Chemotherapy and Radiation For Dummies book cover

Chemotherapy and Radiation For Dummies

By: Alan P. Lyss and Humberto Fagundes Published: 04-22-2005

An informative, compassionate guide for cancer patients and their loved ones

Each year, more than 1 million people get treated for cancer, and most of these will undergo chemotherapy, radiation therapy, or both. This reassuring, optimistic guide helps people get a handle on treatment options and explains in plain English how chemotherapy and radiation therapy really work. It offers detailed advice on how to alleviate and cope with side effects-which range from hair loss to nausea to anemia-and describes how good nutrition, meditation, support groups, and other techniques and resources can help in the recovery process.

Articles From Chemotherapy and Radiation For Dummies

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Chemotherapy and Radiation For Dummies Cheat Sheet

Cheat Sheet / Updated 03-27-2016

Facing cancer treatment is unnerving so during your chemotherapy or radiation build a team of people that can support and help you and take care of yourself to ease the stress. Use some practical methods to handle side effects and deal with the hair loss you may experience during treatment.

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Knowing What Tests to Expect for Cancer Treatment

Article / Updated 03-26-2016

After you've been diagnosed with cancer, tests can provide important information that determines what sort of treatment will work best for you. So roll up your sleeve for that blood test, schedule that biopsy, and make that appointment for an imaging scan. No cheating allowed! You want the best information available from these tests so that you and your doctor can make the best treatment plan possible. Having blood drawn You most certainly will be sent to a laboratory for blood tests, both before chemotherapy and radiation begin and throughout treatment. If you are worried that your veins will neglect to pop up and make themselves easily available to the technician, try playing a little air guitar in the parking lot before you go in the building, or even in the hall before you go in the laboratory. Pick the arm the technician most likely will stick and swing it in full circles, backwards and forwards, to make sure the blood is flowing freely. Some people are nervous about needles because they associate them with pain. Depending on your past experiences, you may think that having blood drawn is no big deal, or you may think it's terribly painful. Sometimes, putting an experience in perspective can help you think differently about it. Compared to having a baby without drugs, slamming your hand in the closet door, or having a broken bone reset, having blood drawn isn't so terrible. Maybe you can consider it comparable to that momentary discomfort that you feel when you accidentally hit your "funny bone." The sensation is strong at first and then ebbs. No one ever said that you have to watch the technician draw your blood. Look at the ceiling, look at the opposite wall, look back over your shoulder at a colorful calendar. To avoid feeling queasy, look anywhere but at your arm or hand. Stretching out on a table High-tech pictures provide invaluable information about the size, shape, and location of a tumor. Several different kinds of imaging scans may aid your doctor in planning the best treatment for you. For some scans, you may be injected with a small amount of radioactive material to better highlight the tissue or organs being scanned. If that's the case, your doctor will tell you about any short-term restrictions you must follow until the material leaves your body. Some of the tests take time, and others can be completed fairly quickly — it all depends on the type and purpose of the scan, the age of the equipment used, and whether the technician sees something that requires a second look. After the scan, you may be asked to stick around long enough so the technician and the doctor can be certain they have all the images they need. Imaging scans don't hurt, though lying still on a hard table can become uncomfortable if the scan takes a while. Some of the imaging machines are noisy, making whirring or clicking noises throughout the scan. You may be offered a choice of radio stations to be piped in through speakers near your head, but often the sounds of the machine will prevent you from concentrating on anything else. Here are the basics about five different imaging techniques: Computer-assisted tomography scan: Better known as a CT or CAT (for computed axial tomography) scan, this type of test uses a computer linked to an x-ray machine. The scan provides cross-section images of your bones, soft tissue, organs, brain, and blood vessels. These images, or "slices," reveal the size and location of a tumor. Positron emission tomography scan: Also known as a PET scan, this scan may do a better job than a CT scan of finding some (but not all) types of cancer cells and determining what actions those cells are taking. (A machine that does both CT scanning and PET scanning now is available, combining the best of both, but few medical centers have the machine at this time.) Also, PET scans sometimes are used to help stage cancer, assess response to treatment, or, in the case of a possible recurrence, show the difference between scar tissue and active cancer tissue. PET scans also are useful for planning radiation therapy. Before the scan, you may be injected with a radioactive tracer, but the amount of radiation is small and will quickly leave your body. Drink a lot of water throughout the day to help your