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    What is Chemo Brain and How Do You Cope?

    Chemo brain is an expression used by cancer patients and survivors. This phrase describes the cognitive symptoms and effects that cancer treatment may cause. Although most often associated with the mental changes caused by chemotherapy, these mental lapses can also occur with radiation or hormone therapy.

    We, as cancer survivors, have to have a sense of humor about the entire topic. There is confusion over how we spell this side effect — is it “chemobrain” or “chemo brain” — or is it what others call “chemo brain fog”?
    Whatever we call it, these cognitive dysfunction is real and varies in intensity and duration from patient to patient.
    What are the symptoms of chemo brain?
    Chemo brain is a frustrating condition where cancer patients experience difficulty with memory and thinking. We can’t think as clearly as we once did or experience problems doing a task that we’ve always done. We can’t say the word that we want to say, even though we know what we want to say.
    This “brain fog” is disturbing and may be embarrassing when it occurs at work. It might even put our jobs at risk if we have difficulty using common applications like Word and Excel. We might be making a presentation to a potential customer, and we can’t pull the word we need out of our brain.
    According to Mayo Clinic, researchers don’t yet fully understand the brain fog that cancer survivors experience. Common symptoms include:
    • Being disorganized • Confusion • Difficulty finding the right word • Difficulty learning new skills • Lack of concentration • Memory recall, such as remembering a list of words • Mental fogginess • Problems with multitasking • Short-term memory problems • Shorter attention span • Takes longer to complete a routine task • Trouble remembering a conversation

    The most commonly reported symptoms are memory, concentration and executive function. If we’re still working, this translates into taking longer to complete simple tasks and longer to master new skills. Chemo brain is a frightening side effect if we are still working and particularly concerning if we are the breadwinner for our family.
    What are some other reasons for memory and concentration problems?
    Cancer patients rack up a complex medical history after they finish treatment and enter survivorship. We’ve had multiple procedures/surgeries requiring anesthesia or sedation. We’ve had chemotherapy, hormone therapy, targeted therapy and/or immunotherapy. We’ve had radiation therapy, perhaps more than once. We’re experienced more stress in a short time than non-cancer patients experience in a lifetime.
    Many of us experience insomnia and other sleep issues. We may be depressed. We experience high levels of anxiety at scan times. The fear of recurrence hangs over our heads. Many patients have lingering pain and discomfort. Many women experience early-onset menopause as a result of breast or ovarian cancer treatments. Some men experience erectile dysfunction. Adjusting to life after cancer is challenging.
    So our medical team has to sort out if these other issues may be the cause of memory or concentration problems.
    Are there links between chemo brain and aging?
    One of the troubling aspects of chemo brain is that age is a risk factor for cancer. The median age for a diagnosis of cancer is 66. Almost 70 percent (69.1 percent to be exact) of new cancers diagnosed are for patients between the ages of 55 and 84.
    Perhaps, the harsh treatments, the stress and anxiety, the anesthesia, pain medications and the disease process itself contribute and accelerate the decline of memory and cognitive functions. Researchers don’t understand chemo brain enough to know the specific cause.

    Are there any treatments for chemo brain?
    While there are no specific medications that treat chemo brain, our doctors do have some medications that may produce symptom relief. Some patients get relief when prescribed psychostimulants, drugs including Ritalin (methylphenidate), Provigil (modafinil) and Aricept (donepezil) — these drugs are usually prescribed for attention deficit disorder (ADHD). For some patients, these drugs work wonders. Generally, if a psychostimulant is going to work for a cancer survivor, it works within a short time. Other patients experience an adverse effect on their quality of life from the side effects.
    Scientists are hopeful that exercise may help other patients since exercise helps prevent cognitive decline in older adults. Since a certain subset of survivors experience cognitive issues long-term, exercise would provide an affordable treatment without adverse side effects.
    The best advice is make an appointment with a neurologist to help determine if your cognitive issues might be caused by something else that is treatable. Other causes of cognitive dysfunction include sleep apnea, anxiety, anemia, depression, Vitamin D deficiency or thyroid disease — all treatable.
    Some cancer survivors find that brain games
    including Lumosity or thinking skills workshops are helpful. But other survivors are frustrated by these mental exercises.
    Don’t just assume that cognitive issues are chemo brain. Don’t just assume that there is no help for your brain fog. Talk to you medical team and get a referral to a trained specialist who can help sort out your symptoms and possibly find some solutions.
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    You Don't Have to Face Cancer Alone!
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    31 Thoughtful Things to Do For Someone With Cancer

    Many of our friends or co-workers want to know how they can help us through our cancer treatment. We’re often reluctant to ask for help. But we are eternally grateful when someone does one or more of these things for us or our family.

