Chemotherapy and Radiation For Dummies

Alan P. Lyss, MD, is a medical oncologist. Humberto M. Fagundes, MD, is a radiation oncologist. Patricia Corrigan is a professional writer and cancer survivor.

"...spiced with humour ... succeeds in demystofying cancer therapy ... a compassionate and practical book ... a welcome addition to cancer patient literature..." (Cancer World, April 2006)

• Introduction 1About This Book 1Conventions Used in This Book 2What You Don’t Have to Read 2Foolish Assumptions 2How This Book Is Organized 3Part I: Your Journey Through Cancer Treatments: Preparing for the Trip 3Part II: Your Choices along the Way: Making Good Ones 3Part III: Chemotherapy: What to Expect and How to Deal with Side Effects 4Part IV: Radiation: What to Expect and How to Deal with Side Effects 4Part V: Your Success Strategies: Assembling Your Support Team 4Part VI: Your Future after Cancer Treatments: Looking Ahead 4Part VII: The Part of Tens 5Glossary 5Icons Used in This Book 5Where to Go from Here 6Part I: Your Journey Through Cancer Treatments: Preparing for the Trip 7Chapter 1: Recognizing the Realities of Chemotherapy and Radiation 9Making Peace with Your Diagnosis 10Registering your emotions 10Taking time to process the news 10Experiencing a range of emotions 11Telling family and friends 11Gathering Information 12Shopping for Cancer Specialists 12Finding good doctors 13Preparing to embrace a new culture 14Considering Options 15Understanding chemotherapy and radiation 15Looking into clinical trials 16Taking a chance on a transplant 16Exploring Virtual Chemotherapy 17Getting started on chemo 17Taking care of your immune system 17Signing up for side effects 17Trying on Radiation Therapy for Size 18Getting set up for the first treatment 18Managing side effects 19Sending for Help 19Making room on the team bus 20Practicing good nutrition 20Tending to your spirit 21Finding support from strangers 21Looking Beyond Cancer Treatments 22Beginning anew 22Returning to square one 23Making peace with a new you 23Chapter 2: The Mutants Take Over: A Primer on Cancer 25Demystifying the “C” Word 26Understanding how cancer develops 27What causes cancer? 28Listing the types of cancer 29Differentiating among tumors 30Watching the Immune System in Action 30Discovering How Treatments Fight Back 32Considering Risk Factors 34Blaming your genes 34Looking for other causes 35Looking to the Future: Ongoing Research 37Targeting genetic culprits 38Developing fortified antibodies 38Speaking of the “C” Word 39Practicing saying the word 39Scheduling pity parties 40Comforting the people around you 41Playing the blame game 42Keeping Your Sense of Humor 43Chapter 3: You Will Be Tested: What All Those Tests Show 45Passing a Battery of Tests 46Having blood drawn 46Stretching out on a table 47Undergoing a biopsy 51Playing the Waiting Game 52Setting the Stage for Treatment 53Hearing your numbers 55Ignoring your numbers 55Recognizing Symptoms of Cancer 56Resisting the urge to self-diagnose 57Analyzing pain 57Appreciating Early Detection 58Knowing the types of screening tests 59Redirecting anger about tests 60Part II: Your Choices along the Way: Making Good Ones 63Chapter 4: Defining Chemotherapy: The Anticancer Drugs 65Getting Some Chemotherapy Basics 66Sorting out the different drugs 67Taking heart from new developments 68Investigating Different Delivery Systems 69Having intravenous chemotherapy 70Wearing a pump 73Taking chemotherapy by mouth 74Looking at lesser-known forms of chemotherapy 74Evaluating Your Oncologist’s Recommendation 75Setting up a treatment plan 75Determining the dose 76Getting a second opinion 77Making the Best Choice for You 78Asking the right questions 79Getting the right answers 79Moving forward with confidence 80Chapter 5: Defining Radiation: A Burning Issue 81Understanding Radiation Therapy 82Defining external radiation therapy 83Defining internal radiation therapy 85Exploring ways to improve radiation therapy treatments 89Evaluating Your Radiation Oncologist’s Recommendation 89Setting up a treatment plan 89Determining the dose 90Meeting the team 91Getting a second opinion 91Making the Best Choice for You 91Chapter 6: Setting New Standards: The Role of Clinical Trials 93Grasping the Importance of Clinical Trials 94Realizing the scope of cancer trials 94Understanding the development of clinical trials 94Deciding Whether to Participate 96Considering the benefits 97Considering the risks 97Asking questions 98Seeking more information 99Taking Part in a Clinical Trial 100Meeting eligibility guidelines 100Knowing your rights 101Feeling Good About Taking Part 101Hearing what participants have to say 102Banishing the notion of guinea pigs 103Chapter 7: Getting a Second Chance: Bone Marrow Transplants 105Demystifying Bone Marrow Transplants 106Defining bone marrow 106Identifying the purpose of a transplant 107Recognizing the source of stem cells 108Exploring the Types of Transplants 108Looking at autologous transplants 109Looking at syngeneic transplants 