body eliminate it. Radionuclide scan: In some instances, you may be asked to swallow, or have an injection of, a radioactive substance. A scanner measures radioactivity levels in your organs, which allows the doctor to detect abnormal areas based on the amount of radioactivity. Ultrasonography: Ultrasound uses high-frequency sound waves that scan the body and then bounce back to produce an image called a sonogram. To produce the images, a technician rubs a chilled gel on your skin and then moves a small imaging wand back and forth over your skin, through the gel. The images appear on a monitor and can be printed to provide specific information for your doctor. Magnetic resonance imaging: Also known as an MRI, magnetic resonance imaging uses a magnet linked to a computer to produce detailed images of the body. These images also can be viewed on a monitor and printed. Many MRI machines require that you lie inside a narrow metal tube. If you're not claustrophobic, that's not a problem. From time to time, the technician will announce how many minutes more remain to complete the scan. Also, you will be given a buzzer, or panic button, to summon the technician if you become uneasy. If that happens, by all means press the button! You won't be the first person to do so — or the last. Neglecting to notify the one person who can relieve your anxiety will only add to it. Your rational mind may continue to insist that you are perfectly fine, but if your adrenaline starts pumping and your emotions insist that you are in a "fight or flight" situation, summon the technician and take a minute to calm yourself. No one will think less of you. Nor does such an interruption mean you have to start all over, as long as you are willing to resume after calming yourself. Normally, if you ask to stop, the technician will tell you just how much time is needed to complete the scan, and you may decide whether to continue. If you choose to leave, you may have to start all over another day. If the idea of lying in a narrow metal tube while a noisy machine takes pictures of your insides scares you as much as having cancer in the first place, ask your doctor where you might have the test with an MRI machine that has open sides. Undergoing a biopsy Having tissue removed is practically standard procedure for anyone with cancer. This tissue removal is called a biopsy, which is another type of test that provides information about your cancer. For instance, a biopsy reveals the cellular composition of a tumor, and that information may hold clues to the virulence of the tumor. Biopsies of tumors also provide what is known as a grade, or an indication of the degree to which malignant cells resemble healthy cells. In other words, the grade denotes the aggressiveness of the cancer cells. A tumor can be graded from 1 to 3 or 4. Low-grade malignancies tend to be less aggressive; high-grade tumors are more so. Also, along with other tests, biopsies help your doctor determine the stage, or the extent, of your cancer. You can have a very early stage cancer that is high grade, or aggressive. How is the tissue removed during a biopsy? One of three ways, depending on the type of cancer you have: Needle biopsy: A doctor inserts a long, hollow needle at the site of the tumor to remove a small amount of tissue. You may feel pressure, but a local anesthesia prevents you from feeling any pain. Typically, needle biopsies are brief, and they take place in a doctor's office, outpatient surgery suite, or radiology department. Though you have to be present for a needle biopsy, you do not have to watch. The needle is big, and closing your eyes may make you more comfortable about the experience. Surgical biopsy: If your doctor suspects that you have a cancerous tumor, the surgeon may remove a small part of the tumor for further tests. Surgical biopsies take place at an outpatient surgical center or a hospital. Generally speaking, surgical biopsies require an IV drip and then a trip to the operating room where you likely will receive local anesthesia. You also may be lightly sedated. Endoscopy biopsy: An endoscopy is a test that allows the doctor to examine areas inside the body through a long lighted tube. The equipment allows the doctor to take pictures and, sometimes, to remove suspicious tissue or cells. Endoscopy tests take place at an outpatient surgical center or a hospital, and you will be lightly sedated. Before a surgical biopsy or endoscopy biopsy, your doctor will tell you how much time to allow for the procedure, and whether you will feel like heading to work or going on about your day afterward. Also, she may prescribe a mild pain reliever for you and/or recommend that you use ice on the incision to keep down any swelling. What your doctor may not tell you is that frozen peas work better than ice. Before the biopsy, buy a big bag of frozen peas. Divide the peas into individual plastic sandwich bags and throw them back in the freezer. You'll find that a bag of frozen peas more easily takes on the shape of your biopsied body part than any bag of ice. Usually the icing routine is 20 minutes on and 20 minutes off, but check with your doctor about that. You can refreeze your bags of peas over and over. It's normal to be nervous about any kind of medical test, and it's impossible to ignore that biopsies are most often scheduled to investigate or confirm the presence of cancer. That said, the tests themselves are done under the strictest of controlled circumstances with the highest attention possible paid to safety measures. In other words, it is highly unlikely — highly unlikely — that a biopsy will cause cancer to spread.

