How I prepared my aunt’s mind for chemo

Two months ago, my 60-year-old aunt was diagnosed with stage one breast cancer and as luck would have it, she was scheduled for chemotherapy just a few weeks after the diagnosis.

I particularly stress on the word “luck” because over 70 per cent of cancer cases are diagnosed at very late stages in Tanzania, yet there are only two available cancer facilities in the country—the Ocean Road Cancer Institute and Bugando Medical Centre.

These institutions serve only 5,000 of the country’s estimated 35,000 new cancer cases each year. None of this, however, makes enough sense to consider oneself lucky when one has been diagnosed with one of the leading causes of mortality globally.

So, when my aunt sat on the waiting benches for her first chemo cycle, fear, depression and some serious clinical changes had long crept into her life. As much as her family would have loved to help, they barely knew how to.

Coping with chemotherapy

Now, cancer causes more deaths in developing countries than anywhere else in the world and this puts our societies in a dire need for information regarding - well- anything and everything to do with cancer. This article sheds light on how to cope with chemotherapy.

So if you are on chemo, scheduled for chemo or taking care of a patient on chemo, then you would benefit from knowing what to expect and different ways to cope with it.

It is very important to first and foremost understand that chemotherapeutic drugs are chemicals that target to destroy dividing cells for curative, control or palliative purposes and that it is normal and almost natural to go through an array of changes that may challenge one’s physical, emotional and mental health while on chemotherapy.

Reason why these changes are bound to take place is largely attributed to the fact that chemotherapeutic drugs for cancer are very strong medications, which in the process of killing fast growing cancer cells end up destroying some normal and pretty useful cells of the body hence some side effects.

Not to overwhelm the body with these side effects, chemotherapy is given in cycles, allowing rest periods between doses for the body to regain. The length of these rest periods varies and it depends on types of medication used.

Some people may have little or no experience of these side effects and even among those experiencing side effects, the variation of intensity could be wild.

Fatigue is the most common and probably one of the most distressing side effects of chemo and people find it particularly difficult to cope with because it does not always resolve with rest/sleep.

Pushing ones physical limits may have always been a good idea but at this point it is wiser to conserve as much energy as possible. Try not to overwhelm your daily plan with activities and whenever possible, let your loved ones give you a hand.

Most people will also go through periods of feeling very nauseous few hours after chemo with vomiting (sometimes so severe to points of dehydration). If your doctor has prescribed medication for this, make sure you take them and avoid foods that would make you even more nauseous (example: too oily or too sweet).

One would also benefit from taking small sips of fluids as frequently as possible rather than trying to gulp down a large amount all at once.

Due to its effects on the production of blood cells, chemotherapy increases susceptibility to anaemia, excessive bleeding and infections.

Vulnerability to infections necessitates the adoption to a more hygienic lifestyle making sure that one’s environment, food, water, clothes and other things you make contact with are clean and safe for use.

It’s important to also avoid physical injuries as even minor cuts could bleed excessively.

Chemo may change some aspects of one’s sex life by interfering with both one’s ability and readiness to have sex. Talking to your partner about this should go a long way in easing things out here.

Some people may continue to have a normal sex life but it is strongly adviced to avoid pregnancies because chemotherapy affects both male and female reproductive cells and this could be detrimental to the unborn baby.

Likewise, breastfeeding is strongly advised against.

It is also normal to experience a fogged mind “chemo brain”. Don’t stress so much when you keep forgetting where you left your phone or when you take longer to catch a joke, it’s normal and should resolve after chemo though sometimes it may take longer.

Keep a record of important things you need to remember and let a trusted family member know where you keep this record ( just incase you forget).

The side effects are temporary

Chemo may have debilitating effects on one’s nutrition. Maybe you have lost your appetite and your favourite meal does not taste the same anymore, remember this is only temporary and you may find new ways to prepare your food to make it more palatable.

Don’t force yourself to finish your food if it does not appeal to your taste, instead have as much of the foods you enjoy as possible (unless of course you have another medical condition contraindicating the consumption of such foods).

And just like with fluids, a lot of little portions is better than one big meal.

Like I mentioned before, chemo affects some useful body cells too. Rapidly dividing cells of the hair, nails mouth and stomach are mostly affected. This is why people on chemo will have hair falling off and mouth sores and “not so good looking” nails.

Now this coupled with a pale anaemic look, gives one a very sick physical appearance. This could be very distressing to patients and also to their loved ones.

Unfortunately, there is no way around these side effects but preparing for it before it happens makes the whole experience a whole lot bearable.

One can talk to loved ones about the expected physical changes and maybe explore alternatives to better looks like a low hair cut before chemo, turbans, hats or other head wraps if needed.

I’v had the chance to communicate this information to my aunt before she goes for her second cycle and as she waits for the date, she is stronger and feels more included in the loop.

So viewing this from a brighter side, being on chemo is a grace in disguise, once you have learned how to properly cope with it. This period requires you to pay closer attention to your needs and make the effort to take extra care of your healing body.

Though it may be one of the hardest periods you may ever have to go through, it has the unbeatable joy of really taking good care of oneself.

The author is a pharmacist based at Muhimbili National Hospital(MNH)