According to many recent studies, one third of cancer survivors have suffered from symptoms of post traumatic stress disorder, which are;
Recurrent, unwanted distressing memories of the event(cancer treatment)
Reliving the event as if it were happening again (flashbacks)
Upsetting dreams about the having cancer and getting treated
Severe emotional distress or physical reactions to something that reminds you of the event
Negative feelings about yourself or other people
Inability to experience positive emotions
Feeling emotionally numb
Lack of interest in activities you once enjoyed
Hopelessness about the future
Memory problems, including not remembering important aspects of the event
Difficulty maintaining close relationships
This shows us the huge need of counseling and psychological support for cancer patients together with the cancer treatment. (And caregivers and loved ones also need support during this time.)
Even though being alive is something to be happy about, there are some patients who feel guilty about it. This happens mainly if they have a friend or family member who has died with a cancer. As we know some patients join support groups where there are many cancer patients. Here these patients make very close friendship with each other most of the time. Yes, this is a great support to face cancer than fighting it alone. But, with the time, when members pass away the other patients might experience loss, grief and then guilt of being alive. Hence, there should be a proper counseling support in a support team as well.
Knowing the side effects of chemotherapy
As all the other drugs, even chemotherapy has its side effects too. But every person does not face the same experience during chemotherapy. Some have really less amount of side effects while the others find it very hard to face the treatment.
Fatigue or the feeling of exhaustion is the most common side effect of chemotherapy. Many people complain about the general weakness even up to a few weeks after chemotherapy treatment. It is because the chemotherapy affects many other normal, active cells of the body and the destruction of them may weaken the body.
Next on the list is the pain. This is the main side effect, which most of the patient hate. Pain during chemotherapy may include headaches, muscle aches, stomachaches and shooting pains in fingers and toes. Some patients also feel a burning sensation and numbness in fingers and toes due to nerve damage. Usually this pain decreases with the time unless a person has permanent nerve damage. Permanent nerve damage may cause symptoms up to months or years.
There is nothing to worry as there are medications to relieve pain. These pain relieving medications have been noted to have helped to minimize the side effects of chemotherapy for many patients. (Note: do speak with your doctor about addiction / dependency risks of your pain medications. There are many options – you don’t have to be saddled with an additional challenge down the road.)
Sometimes this medication affects the gastrointestinal tract too. Painful mouth sores which appear after 5-14 days of treatment are one of the most unpleasant side effects. But, a person can prevent it by maintaining a proper oral hygiene. These sores disappear as the treatment comes to an end. Moreover, diarrhoea, nausea, and vomiting and constipations are some other common side effects of chemotherapy.
Many people experience a loss of appetite during chemotherapy. Some feel full after eating a small amount, while some do not feel hungry at all. This might result in weight loss, lack of nutrition in your body and also this might make it difficult for the patient to recover from chemotherapy. Therefore, it is a must that you keep your body filled with nutrition, so that your body can fight against cancer, even though you don’t feel like eating.
Chemotherapy brings another picture to our mind. Hair loss, some types of chemotherapy results in loss of hair. This is a really hard time, especially for women, but once you finish the treatment the hair will grow back. The person needs to be strong during the treatment and should talk with a counselor about how she is going through.
Chemotherapy can also affect your sexual life. The chronic fatigue, weakness and other side effects may reduce the patient’s ability and interest of having sex. It is not only that, but, also the fertility can be affected in men and women. During chemotherapy, the ability to get conceived and make a baby will be reduced. It is important that patients discuss these issues with a doctor, if it is disturbing your personal life.
The medications used in chemotherapy, can harm a growing fetus. Hence, if the patient cannot be sure of avoiding a pregnancy, it is important to use effective birth control. In case of an unexpected pregnancy during chemotherapy, the patient should inform the doctor right-a-way.
Radiotherapy has side effects too. The side effects of radiotherapy depend, on the part of the body which is being treated, the dose of radiation and the ability of the healthy cells to repair the damage soon.
As with chemotherapy, people‘s body reacts to radiotherapy in different ways, and it is difficult to know exactly how it will affect a person.
One of the most common side effects is ‘sore skin ’. The skin might get red and sore in the area, which is being treated with radiotherapy. Sometimes it may look like a sun burn. These will be healed within a couple of weeks after finishing radiotherapy. Keeping your skin safe and avoiding further irritation may help recover soon.
General weakness, nausea, weight loss, Loss of appetite and other gastrointestinal tract disturbances are common during radiotherapy as well.
Even though hair loss is not a common result of radiotherapy, it can be seen in patients who undergo radiotherapy in the areas of the neck and the head. But unlike chemotherapy, loss of hair will be limited to the areas of treatment.
Stiff joints and muscle stiffness are also in the list. This will also occur only in the areas which are being treated. Sometimes the patients might experience a discomfort due to the swelling of the affected area. This stiffness of muscles and joints can be eliminated by special exercises and it is advised to go to a physiotherapist in the presence of these symptoms.
Other symptoms of radiotherapy are almost same as in chemotherapy. The only difference is that the location of the side effects appearance is almost always the same and is related to the location of treatment.
Childhood cancer and getting treated:
When a child is diagnosed with cancer, the parents and the loved once have to be acknowledging on how they are going to cope with the kid, as a childhood cancer, unlike cancer in an adult, may cause a lot of late health effects.
Thanks to the advanced methods of treatment, more than half of the children who are treated survive a long time or get cured. Even though, the cancer is being treated, this treatment itself may cause a lot of problems in a child’s health when they grow. The reason of these late effects is the damage caused by chemotherapy, radiotherapy, or surgery to the healthy body tissues and cells. When these growing cells are killed or damaged, they may lose their function or the ability to function well.
Treatments for a brain tumour during childhood may affect the normal growth and function of the brain. Some kinds of chemotherapy and radiotherapy may cause cognitive impairments such as low IQ, low academic achievement, poor hand – eye coordination and behaviour problems as the child grows.
Mathematical skills and logical thinking are more likely to be affected. Moreover, this treatment may cause vision and hearing disturbances as well. It is clear that almost all the system of the body may get affected after a childhood cancer treatment.
The next thing which get’s affected most commonly is the growth and development. Many children with chemo and radiotherapy show a lower growth rate than the growth rate of a child without cancer in the childhood. It is believed that this occurs due to damage of hormone secreting endocrine glands and tissues of the body.
Other than the physical disturbances, there might be issues with the emotions as well. Even though cancer is fully treated, the child and the parents might live with an uncertainty, whether it will return. The physical changes as mentioned above may also cause psychological concerns. Concern about future, career and marriage may come up too.
We know that nobody chooses to have cancer. But some childhood cancer survivors embrace their past struggle and use it to forge meaning and purpose in their life – they add a value to the experience and in my opinion, to the world in doing so.
A great family support, friends and loved ones in the background may help the child overcome the physical as well as the psychological obstacles which he might have to face after an intense childhood cancer treatment. When a little more is needed, a seasoned counselor who specializes in working with children and cancer may be helpful to all concerned.
Live Better Live Now / Houston, Texas / Challenges and struggles in response to chemo and radiation therapy