Referrence:
National Cancer Institute
American Cancer Society @ www.cancer.org
www.Breastcancer.org
People Living With Cancer @ www.plwc.org
www.medicinet.com
ALOPECIA (Hair Loss)
What is alocepia?
Alopecia (a-lo-PEE-shee-ah) is another word for hair loss or thinning of the hair. It is common, yet temporary, side effect of some cancer medicine. Alopecia can occur anywhere on the body and may happen after a few treatments. Currently there are no medicines that can prevent hair loss during treatment.
How can I prepare for the changes that may occur?
1~Before treatment starts, have your hair cut short. It will help you prepare mentally for the change in your appearance.
2~Talk to your family & friends about how you feel, or join a support group with people who are going through or have gone through the same experience.
What are some steps I can take to care for my scalp?
1~Keep your scalp clean with a moisturizing shampoo and conditioner.
2~Use gentle lotions or creams on your scalp when needed; and use sunscreen, hat, scarf, or wig (for muslimah: wear tudung is perfect)
Will my hair grow back?
1~If you do lose your hair, it will usually grow back after the treatments are over.
It may grow back while you are still having treatments
Your hair may grow back a different colour or texture.
When my hair grows back, how should I take care of it?
1~If you usually wash your hair daily, limit the number of times to twice a week.
2~If you usually blow-dry your hair at a high temperature, use a lower heat-setting
Gently style your hair with soft brushes and wide-tooth combs.
CHANGES TO YOUR NAILS
How will my treatment affect my nails?
During your treatment you may notice certain changes to your nails. For instance, they may become darkened or yellow. They may also become cracked and brittle, growing less and breaking more easily. Your nails may also develop lines related to cycles of chemotherapy. These lines are not permanent and will grow out with the nail, generally in about 6 months. The area around the nail bed may also become dry, cuticles may fray, and it is possible for the nail to lift off the nail bed.
Fortunately, most of these changes are not permanent and there are steps you can take to prevent or ease some of these problems.
What can I do if my nails began to change?
1~Do not bite your nails or cuticles. If you find this habit difficult to break, consider wearing thin white cotton gloves around the house to help you.
2~Clip nails short and don?t rip or peel off loose cuticles. Cut them carefully with a clean pair of nail scissors, or use cuticle remover cream or gels and push your cuticles back gently. Massage cuticle cream into the cuticle area daily to prevent dryness, splitting, and hangnails.
3~Do not use fake nails as they can trap bacteria. Also, do not use acrylics or other nails wraps.
4~If you have a professional manicure, bring your own tools to help protect against infections.
5~Protect your nails by wearing gloves while doing chores around the house such as washing dishes or gardening.
6~You should know that your nail may lift away from the nail bed. In time, it will return to normal, but you should still be very careful as this will make the nail vulnerable to falling off. Because the nail is not tightly attached, it can also become a site for bacteria to enter. Be sure to maintain good hygiene to avoid infection.
ANAEMIA
What is anaemia?
Anaemia (ah-NEE- mee-ah) is another word for too few red blood cells. Red blood cells carry oxygen from the lungs to every part of the body. When there are too few blood cells, your muscles and organs cannot get enough oxygen to work properly, leading to symptoms that affect your quality of life.
Anaemia is common side effect experiences by 70% to 90% of patients during the course of their cancer treatments.
Why does cancer treatment cause anaemia?
Chemotherapy works by destroying cancer cells. It may also damage healthy cells, including red blood cells, and can reduce the bone marrows ability to make enough red blood cells.
Other side effects that can also affect your body?s ability to make red blood cells. Such as decreased in appetite, nausea and vomiting.
Anaemia due to chemotherapy is usually temporary.
What effect can anaemia have on me?
1~Besides feeling very weak and tired, you may experience the following symptoms:
2~Heartbeats rapidly or irregular
3~Breath shortness
4~Headaches or dizziness
5~Sleeping difficulty or staying warm
6~Concentrating difficulty
How will I know I have anaemia due to my treatments?