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Pinpointing the Importance of Clinical Trials

Article / Updated 03-26-2016

Research studies in all fields of medicine are known as clinical trials. These studies are conducted with an eye to the future, in hopes of finding safer or more effective methods to screen for, prevent, diagnose, or treat a variety of diseases. Realizing the scope of cancer trials Just how many clinical trials on cancer are there? Here's some perspective: In June 2004, more than 25,000 cancer specialists attended the conference for the American Society of Clinical Oncologists. At that conference, participants could learn about the results of 3,700 different cancer research studies. These studies — and others in related fields — are conducted on many fronts. For example, many cancer research studies address the following areas: New techniques for screening for, diagnosing, or staging cancer New anticancer drugs New methods of surgery New approaches to radiation therapy New combinations of standard treatments New technologies, such as gene therapy Tests are carried out according to standard procedures used to evaluate new drugs and methods of treatment. Powerful treatments in use today for breast cancer, colon cancer, rectal cancer, and childhood cancers all began in clinical trials. The results of clinical trials have allowed many people with cancer to live longer, and these scientific tests also have pointed the way to future research. Understanding the development of clinical trials A clinical trial is not the first step in the development of a new drug or treatment. In fact, it is one of the last. Research and development generally begins in a scientific laboratory. After extensive testing, scientists may test a promising drug or technique on animals. Later, a small number of volunteers willing to undergo experimental treatments takes part in studies. Based on the results of these studies, drugs and treatments that have been shown to be effective are made available for larger clinical trials. According to the National Cancer Institute, which is part of the National Institutes of Health, cancer clinical trials include research at three different phases, each designed to answer different questions about the new treatment or technique. The first two phases generally are made available only to a limited number of patients who are not benefiting from standard treatment. Here are the three phases of research: Phase I: This is the first step in testing a new treatment on humans. Researchers may study whether the best way to give a new treatment is by mouth, IV drip, or injection. They may try to determine the best dose and how many times a drug or treatment should be given each day. They also watch for harmful side effects. Phase II: Trials conducted in Phase II determine whether the new treatment has an anticancer effect. For instance, does the treatment shrink tumors? What types of tumors does it shrink? Does it improve the results of blood tests for some cancers but not others? Phase III: After a treatment has demonstrated promising results in Phases I and II, Phase III studies compare the results of people taking standard treatments for specific cancers in specific stages with people taking the new treatment. Researchers all over the country conduct Phase III clinical trials, and thousands of people take part. In Phase III clinical trials, participants are assigned at random to receive either the new treatment or a standard cancer treatment. Participants in clinical trials are divided into the two groups to help avoid bias. In this instance, bias is defined as an effect on the results of the study due to personal choices. In most cases, the treatment group receives the drug or method being tested, and the control group receives a time-tested standard treatment for cancer. All patients, of course, are carefully monitored. In single blind studies, participants are unaware of which group they are in. In double blind studies — which are not done in the majority of cases — neither the participant nor the doctor knows whether the participant is in the experimental group or the control group (the group receiving standard treatment). These studies are designed to protect against bias, because participants (and their doctors) may act differently if they know whether they are taking the experimental drug or receiving standard treatment. Comparing the results of two different treatments for the same type of cancer allows researchers to document the study results and show which treatment is more effective and has fewer side effects. A small number of clinical trials involve the use of placebos for participants in the control group. Placebos are pills or injections that look like the drug or substance being tested but contain no drug. Everyone participating is informed if placebos are in use. Again, most clinical trials do not use placebos, and only if a patient agrees to participate in a placebo-controlled clinical trial can she receive a placebo.

