Chemotherapy, despite its potentially life-saving benefits, can be a frightening, and highly-uncomfortable experience for caregiver and cancer sufferer alike.
Stewart Fleishman, M.D., Founding Director of Cancer Supportive Services at the Continuum Cancer Centers of New York, and author of, "Learn to Live Through Cancer: What You Need to Know and Do," answers some common questions of people caring for a loved one who is undergoing chemotherapy:
Q: What can I do to help my loved one reduce the effects of nausea from chemotherapy?
A: Chemotherapy has developed a notorious reputation for making a person with cancer feel sick to their stomach. The reason for this feeling of nausea is two-fold: first, chemotherapy drugs are geared towards attacking the cells that divide quickly (like cancer cells), a number of which reside in the lining of the stomach, and second, these medicines have the unfortunate side effect of stimulating the part of the brain responsible for the feeling of nausea.
However, Fleishman offers some suggestions for things you can do to help minimize the amount of nausea your loved one feels as a result of their chemotherapy:
- Make sure they understand and adhere to their doctor's instructions for taking prescribed anti-nausea medications before and after a chemotherapy treatment.
- Encourage them to stay away from their favorite foods just prior to a chemo session.
- Try and keep them away from anything strong-smelling (perfume, chemical cleaners, etc.).
- Invest in an anti-nausea pressure point bracelet for their wrist.
- Pack a bag full of audiobooks, puzzles, small crafts, and music to help distract them.
Q: What is ‘chemobrain'? Should I worry that my loved one will get it?
A: ‘Chemobrain' is the layman's term for the cognitive impairment that some cancer sufferers get after undergoing chemotherapy or radiation therapy. Marked by an inability to multitask and retain new information, the possibility of contracting chemobrain is sometimes scary enough to make a person decide they don't want to undergo chemotherapy.
Fleishman concedes that the medical community knows just a little about the changes in brain tissue after chemotherapy and not a whole lot about chemobrain when it comes to the influence of hormonal or other causes, or how to prevent it. But, he says that only a small number of people are remain affected by it for more than a few months.
In Fleishman's opinion, an elder with cancer who has been prescribed chemotherapy or radiation shouldn't refuse potentially life-saving treatment because they fear the treatment will permanently affect their cognitive ability. But, he does suggest that either your or your loved one should have a discussion with their treatment team about specific benefits and hazards of chemotherapy.
Q: What is an example of a good post-chemotherapy diet?
A: For a senior who is on the mend after treatment, Fleishman says that caregivers should encourage their loved one to eat high quality calories on the days that they feel hungry.
The challenge is that, even though their body may need healthy foods, such as high quality proteins, whole grains and fresh fruits and veggies, to recover properly, according to Fleishman, "people tend to reach for comfort foods during and after chemotherapy."
Right after chemotherapy, an elder will only likely be able to tolerate liquids—which can be good since dehydration is a big concern for people with cancer. Try giving your loved one a sports drink such as Gatorade, or a mixture that is half-juice, half-water to help them re-hydrate and rebalance their sugar and potassium levels.
The next step in the progression would be a home-made smoothie with any kind of combination of milk, protein powder, yogurt, fruit, peanut butter, etc. to introduce protein and more nutrients into their diet.
When your loved one feels well enough to tolerate solid foods, Fleishman suggests introducing whole grains like oatmeal, cream of wheat, quinoa, polenta, couscous, and patina which can be paired with vegetables and lean proteins such as turkey, fish and chicken.
Things to keep in mind when trying to get a person with cancer to eat: your loved one's level of hunger will vary—don't try to force them to eat if they don't want to, keep portions of both liquids and solids small and be sure to space them out throughout the day.
Q: What should an elder who has just had chemotherapy do in terms of exercise?
A: Fleishman says that the fatigue associated with cancer and cancer treatment can be caused by a variety of interrelated problems, including: anemia, hypothyroidism, and low testosterone, among other things.
Even so, it's imperative for people with cancer to get up and get moving.
While it may seem slightly counterintuitive, "just sitting around and doing nothing makes you feel more tired," according to Fleishman. The right exercise plan may help a person with cancer feel hungrier, sleep better, and combat cancer-induced fatigue.
But that doesn't mean that you need to encourage your loved one to start training for a marathon.
Fleishman suggests putting together a plan for a graded amount of activity. Once your loved one returns home after treatment, have them start gently by walking up and down the hallways in the house a few times a day. Once they feel comfortable with this level of activity, they may be able to do a few stair climbs, or walk around the block a couple of times.
Q: What about rest, how much, how often?
A: Fleishman holds up the right amount of rest as equally important to the health of a person with cancer as the right diet and exercise plan.
Not a lot of research has been done to examine the precise effects that cancer has on a person's sleeping patterns, but much of the advice given to healthy adults can also apply to a person suffering from the disease. Most people need somewhere between seven and eight hours of sleep to function optimally. The problem for people who have cancer is that some of the pain and anti-nausea meds that they need to take may contain both sedative and stimulant ingredients that can make your loved one's sleep cycle a bit wonky.
"Naps are secret weapons against fatigue," Fleishman says in his book. Spending up to 60 minutes per day napping can be helpful to a person who is battling cancer, but don't let your loved one overdo it. Anything over an hour might have a negative impact on the quality and amount of their nighttime sleep.