Hotlines
Hotline FAQ
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They say, people who share a common direction, a sense of community and "shared experiences" get to where they are going more quickly. For a cancer survivor, there is nothing truer. After diagnosis and throughout the confusing schedules of doctor's appointments, treatments, tests, there was nothing more encouraging than hearing the words: "I know exactly how you feel". Whether it is simply a "pwede bang magtanong?" (Can I ask a question?) or an all-out "ito kasi and kwento ko..." (this is my story), cancer survivors connect with other survivors everyday to empower and enrich each other. When I Can Serve launched the first edition of its book in October 2000, the Ka-Chat counseling hotline was also introduced. The hotline, manned by breast cancer survivors has received an overwhelming response . We would like to share the hotline's ten frequently asked questions. Dr. Mark Kho, a surgical oncologist, supports our answers. Does Chemotherapy Hurt? DOES CHEMOTHERAPY HURT? Crisann: No, apart from locating a good site for the injection and "finding" a vein to administer the treatment intravenously, the procedure itself does not. I recall instances of a warm sensation in my arm as the medicine was being injected though none of which lasted more than a few seconds. WHAT ARE THE SIDE EFFECTS OF CHEMOTHERAPY? HOW DO I MANAGE THESE? Crisann: FATIGUE. Most describe the fatigue during treatment as not having the energy they are used to. Pay special attention to the signals your body is sending but learn to find a good balance. If you are extremely tired, rest. Take short naps but try not to lie down in bed all day either. If you find yourself confined to a bed, continue to do simple exercises to keep alert. DROP IN WHITE BLOOD CELL COUNTS. Usually occurring between two cycles, the drop, can raise a person's risk of infection. Call your doctor if you develop a fever of 38.3 C or higher. Avoid raw food at this time and keep away from enclosed and extremely crowded areas. MOUTH SORES. Rinse your mouth with a salt solution (1/2 tsp of salt in 8 oz. Of water) every few hours. Switch to a soft-nylon brush and gently brush your teeth and gums with a fluoride or baking soda toothpaste. Use a moisturizer on your lips. TASTE CHANGES. Some anti-cancer drugs cause food to change taste. Substitute stainless steel utensil and silverware that sometimes aggravate the metallic taste in the mouth with plastic spoons, forks and chopsticks. Strange as it may sound, these have helped me somehow. WEIGHT GAIN. Given the misconception that everyone who goes into treatments grows thin and gaunt, many are confused and shocked to experience puffiness and weigh gain. This is very common due to steroid medications, decreased activity and fluid retention. It will generally take 6-12 months to get back to your usual weight. Continue to eat well-balanced meals. Observe a sensible diet but no radical ones, please. Maintain a reasonable active lifestyle but during and after and get your doctor's go-signal to exercise. NAUSEA/VOMITING. In the last few years, a new category of anti-nausea drugs has been introduced. Ask your doctor about these drugs usually taken orally after chemotherapy and have practically eliminated the sensation of nausea associated with many forms of chemotherapy. If you do decide to take these, do not wait for the moment you are already nauseous to take them. They will be of no use. Stay away from greasy dishes, eat small servings and do not expose yourself to food with very strong odors. WILL I LOSE MY HAIR? Crisann: This is undoubtedly Ka Chat's most frequently asked question and the one that brings all women the most sadness. With high doses of the drug Adriamycin, it is likely you will lose your hair 12-15 days after the first cycle. As for the other chemotherapy agents, you may experience thinning of the hair, partial hair loss, or total hair loss. Do not wait for this moment. Get a very short haircut. Switch to a mild shampoo. Scout around for hats, scarves, wigs even before treatment begins. Allow yourself to grieve but do take solace in knowing it will grow back. CAN I MAINTAIN A NORMAL SCHEDULE DURING CHEMOTHERAPY? Crisann: Yes, but I would like to think of it as a "new" normal schedule with sensible adjustments. Many find that they can continue to work during treatment. Some have observed that maintaining a sense of normalcy has helped them get through treatment although you may need some flexibility in your schedule. For those with work commitments, talk to your doctor about scheduling treatment on a Thursday or Friday. Get well rested over the weekend to help you get back to work on Monday. It may be best to inform your employer or some of those you work with so they can help cover for you during those times you will be needing the extra rest. WHAT SIDE EFFECTS CAN I EXPECT FROM RADIATION? Crisann: Side effects most likely to occur include swelling and heaviness in the breast, some pattern of increasing fatigue as treatments continue and sun-burn like skin changes in the treated area after the 