Will I Be Normal During Chemo?

Chemotherapy Side Effects

Will I permanently lose
all my hair?

Let's answer these questions. Will I be normal during chemo? Yes, Absolutely! Will I permanently lose all my hair? No, absolutely not! All the hair is going to come back. Each and every one of it. It's only a temporary phase; all the hair start growing once the chemo cycles are over.

Chemotherapy drugs do have their own side effects, but most of them can be very well managed. There are lots of chemotherapy drugs and discussing the side effects of all of them is beyond the scope of this website. Instead, there are excellent sites on the web with good info on drugs side effects. It is worthwhile linking to the same. So we will discuss the following few points, specifically related to chemotherapy for breast cance,r and in the end, we have made a list of coomon drugs and linked to patient handouts from BCCA (British Columbia Cancer Agency), which is one of the best when it comes to patient information about drugs. So here we go:
Hair Loss
Other side effects
Individual Drug side effects

Hair Loss

If there is one thing, that comes to anyone's mind, when the word 'chemotherapy' is said, it is hair loss. Almost all chemotherapy drugs used in the treatment of breast cancer cause hair loss. To note, this hair loss is temporary; once the chemotherapy stops, all the hiar is going to come back. It is not permanent. Few points to be noted:

The time when hair loss starts is not fixed, and varies from patient to patient. For most, it starts by the end of first cycles and into the second cycle of chemo. For others, it may start even later. In one stroke, lots of hair comes out. Many patients prefer to shave their heads prior to this happening.
There are no medicines, which can prevent hair loss. But some newer techniques have been used in some centers and have shown promising results. One of the common such technique is - Paxman scalp cooling cap. In Mumbai, a few centres have it - Mumbai Onco Care Centre - and talking to them, they estimate that, it will reduce the hair loss in 60 to 70 percent women on certain chemotherapy drugs (not all drugs)
The hair starts growing within a couple of weeks after the last chemo. Once chemo is over, and hair grows to a reasonable length, if the patient wishes, she can use dyes and other such things to spice up the hair.
During the pariod of 'no hair', most patients use either a wig or a scarf for the same. And I assure you, even though they may be bald at that time, in a scarf, and combined with the glow on the face, the charm on their faces, the beauty, still remains. Yes, it does!

Bald is beautiful
black nails

Other common side effects:

Apart from the hair loss, following aare a few of the side effects which are common with the chemotherapy protocols for breast cancer.

Weakness: Weakness tends to remain for a few days after chemo, but slowly wears off. Solutons like Glucon D, Lime water (nimboo pani), do help to maintain hydration. Barring a few restrcitions on raw vegetables, all food that is non spicy and non sour, can be had. If a patient eats something she likes, she will be able to eat properly.
Mouth ulcers: These do happen in some women. Chewing anti fungal lozenges like Clogen, tedns to reduce the super added fungal infection in these ulcers, and also helps to heal. Apart from that, local anesthetic 'paints' and vitamins do help.
Constipation: Adequate hydration will usually prevent this. Else, many patients tend to develop a 'fissure' due to constipation.
Nausea and Vomiting: Nausea is common wih most drugs. A good way out is to suck mint lozenges, many feel better. Apart from that, there are mouth dissolving medicines to prevent vomiting and they help to control nausea as well.
Tingling in fingers and toes: This happens due to damage to nerves endings in the fingers and toes - it is called 'peripheral neuropathy' and is usually due to a group of drugs called 'taxanes'. In some it is mild, and in a few, it can be severe and need treatment with anti neuropathy drugs.
Black discoloration of nails: This is due to Epirubicin; doesnt cause any harm as such, and over three motnhs after chemo is over, all the black discoloration will go away.

Links to Patient handouts

The Drug Index section of British Columbia Cancer Agency is simply super! They have taken a lot of effort to maintain patient handouts for almost all chemotherapy drugs. These patient handouts contain useful info about the drug - the potential side effects and what to do if the side effects happen. You will find every single drug on this index; for ease of use, the links to the common chemotherapy drugs are given below:

Epirubicin / Adriamycin
5 Fluoro Uracil

And the following are Hormonal Therapy drugs:

Anastrozole / Letrozole

Our Approach at this Step

'This too shall pass' is what I re iterate for my patients. Most of the young patients do very well on chemotherapy and do not develop much of the problems. It is the older women where we do see ups and downs. And many of them require regular bouts of a 'feel good factor'. And who better than their surgeon to give it. It's always a pleasure to stand by their side, pass hands behind them and hug them and assure them, that it's just a matter of time, they have come so far, only a little is remaining, and things will be all fine soon! And indeed, they do becomes alright.

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Journey of BC: Diagnosis

1. I feel a lump! - The first visit to doctor
2. Is it really cancer? - Confirmatory tests
3. What is the stage? - Staging and fitness tests
4. Will it be surgery first? or chemo first? - Treatment planning and sequence

Journey of BC: Surgery

5. Should I conserve or remove breast? - Choice of Surgeries for breast cancer
6. How long will be the surgery? - Admission and Surgery
7. Care after surgery - Precautions and guidelines
8. What next? - The Pathology Report

Journey of BC: Further Treatment

9. How many chemo cycles? - Chemotherapy Consultation
10. Is a PORT necessary? - ChemoPORT insertion
11. Will I be normal during chemo? - The Chemotherapy time - You are presently on this page
12. Is Radiation painful? - Radiation Therapy
13. Yes!! I did it! - Treatment is over
14. How frequently do I meet doc? - Follow up guidelines

Other Topics

Risk Factors - The Risk Factors for Breast Cancer
Symptoms of Breast Cancer - Know the Symptoms of Breast Cancer
Early Detection of Breast Cancer - The Guidelines

Neo Adjuvant Chemotherapy (NACT) - For LABC
Sentinel Node Biopsy - How is it done?
Targeted Therapy - Trastuzumab
Hormone Therapy - Who gets it?