Your doctor or nurse will test your blood often during treatment to determine if you have anaemia. If the number of red blood cells is considered low, your doctor may suggest different treatment options. He or she may prescribe a medicine that can boost the production of your red blood cells.
What can I do if I have anaemia?
1~Get plenty of rest. Take naps during the day if you can
2~Limit your daily activities. Do what is most important to you
3~Do light exercises. Take short walks, whenever you can
4~Eat a well-balanced diet that contains all the nutrients your body needs.
5~Drink plenty of fluids
6~When sitting or lying down, get up slowly to prevent dizziness.
NEUTROPENIA/FEBRILE NEUTROPENIA
Most chemotherapy reduces your number of germ-fighting white blood cells (WBCs) which increases your chance of getting an infection. When the number of a particular type WBC, called a neutrophil (NEW-tro-fil), falls below normal, it is call neutropenia . If you have neutropenia and a fever above 100.5?F (38?C) you have a condition called febrile neutropenia, and it may mean you have an infection. If this occurs, you should alert your doctor or nurse right away.
How do I know if I have neutropenia?
Ask your doctor or nurse to check your latest blood test. If it includes a test called a ?differential?, they will be able to calculate your neutrophil count and tell you if it is normal.
How do I know my risk of getting an infection?
1~After the results from each blood test, ask your doctor or nurse to calculate your ?absolute neutrophil count? ANC .
2~There are medications that increase the number of neutrophils and decrease your risk of infection. Ask your doctor if these might be appropriate for you.
3~Inform your doctor if you have symptoms of an infection, such as:
Fever above 38?C. Too chill or too sweat. Do not take any medication to lower your fever without your doctor approval.
4~Lose your bowel movements.
5~Severe cough, sore throat, sinus pain/pressure, earache, headache or stiff neck.
6~Swelling, tenderness or blister/sores on your mouth, lips or skin.
STOMATITIS
What is stomatitis?
Some chemotherapy can caused sores, dryness, irritation and bleeding in the mouth and throat, a condition known as stomatitis. Since many germs live in the mouth, these sores can become infected, which is a serious side effect for some patients with cancer. Therepfore, every precaution should be taken against stomatitus.
How can I protect my mouth, gums and throat?
1~Talk to your doctor about going to the dentist at least a few weeks before starting chemotherapy. Inform the dentist of your cancer diagnosis and treatment, and ask for the following:
i) A check up and cleaning if necessary
ii) A demonstration of the best way to brush and floss during chemotherapy
iii) A recommendation for a special toothbrush or toothpaste if your gums are very sensitive
2~After every meal and bedtime, gently brush your teeth and gums with a soft toothbrush and rinse with warm salt water. Then, rinse your toothbrush well and store it in a dry place.
3~Avoid mouthwashes containing alcohol, but ask your doctor or nurse for medicated or mild mouthwashes, such as those containing baking soda.
What can I do for painful mouth sores?
1~Ask your doctor for medication or for remedies you can put directly on the sore.
2~Eat foods cold or at room temperature
3~Eat soft, soothing food, such as mashed potatoes, scrambled eggs, macaroni and cheese, ice cream, milkshakes, soft fruit, baby food, porridge etc: you can also puree cooked food with blender.
4~Avoid the following: Acidic or irritating juices and foods, such as tomato and citrus.
Spicy or salty foods
Rough or coarse foods such as raw vegetable, granola, popcorn or toast.
What can I do for mouth dryness?
1~Ask your doctor if the following are appropriate for you; using an artificial saliva product, sucking on ice chips or sugarless hard candy or chewing sugarless gum.
2~Carry a water bottle; drink plenty or sip often.
3~Eat soft puree foods and moisten dry food with butter, margarine, gravy, sauce, soup, broth or porridge.
4~For dry lips, use lip balm.