110Looking at allogeneic transplants 110Looking at an alternative 110Searching for a Donor 111Preparing for a Bone Marrow Transplant 112Acknowledging your emotions 112Appointing a caregiver 113Comparing Retrieval Methods 114Harvesting the bone marrow 114Obtaining peripheral blood stem cells 114Undergoing the Rescue Process 115Experiencing external changes 115Experiencing internal changes 116Keeping an Eye Out for Post-Rescue Problems 116Part III: Chemotherapy: What to Expect and How to Deal with Side Effects 119Chapter 8: What to Expect During Chemotherapy: A Head-to-Toe Mouthwash 121Your First Appointment: Getting the Toughest One Out of the Way 122Assessing your feelings 123Preparing for your first treatment 123Arriving for your treatment 125Undergoing your first treatment 125Heading for home 126Continuing with Chemo 127Keeping your appointments 128Reporting changes in your health 128Protecting your health 129Asking for the Support You Need 129Delegating responsibilities to your family 130Appointing a “Chemo Buddy” 131Allowing friends to help 131Giving Yourself a Break 133Keeping everything in perspective 133Keeping an eye on the future 134Chapter 9: Gimme a Boost: Immune and Bone Marrow Stimulants 135Boning Up on Bone Marrow 136Boosting the Immune System 137White blood cells 137Red blood cells 139Platelets 141An additional complication 142Recognizing an Infection 143Considering Supplements 143Chapter 10: Coping with Serious Side Effects of Chemotherapy 145Considering What’s to Come 146Reading a firsthand report 147Predicting your experience 147Keeping an Eye on Kidney and Bladder Function 148Combating Nausea 149Eating smart 149Drinking smart 150Comforting yourself 150Facing Fatigue 151Checking for anemia 152Conserving energy 152Fighting Pain 154Nailing neuropathy 154Watching out for mouth sores 155Dealing with dry mouth 156Demystifying Depression 157Facing your fear 157Identifying other causes of depression 157Getting the help you need 158Confronting Infertility 159Being proactive 159Planning to wait 160Losing Your Hair 160Caring for your hair before it goes 161Planning ahead for hair loss 162Growing new hair 165Chapter 11: Coping with Less Serious Side Effects of Chemotherapy 167Considering What’s to Come 168Battling Intestinal Disarray 168Dealing with diarrhea 169Dealing with constipation 170Retaining Fluids 170Experiencing Vision Problems 171Fighting Fuzzy Thinking 171Losing Interest in Food 172Mistrusting your sense of taste 172Boosting your appetite 173Cutting back on drinking 174Troubleshooting Skin and Nail Problems 174Itching to scratch 175Knowing how to treat nails 176Attacking acne 176Suffering from sunburn 176Reacting to radiation 177Part IV: Radiation: What to Expect and How to Deal with Side Effects 179Chapter 12: What to Expect During Radiation: Tattoos and Moisturizer 181Your First Appointments: Getting the Toughest Ones Out of the Way 182Knowing what to expect 182Mapping the area to be treated 183Determining the dose to use 185Getting tattoos 185Setting up your schedule 186Experiencing the Real Thing 187Assessing your feelings 187Arriving on the first day 188Soothing Your Skin 189Making Wardrobe Adjustments 190Seeking the Support You Need 190Giving Yourself a Break 191Keeping your appointments 192Keeping everything in perspective 192Keeping an eye on the future 193Chapter 13: Coping with Side Effects of Radiation Therapy 195Considering What’s to Come 196Identifying your type of therapy 197Predicting your experience 197Fending Off Fatigue 198Learning an important word 198Getting your timing right 199Caring for Your Skin 200Using protective strategies 200Watching for warning signs 200Soothing Inflamed Mucous Membranes 201Experiencing Diarrhea 201Saying “No” to Nausea 202Making wise food choices 202Making wise drink choices 203Finding comfort 204Living with Lymphedema 204Looking Out for Pneumonitis 205Running to the Restroom 205Watching Your White Blood Count 206Dealing with Hair Loss 207Pampering your hair while you have it 207Making plans in advance 208Recognizing Depression 210Asking for help 210Working through fear and grief 211Part V: Your Success Strategies: Assembling Your Support Team 213Chapter 14: Your Health Professionals: Your Friends and Guides 215Communicating with Your Doctors 216Building a good relationship 216Considering less-than-ideal situations 219Seeking Help from a Psychologist 220Allowing yourself to accept help 221Knowing what kind of help to expect 222Meeting Other Health Professionals 222Making time for massage 223Yearning for yoga 225Renewing with reiki 227Taking up tai chi 228Trying meditation 229Fitting in fitness 231Chapter 15: Good Nutrition: Eating Right No Matter How You Feel 235Welcoming New Members to the Team 236Knowing When You Need Help 236Catching Up on the Food Fights 237Boning Up on the Benefits 238Acknowledging the “A” List 239Finding time for fluids 239Pumping up with protein 239Embracing carbohydrates and fats 240Mulling over vitamins and minerals 242Plumbing the Pitfalls of Poor