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Counting the Ways Life Will Be Better after Cancer

Article / Updated 03-26-2016

Cancer may change your life for the better in more ways than you've ever imagined. Some of the changes are obvious early on; others may be subtle and take a while to develop. Some changes may present themselves as options — changes that you may decide to accept or reject. Cancer goes away One obvious change, and an outstanding one at that, is that after cancer, your doctors will tell you that for now — and maybe forever — you no longer have cancer. What a grand and glorious day that is! It's been a long journey, and a celebration is in order. Treatments end Though you see your doctors from time to time and undergo the occasional screening test, after cancer you no longer have to endure treatments or put up with their side effects. After cancer, life is all about slowly getting better every day, gaining back strength and energy, and feeling more like yourself as each day passes. At one time, your calendar was filled with treatment dates and follow-up appointments. No more. Now, you can use your calendar for other things: Pencil in lunch dates. Schedule an appointment to tour a new fitness center near you. Sign up to volunteer one morning a week at a local cancer education center. Meet with a person planning to run for political office. Sign up to accompany your grandchild's class field trip. Fill other deliciously empty dates on the calendar with plans to spend time on yourself at the zoo, botanical garden, library, or day spa. Fear recedes After cancer, your fear of the disease lessens bit by bit. As the months go by, you think less and less often about the experience of having cancer. Whole days, and then weeks, go by when you don't think about it at all. In years to come — and we have this on good authority, straight from longtime survivors — you may even forget, unless reminded, that you ever had cancer. Imagine that! A sense of adventure grows Just about the time your hair grows back, you may also grow a sense of daring, a wild side. You may head for Florida to ride on an airboat, make reservations at a really nice restaurant, buy two cashmere sweaters instead of just one, call up your high-school sweetheart just to say "hi," and start eating dessert first. Life is too short to be subtle. Carry on! Inner strength builds You have been tested, and you have passed. Maybe it wasn't always pretty; maybe you didn't always get the highest grade. So what? At this point, after cancer, you are no stranger to adversity. You know what you can ask of yourself, and you know what you're made of. Surviving cancer is no little accomplishment. The inner strength that you developed during the course of treatment will continue to grow. People matter more One day over lunch, a man was heard to confide that before he started treatments for cancer, eating lunch with a friend was no big deal — it was just a break in the middle of the workday. "Now," he said earnestly, "having lunch with someone whose company I enjoy feels like a privilege, a special occasion." He was right. After cancer, close personal relationships take on extra meaning. Even unexpected conversations with people you don't know well somehow seem more significant, more interesting than before. You likely will seek out connections with others. Forgiveness gains in importance You say you used to be a pro at holding a grudge? Don't be surprised if that changes right along with your perspective on what matters in life. Maybe it never mattered before that you didn't get along with your in-laws or your sister's husband's daughter or your neighbor. Cancer has a way of making most people more mellow, more willing to look at the big picture, more willing to let bygones be bygones. If you were compassionate before, now you may be more so. If, from time to time, you were thankful for all the good things in your life, now you may live in a continuous state of gratitude. If previously you looked for the good in people, now you will point out their sterling qualities to anyone who will listen. Being grateful to be alive does not mean taking whatever others dole out, and it does not preclude sticking up for yourself when you are wronged. You need not have a full-blown tantrum, of course, but by all means point out the transgression — then move on. Support comes naturally During this period when you realize more acutely than ever that people who need people are the luckiest people in the world, you may find that you are eager to comfort a friend facing an illness, even if you have not been close friends before. When you get the e-mail at work that says a colleague has been diagnosed with cancer, you may find yourself jotting down the address and putting a card in the mail. In a way, you speak a new language after cancer. More than ever, you know what words to say to encourage someone else. Even if you never felt comfortable saying them before, you'll say them now. Time flies One minute, you look in the mirror and decide your hair is long enough to go out without your wig, and the next, you clearly need to make an appointment to get your hair cut. One month, you've saved enough to replace that old couch in the den where you used to nap during chemo, and in a few short years, your grandchildren have spilled so much juice and goodness-knows-what-else on the "new" couch that you realize you need slipcovers — or another new couch. One year, you invite a half-dozen close friends, members of your support team, to join you for dinner as you mark the fifth anniversary of your cancer diagnosis. Dinner is barely over, or so it seems, when you're treating yourself to a trip to Italy to celebrate the ninth anniversary of that diagnosis. What happened? Time flies. It always has, but after cancer, you treasure the time you have and carefully make the most of it.

