| Living with chemotherapy |
| Written by Administrator | |
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Although chemotherapy is rarely a pleasant experience, the extent to which it can be tolerated varies tremendously from one treatment and one patient to another. There are so many variables affecting the patient's experience of treatment that the best one can do in trying to cope with it is to lay out some very basic expectations and questions to be asked.
For example, what kind of cancer is it and how far has it advanced? The intensity of chemotherapy will vary depending on these two factors. If chemotherapy is to be a cure, the treatment may be short and intense; if it is meant to control the growth of a tumor, it may proceed in spurts over months. Also, how healthy is the patient before chemo starts? Some cancer patients' bodies are in fine shape everywhere except for the tumor, in which case they may respond well to intense chemo and will be able to tolerate the nausea, hair loss, depression and blood thinning that often come with it. Other patients are frail and sick for other reasons besides the tumor, or their tumors may have advanced so far that they've been substantially weakened. They may not tolerate many side effects. For them, chemo either will be low-key or it won't be the appropriate choice at all. Because cancers vary in their severity, and patients in their overall health, chemotherapy is often administered in cycles of treatment followed by rest. Treatment might last anywhere from one week to four weeks, rest could vary from one week to a year depending on the degree to which the body must recuperate by building new healthy cells, and the speed at which the cancer grows. Thirdly, what drugs does the patient take in addition to chemotherapy treatment? Chemo meds may interact in unexpected ways with meds for other diseases. How the patient reacts to chemo could be a result of mixing drugs in the body that should not be mixed. In order to get a sense of these potential side effects, cancer patients can bring all of their pill bottles to one of their regular appointments with a nurse or doctor, and share the name of each drug, the reason for taking it, the dose, and the frequency. Healthcare providers often have information about the side effects of some drug cocktails that the patient won't know about, and if they know a particular combination of meds is dangerous, they can prescribe something new. Patients' reactions to any type of chemotherapy are almost impossible to predict, because they depend so much on the overall level of mental and physical health. However, a substantial number feel fatigued after chemo. They may need to ask for some one to drive them back and forth to appointments, or to help with meals and childcare for a few days after treatment, so they are able to rest and recover. Fatigue, like other reactions, is unpredictable. For some patients, post-treatment exhaustion may be so debilitating that it prevents them from doing much else but stay in bed for weeks after treatment. But this is not always the case; it is not essential for all cancer patients to stop working during chemo. Patients with flexible schedules, or relatively low-stress jobs, may benefit from the human contact and the sense of purpose they gain from continuing to work, and could conceivably recover faster if they continue to telecommute or work part-time hours after treatment has ended. It is a wise idea to raise the issue of working hours with employers, because they are often required by law to adjust the work schedules of employees with health issues. If an employer proves inflexible about work hours with patients who wish to continue working at a reduced or altered schedule during treatment, the patients can seek out organizations such as the American Cancer Society who may be able to advocate on their behalf. The biggest problem with chemotherapy is its unpredictability, and its counter-intuitiveness. The side effects of chemo drugs, for example, have nothing to do with their level of success at killing, shrinking, or controlling growth in a tumor. A powerful chemo drug could be covered by insurance, and so well adapted to the patient's body that it has no side effects to speak of. Another drug may prove to be a complete strikeout because it fails to kill the tumor, it has painful side effects, and it's expensive. The cost, too, of chemotherapy is unpredictable. It depends on the length of a treatment, its location -- home, clinic or hospital?-- and the area of residence. Health care plans vary widely by regions and will reimburse or cover patients' medical expenses at different rates. Hence, in addition to clarifying terms and speaking honestly about symptoms to their doctors, patients must also press for information from their insurers, asking them the following:
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