4th or 5th week of treatment. Changes to the breast tissue and skin usually go away in 6 months. Avoid using deodorants, powder or perfumes at this time. Some of their ingredients may cause skin irritation. Religiously apply aloe very gel to the radiated area and substitute tight bras and shirts for loose cotton clothing. Again, maintain a normal schedule but allow yourself to rest when you feel you need to. WHY ARE SOME GIVEN TAMOXIFEN AND OTHERS AREN'T? WHAT ARE THE SIDE EFFECTS? Crisann: Side effects include menopausal symptoms such as hot flashes, irregular menstruation and weight gain. AFTER A DIAGNOSIS, SHOULD MY DIET CHANGE? Crisann: This is one question I always have great difficulty answering, as it is one of the most hotly controversial topics in breast cancer research today. I have read conflicting studies on the good, bad or very bad effects of certain foods on the body. This is a very personal decision. Can certain food cancer-proof your body? Probably not but there are some with unmistakable benefits. The key is moderation and variety. Eating any food in moderation and a verity of foods probably afford your best protection against cancer. Cancer diagnosis or not, there seems to be no objections to a diet low in fat and salt, high in fiber, one with a lot of fruits and vegetables and one without excessive alcohol consumption. AFTER ALL MY TREATMENT, WHAT FOLLOW UP ROUTINE IS REQUIRED? Crisann: Regular follow-up exams are important. Expect to continue visiting your doctor for a regular series of check-ups even after you are done with treatment. Physical exam every 4 months for 2 years, then every 6 months for 3 years, then every 12 months. Mammography of remaining breast every 12 months. Chest x-ray, bone scan and liver scan once a year. Some doctors will require you to check your blood chemistry several times in a year. There are numerous factors that will affect the specifics of your follow-up routine. Work out a schedule with your doctor and be conscientious in keeping your schedules. Watch out for yourself as you know your body best. Remember, forgetting to take our tests are missed opportunities to be well. IS IT NORMAL TO BE CONSTANTLY SCARED OF A RECURRENCE? Crisann: It would be abnormal if you weren't. Worries about certain aches, pains and upcoming tests are common. These are all part and parcel of being a cancer survivor. Recognize that fear but learn to tame it. Many women find coping with these difficulties easier when they have helpful information and support services. Take comfort in knowing there is a world of support out there waiting to help you. Then there is always Ka Chat. Crisann Celdran is a breast cancer survivor and a volunteer for I Can Serve, and a furniture manufacturer. She had a radical mastectomy with 6 cycles of chemotherapy and 33 sessions of radiation. She can be reached at icanserve@yahoo.com Dr. Mark Kho is a surgical oncologist and a consultant at the Surgical Department of the Philippine General Hospital. He can be reached at … WHAT CAN I EXPECT AFTER A MODIFIED RADICAL MASTECTOMY? Dr. Kho: Surgical technique and post-operative care have improved markedly throughout the years. A patient goes through a mastectomy as if it were minor surgery, even to the extent of having this done as an outpatient procedure. The usual in-hospital stay is around 2-5 days. A single sutured skin wound over the removed breast is most common. Some type of drain is usually placed to prevent fluid accumulation under the operative site and is pulled out (without much pain) a few days after surgery. Some common events, although quite rare and mostly managed conservatively, include small amounts of bleeding or hematoma formation, wound infection, mild to moderate post-operative pain, areas of skin necrosis, numbness of the skin around the operative site and medial aspect of the upper arm, swelling, and seroma (clear fluid) formation. Lymphedema or swelling of the ipsilateral arm occurs in less than five percent of patients who underwent an axillary node dissection as part of a modified radical mastectomy (MRM). Transient limitation of range of motion of the shoulder may also occur and can be minimized by early mobilization and performance of post-mastectomy exercises. Crisann: The consensus is, after surgery, the first two days and nights are uncomfortable, but no real pain. Most women feel a sensation of tightness at the site of the surgery, numbness in the chest, underarm, shoulder and arm. These typically go away within a few weeks or months. Most women also experience loss of strength and limited movement. Rest assured, this is temporary. I cannot emphasize enough the importance of the exercises your doctor will recommend. Do it within a day or so after surgery. These are vital in helping you regain motion and strength as early as possible. After surgery, avoid having your blood drawn or your blood pressure taken on your surgical side. Stay away from carrying very heavy objects, take extra precautions to avoid cuts and burns and prop your arm up on a pillow when resting. |
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