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Covering the Chemotherapy Basics

Article / Updated 03-26-2016

Chemotherapy, administered under the direction of a medical oncologist with assistance from angels otherwise known as chemo nurses, covers a wide range of drug regimens that all produce side effects. Most people undergoing chemotherapy do have to alter some aspects of their lives to accommodate the treatments and the side effects, though many people continue to work and carry out most of their family responsibilities. For a number of reasons — chiefly the possibility of an improved outcome — some people even opt to undergo chemotherapy and radiation therapy at the same time, if both are indicated. Your chemotherapy treatments are scheduled in cycles, maybe every three or four weeks, with time in between for your body to recover. How many different treatments will be required depends on several factors. Among them are The kind of cancer The kind of drugs used Your age Your general health Your body's response to the drugs That last factor, of course, is monitored by your medical oncologist. If you do well, your series of chemotherapy treatments will take place one after another, following logically from the first to the last. However, if chemotherapy is particularly tough for you, your doctor may spread out the treatments, try a different drug or combination of drugs, or perhaps halt chemotherapy altogether. Sorting out the different drugs More than 50 different chemotherapy drugs are available to treat cancer. All of them kill cancer cells, though they work in different ways. Generally speaking, all the drugs are designed to go after chemical substances within cancer cells and to interfere with cellular activity during specific phases of the cells' growth cycles. In the process, chemotherapy drugs also kill healthy cells, and that's why side effects develop. Of course, not all drugs work well for all cancers, and in many cases, a combination of chemotherapy drugs is the best course of treatment. If you're the type of person who wants the details about the treatment you'll be receiving, you can get started here. Researchers have divided the available chemotherapy drugs into categories based on how they work. Here are some of the different types of drugs used, the kinds of cancer they are used to treat, and some of the drug names: Antibody-based therapies: These new agents are aimed at molecular targets. These are truly the magic bullets of oncology because they hone in on cancer cells, sparing most normal cells. Currently, antibody-based agents are used to treat breast cancer, colon cancer, lung cancer, lymphoma, and several types of leukemia, but additional targeted therapies are being developed. Ultimately, many other cancers will likely be treated with antibody-based therapies as well. Some of the drugs in use now include trastuzumab, bevacizumab, cetuximab, gefitinib, imatinib, rituximab, and erlotinib. Alkylating agents: These anticancer drugs act directly on a cell's DNA, which prevents further cell division. Alkylating agents are used against chronic leukemia; non-Hodgkin's lymphoma; Hodgkin's disease; multiple myeloma; and some cancers of the lung, breast, and ovary. Some of the drugs in use are chlorambucil, cyclophosphamide, cisplatin, carboplatin, thiotepa, and busulfan. Nitrosoureas: These drugs act in a way similar to alkylating agents, interfering with enzymes that help repair DNA. Nitrosoureas are used to treat brain tumors, non-Hodgkin's lymphoma, multiple myeloma, and malignant melanoma. Some of the drugs in use are carmustine and lomustine. Antimetabolites: These drugs alter the function of enzymes required for cell metabolism and protein synthesis, starving the cells to death. Antimetabolites are used in cases of acute and chronic leukemia and tumors of the breast, ovary, and gastrointestinal tract. Some of the drugs in use are 5-fluorouracil, capecitabine, methotrexate, gemcitabine, cytarabine, and fludarabine. Antitumor antibiotics: These drugs bind with DNA and prevent the synthesis of ribonucleic acid (RNA), which is imperative for cell survival. Antitumor antibiotics are used to treat many different cancers. Some of the drugs in use are dactinomycin, daunorubicin, doxorubicin, epirubicin, idarubicin, and mitoxantrone. Mitotic inhibitors: These drugs, derived from plants, halt cell reproduction by inhibiting cell division and prohibiting the use of certain proteins required for mitosis. Mitotic inhibitors are used to treat leukemia, lymphomas, and lung and breast cancers. Some of the drugs in use are paclitaxel, docetaxel, vinblastine, vincristine, and vinorelbine. In some circumstances, corticosteroids, or natural hormones and hormone-like drugs, also are used to treat such cancers as lymphoma, leukemia, and multiple myeloma. Some of the drugs in use are prednisone and dexamethasone. Do these sound familiar? In the past, your doctor may have prescribed corticosteroids for you for conditions or illnesses entirely unrelated to cancer, but the dosages were much smaller and the course of treatment much shorter. Some additional chemotherapy drugs that do not fit into any of the listed categories also are available. Taking heart from new developments Every day, cancer research moves forward. Here are just a few new developments. Introducing new drugs New chemotherapy drugs are being introduced all the time. Of course, all new treatments undergo years of research and testing before the Food and Drug Administration (FDA) releases them for public use. This testing period allows scientists to determine if the drugs work, if they work better than treatments already in use, and if they are safe. Drugs waiting for approval, drugs that are considered experimental, are tested in clinical trials. Changing the course of treatment Other new developments include pairing established drugs with new drugs for a better outcome and administering chemotherapy drugs on a different timetable. Sometimes when the schedule of treatment is altered, the effectiveness of the drug is improved. For that reason, even after chemotherapy drugs are approved by the FDA, the schedule and manner in which the drugs are delivered are explored in clinical trials so the effectiveness of the chemotherapy can be further improved.