Eating 242Considering Problems that May Develop 242Realizing how tumors impact nutrients 243Seeing how surgery affects eating habits 243Knowing how chemotherapy influences nutrition 244Acknowledging problems caused by radiation therapy 245Assessing effects of bone marrow and stem cell transplants 245Chapter 16: Meeting Spiritual Needs: Turning to Prayer and Meditation 247Defining Distress 248Tallying Up the Benefits of Faith 248Talking about Spirituality with Your Doctors 251Examining Prayer Practices 252Personalizing prayers 252Praying in free verse 252Meditating in a prayerful manner 253Accepting Prayers from Others 254Assessing the Healing Power of Prayer 254Listening to a Doctor on Spirituality 255Squaring Faith with Cancer 256Chapter 17: Finding a Support Group: Realizing You Are Not Alone 257Determining Your Level of Interest 258Defining “Group” 258Locating a Group 259Asking the Right Questions 261Seeking One-on-One Support 262Looking at the Benefits 262Assessing the Risks 263Handling the hard stuff 264Protecting yourself emotionally 264Helping Newcomers 265Part VI: Your Future after Cancer Treatments: Looking Ahead 267Chapter 18: Finishing Therapy: An End and a Beginning 269Monitoring Your Health after Cancer 270Expecting a recovery period 270Scheduling follow-up care 271Keeping appointments 271Telling the truth 272Worrying about recurrence 273Coping with Long-Term Side Effects 273Fighting fatigue 273Putting up with pain 274Managing lymphedema 274Making the best of mouth problems 274Facing bladder or bowel problems 275Accepting early menopause 275Sorting out sexual issues 276Reducing Your Hormone Level 277Hearing arguments for hormone therapy 277Considering different approaches 278Sizing up the side effects 278Deciding what’s best for you 279Working Out a Wellness Plan 279Chapter 19: Dealing with Recurrence: Here We Go Again 281Defining Recurrence 282Recognizing signs of recurrence 282Getting up to speed on semantics 283Redefining Survivor 283Riding the Emotional Roller Coaster 284Questioning everything 284Moving on 285Establishing a Treatment Plan 286Understanding your options 286Making the most of past experiences 287Setting treatment goals when a cure isn’t possible 288Considering Unconventional Treatments 288Facing the Future, Whatever Comes 289Finding comfort in hospice care 290Debunking the myths of hospice 291Traveling on 292Chapter 20: Defining Yourself after Cancer: The New Normal 293Looking at Life Through New Eyes 294Reaping the benefits 294Getting a physical boost from positive thinking? 295Making Semantic Decisions 296Allowing for Negativity 296Finding Inspiration in Amazing Recoveries 297Looking at Time Differently 298Hearing the wakeup call 298Living in gratitude 299Spending time on yourself 299Protecting Yourself Emotionally 301Looking out for number one 301Making friends with lingering fear 302Defining Your Boundaries at Home and Work 302Lightening Up 303Part VII: The Part of Tens 305Chapter 21: Ten Myths about Cancer 307Myth #1: When You Get Cancer, You Die 307Myth #2: If the Cancer Doesn’t Kill You, the Treatments Will 308Myth #3: Cancer Treatments Are One-Size-Fits-All 308Myth #4: You Can’t Work while You’re Having Cancer Treatments 309Myth #5: It Takes Forever to Get Over Cancer Treatments 309Myth #6: It’s Your Fault You Got Cancer 309Myth #7: The Medical Community Suppresses Alternative Healing Methods 310Myth #8: Now Your Family Will All Get Cancer 310Myth #9: Cancer Always Comes Back 310Myth #10: Nothing Is Ever the Same after Cancer 311Chapter 22: Ten Ways for Family and Friends to Help You 313Acknowledging That You Have Cancer 313Giving You Time to Accept the Diagnosis 314Holding You While You Cry 314Making You Laugh 315Seeking Help Coping from Someone Else 315Asking for Specific Ways to Help You 315Carrying Out Your Requests 316Offering What You Are Reluctant to Ask For 316Helping to Protect You 317Celebrating with You 317Chapter 23: Ten Things Beyond Your Control 319Turning Back the Clock 319Keeping the Diagnosis a Secret 320Encountering an Alien Culture 320Making New Friends 320Experiencing Mood Swings 321Facing Your Own Mortality 321Suffering Power Outages 321Missing Some Good Times 322Choosing the Texture of Your New Hair 322Receiving Help from Many Sources 322Chapter 24: Ten Ways Life Will Be Better after Cancer 323Cancer Goes Away 323Treatments End 324Fear Recedes 324A Sense of Adventure Grows 324Inner Strength Builds 325People Matter More 325Forgiveness Gains in Importance 325Support Comes Naturally 326The Tongue Loosens 326Time Flies 326Chapter 25: Ten Sources for More Information 329Searching the Web 329National Cancer Institute 330American Cancer Society 330                                             National Comprehensive Cancer Network 330American Society for Therapeutic Radiology and Oncology 331People Living With Cancer 331OncoLink 331Planet Cancer 331Coalition of National Cancer Cooperative Groups 332National Marrow Donor Program 332Coping with Cancer Magazine 332Glossary 333Index 339