ASTHENIA/FATIGUE
What is Asthenia/Fatigue?
This is the most complaint by cancer patient. However, this condition may feel different from the fatigue you experience before developing cancer. Some patients may experience physical, mental or emotional fatigue for days, weeks or months that are not relieved by rest.
What causes asthenia/fatigue?
Fatigue may result from cancer treatments or from the disease itself; however the cause is not fully understood. Poor sleep. Pain or pain medications, stress, poor diet, or low blood count (anaemia) may also lead to fatigue.
How can I cope with this?
1~Plan to rest a little each day with breaks or short naps that will not disturb your goodnight sleep.
2~Keep a daily diary and note your energy levels after your cancer treatments. This can help you with scheduling important activities.
3~Allow others to help you with your daily routine and save your energy for the important things.
4~Discuss any sleep problems with your doctor or nurse.
5~Limit your intake of caffeine and alcoholic drinks or stop it right away.
6~Balance your diet and drink plenty of water, unless given other instruction by your doctor or nurse.
7~Exercise lightly or take short walks. If your doctor approves.
8~Consider doing activities you enjoy, but do them more easily or less time.
Activities that may help fatigue include meditation, prayer, yoga etc.
INFECTION
What is an infection?
It occurs when germs (bacteria, virus and fungi) enter your body and multiply. Cancer or chemotherapy can make infections more likely to occurs, and they can make infections more serious than they would have been before you developed cancer.
How do I know if I have an infection?
1~Fever above 38?C. Too chill or too sweat. Do not take any medication to lower your fever without your doctor approval.
2~Loose bowel movements (e.g. diarrhoea). Changes in urination or unusual vaginal discharge or itching.
3~Severe cough, sore throat, sinus pain/pressure, earache, headache or stiff neck.
4~Swelling, tenderness or blister/sores on your mouth, lips or skin.
What are some ways I can lower my risk of getting an infection?
1~Wash your hands often before you eat, after coughing, sneezing, or blowing your nose. After bathroom, touching animals or gardening etc.
2~After bowel movements, gently clean your rectal area. Ask your doctor or nurse for advice if you have irritation or haemorrhoids.
3~Avoid peoples with illnesses you can catch (cold, flu, measles, chicken pox etc) or children who were recently vaccinated with ?live virus? (oral polio, chicken pox etc)
4~Avoid crowds when possible. For example, shop when store are not b busy.
5~Take good care of your teeth and gums.
6~Take a warm shower, bath or sponge bath every day. Gently pat yourself dry using a towel that has not been used by others.
6~Use an electric shaver instead of razor to lessen cuts to your skin and do not share with others.
7~Wear gloves that protect your hands while gardening or cleaning up after others, especially small children.
8~Avoid animal cages, litter boxes and fish tanks, let others clean them.
9~Clean cuts everyday with warm water, soap and an antiseptics and cover them with a clean and dry bandage if you get an accident/cut.
10~Do not squeeze or scratch pimples.
11~Moisturize dry or cracked skin with lotion or oil.
12~Do not get manicures or pedicures temporarily.
13~Women should not use tampons, or douches.
14~Avoid standing water, bird bath, pools.
15~Do not eat any of these foods raw or undercooked: fish, meat, chicken, seafood, eggs or tofu.
16~Ask your doctor if you or your family members should get flu shots or other vaccinations.
NOTE TO SELF: Pesanan yang diberikan oleh seorang jururawat di wad harian HKL, Kak Jamaiah (kak Jem):
1~ingat Allah selalu
2~banyak kan minum air
3~jaga kebersihan diri
Terima kasih atas nasihat & layanan yang baik oleh semua jururawat dan doktor yang merawat saya di wad harian ONKOLOGI HKL. Selepas ini saya di hantar untuk rawatan radioterapi di Gleaneagles Intan, Kuala Lumpur pula pada 3hb Disember ini.





