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Dealing with Hair Loss from Cancer Treatment

Article / Updated 03-26-2016

Radiation therapy causes hair loss only in the area being treated. For instance, if your lower body is being treated, you likely will lose pubic hair or leg hair. If your chest or a breast is undergoing radiation, hair on and under your arms will come out. If your head or neck is being treated, you likely will lose scalp hair, and you may also lose your eyebrows and eyelashes. Depending on the type of radiation and the dose, hair loss that results from radiation may be permanent. Often, the hair cannot grow back because the hair follicles are damaged too severely. Pampering your hair while you have it While you still have hair, you want to treat it well. Here are some tips that will help keep your hair — and your scalp — healthy when you begin radiation treatments: Invest in a mild shampoo. Brush your hair with soft strokes using a soft hairbrush. Refrain from dying, perming, or relaxing your hair. Put away the brush rollers. Use only the low setting on your hair dryer. Protect your scalp from the sun. Even before you lose any hair, your skin will be more sensitive during radiation therapy. Working up to the reality Because hair loss is such an emotional experience (for men as well as women), spend some time getting used to the idea of yourself without hair, especially if your doctor expects the loss to be permanent. The idea is to figure out how to maintain a positive body image after your hair is gone. For obvious reasons, this is easier to do before you lose your hair. Choosing a wig If you are a woman, think about whether you will want a wig. If you want a wig and you think you will prefer to recognize yourself in the mirror, visit a wig shop before your hair falls out so you can match your current style and color. You may think that visiting the wig shop will be a grim expedition. It doesn't have to be. Take a friend who makes you laugh, and then go out for lunch afterward. You may even decide to try a wig that is a totally new style and color of hair for you. If price is not an issue, get two! Most insurance companies pay for one wig — which they call a prosthesis — for people undergoing radiation therapy. If your insurance company will not pay for a wig or you don't have insurance, contact your local branch of the American Cancer Society. Women who have recovered from cancer often donate their wigs and other head coverings, and these are available for free. Also, some medical centers have a wig "exchange" where you can find an attractive covering for your head. Sometimes, wigs cause a rash on the scalp, especially in summer when your scalp perspires under the wig. The best way to treat this rash is to expose your bald head to the open air as often as possible. Rub on a mild, over-the-counter cortisone cream if needed. If that doesn't work, by all means speak with your doctor. When you want to wear the wig, place a piece of clean cotton fabric between your scalp and your wig — an old, well-washed bandanna, folded to fit, is perfect. It won't show, and the cotton will absorb the moisture that caused the rash. Choosing an alternative head covering A wig is not your only option: Some women prefer to wear a scarf or turban instead of a wig after they lose their hair. Most men — and a few women — go about with bald pate gleaming. Will people stare? Some may; if they do, just flash a confident smile and go on your way. Going "topless," of course, is fine when you're at home. If your bare head gets cold at night, consider buying or making a stretchy, cotton knit cap that will keep your head warm and your dreams in place. Some people invest in a signature hat to wear outdoors to protect their bald scalps from sunburn, which is important all the time but especially so during cancer treatments. All these decisions are personal, so do whatever feels right for you. There are no rules except those you make, and you can always change the rules to suit yourself. Cutting your hair You may want to make an appointment to have your hair cut short. This proactive approach provides you with an emotional way station between having a full head of hair and none at all. If all your hair comes out, it's easier to manage losing short hair than long — for a while, anyway. And if only a little of your hair ends up falling out, the hair that is left will look thicker and fuller if it's short. Hair falls out in single strands and in clumps. Once it starts coming out, hair will lie on your pillow, litter your collar, and coat the walls of your shower. Frankly, it's a mess — such a mess that you may find yourself dialing your hair stylist and asking for an appointment to have your head shaved. If you suspect that you may become weepy while having your head shaved, ask if you can schedule the appointment after hours or if there is a private room where you can get the job done and then don your wig or head covering before leaving the salon. Keep in mind that you are not the first person to make this type of call, and you will not be the last. Most stylists are happy to do what they can to help you through this difficult appointment. Replacing eyebrows and lashes Whether to replace your eyebrows and lashes is a personal decision: Some women choose not to bother, and some feel comforted when they look in the mirror and see the eyebrows and lashes they expect to see. If you are a woman accustomed to running an eyebrow pencil over your brows to thicken or darken them, you may do fine when it comes time to draw them on from scratch. If you've never owned an eyebrow pencil, you may want to buy one before treatment begins and pay attention to that bony arch above each eye. That's where the brow goes. Usually, a natural brow starts out fairly thick near the bridge of the nose, thickens slightly right above the iris, and then tapers off on the other side. You can actually buy a set of eyebrow stencils and play around, seeing what shape suits you. Some people opt for permanent cosmetics, or tattooed eyebrows. If that interests you, make an appointment before your eyelashes fall out so the aesthetician can match the color and shape of your natural brows. As for eyelashes, you could invest in a pair of false eyelashes or glue on false lashes one at a time, though that strikes us as a lot of trouble. You could also put a little eyeliner on the edge of each upper and lower lid. Another option is tattooed eyeliner, which you would have forever.

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Building a Cancer Treatment Support Team

Article / Updated 03-26-2016

When you’ve been diagnosed with cancer and you’re going through treatment, you need not only help from your family and friends but from an entire support team of people, with your doctors at the forefront. Build your support team with the following people to help you manage all levels of cancer treatment: Medical oncologist: A doctor who treats cancer Radiation oncologist: A doctor who directs radiation therapy Social worker: To help with practical concerns Psychologist: To help with emotional concerns Massage therapist: To help manage stress Fitness expert: To help reduce fatigue and keep you moving

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Facing Hair Loss from Cancer Treatments

Article / Updated 03-26-2016

Many forms of chemotherapy cause temporary hair loss, and radiation causes permanent hair loss for the body part treated. Losing your hair is an emotional experience, so you need to spend some time getting used to the idea of yourself without hair. You can also take some steps to care for your hair before it falls out and your scalp afterward: Before: Prepare yourself emotionally by deciding that a lack of hair will not cause your self-esteem to suffer. Choose a wig ahead of time — if you plan to wear one — so you can match your own hair. Consider cutting your hair short so the loss is not so dramatic. After: If you don’t wear a wig, protect your scalp from the sun with a hat. Sleep in a stretchy, cotton knit cap if your head gets cold at night. If you are female, discourage comparison to Telly Savalas, Patrick Stewart, or Howie Mandel.

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Managing Chemotherapy and Radiation Side Effects

Article / Updated 03-26-2016

Don’t panic and assume that since you’re undergoing chemo or radiation that you will experience every possible side effect. Cancer patients experience treatments differently, but most experience nausea and dehydration. Here are some tips for managing them: For nausea: Take your anti-nausea medications. Eat something before you get out of bed in the morning. Avoid spicy foods. Eat several small meals, and take small bites. Take in some protein. Stay away from sweets. For dehydration: Sip small amounts of fluids. Drink from a straw. Stick to unsweetened fruit juices. Defizz carbonated drinks. Settle in with a cup of peppermint tea. Avoid caffeinated drinks.

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Treating Yourself Well during Chemo and Radiation

Article / Updated 03-26-2016

While you’re going through chemotherapy and radiation, take some time to pamper yourself. Even if you experience just a few cancer treatment side effects, you may not have your usual level of energy. So that you have time for family and friends, use these tips to help you save energy: Lower your expectations for yourself. Delegate responsibilities at home. Talk with your boss about a temporary reduction in work schedule or production level. Balance your schedule, alternating busy days with quiet days. Pace yourself — refrain from pushing past what’s physically possible. Eat nutritious meals rich in protein. Content yourself with periods of mild exercise, leaving the marathon workouts for after treatments end. Sleep when you need to. Sleep when you want to, as well. Practice patience — treatments do eventually come to an end.

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