    1. Grocery shopping. Offer to go grocery shopping or to pick up our on-line order.
    2. Offer a ride to treatment. Our caregivers may be juggling a job and taking us back and forth to treatment. A ride to and from daily radiation or picking us up after chemotherapy is a blessing for us.
    3. Babysit. A young mother in cancer treatment needs help with her young children, if they are under school-age. Organize babysitting for her on treatment days or after she has surgery.
    4. Bring a meal. Dishes that are easy to reheat are a lifesaver.
    5. Organize meals. Use an app like Meal Train® for a family when their loved one is facing surgery and won’t be able to cook for several weeks.
    6. Offer help with school-age children. Invite children over for slumber party or a Saturday outing.
    7. Pet sit. Boarding is expensive. If a friend is facing an out-of-town second opinion or specialized procedure, offer to take care of their cat or dog.

    8. Do their laundry. Ask if you can come over and do the laundry. We are often too tired to strip the beds, wash the linens and then make up the beds again.
    9. Volunteer to pick up their prescriptions. All of those extra trips take a toll. Offer to pick up their monthly medicines at the pharmacy.
    10. Text an inspiring quote. We need all of the encouragement we can get. Hearing from you means the world to us.
    11. Mail a gift card. We don’t like to admit that money is tight. Extra gas going back and forth to treatment and our medical bills take a huge chunk out of every patient’s budget. A gas card, a pharmacy card, a grocery store card, a restaurant card or a card to a hobby/craft store will be welcomed by everyone. If they have a Kindle, buy them an Amazon gift card
    to buy some new books. Buy a pre-paid Visa card to help take care of doctor visit copays.
    12. Hire a housekeeper for a day. Talk about a great project for a Sunday school class! Arrange with the housekeeper so that your friend can call to schedule at a time that works with their treatment schedule. Prepare a new document/gift certificate to present.

    13. Plow their driveway in the winter. Medical emergencies happen in the winter. Coordinate with a couple of other families to keep their driveway plowed.
    14. Donate some vacation days (if your employer is willing). Unpaid leave causes many families financial hardship as they struggle to pay their mortgage and other household expenses. Talk to your fellow employees to see if they might be willing to donate a vacation day or two.
    15. Volunteer to water the hanging baskets. Lifting a gallon of water or pulling a hose may be difficult for someone in cancer treatment. But if they love their flowers, come by twice a week and water their plants.

    16. ITunes gift card. Long chemotherapy sessions can become tiresome. Listening to new music
    or podcasts or downloading a new book will help the time go by more quickly.
    17. Laundry service. Give a gift certificate for a laundry service the offers pick-up and delivery.
    18. A soft, cuddly blanket. Not only does this feel good when at chemotherapy, but this feels good when we’re watching TV or taking a cat nap.
    19. Loungewear. Pull-on pants, V-neck tee shirts (to allow access to our chemo port
    ), button up-the-front shirts made of fleece or knit jersey are wonderful gifts. We don’t feel like dressing up. We love to feel cozy and comfortable.
    20. Insulated lunch bag. Many of us take a light lunch to our chemotherapy center. An insulated lunch bag
    or tote is just right for help keep our sandwich or yogurt cold.
    21. Adult coloring book
    with colored pencils.
    Art and coloring help pass the hours in waiting rooms or chemo rooms or while we are recovering at home.
    22. Don’t forget the caregiver. Call or text the caregiver to offer help with household chores or driving or grass mowing or laundry. Caregivers carry a big burden.
    23. Call before you visit. We, as cancer patients, aren’t always physically or emotionally able to appreciate company. We may have just gotten bad news or we may be exhausted from chemo or radiation treatments. Be courteous and call us before you come.
    24. Don’t forget us after we are first diagnosed. When we are first diagnosed, everyone offers help. Many of us face a year or more of treatment, please don’t forget us.
    25. Snail mail a card or note. There is nothing better than to get a hand-addressed note or card in the mail. It seems like all that we get is medical bills, but seeing your handwriting and return address brings joy to our heart.

    26. Run errands. Give us a call and ask if we need anything from the pharmacy, grocery or big box store. 27. Ride for your child to an after school or Saturday activity. If they have children, ask if they need a ride to soccer, softball practice or dance lessons.
    28. Give blood in their name. Patients who have blood cancer frequently need blood transfusions. Donate blood if they are in need or give in their honor.
    29. Host a scarf and hat party. Invite close friends and have coffee or light refreshments if one of your friends knows that she will lose her hair.
    30. Soft, warm socks. Many cancer patients experience cold hands and feet. Most would enjoy an extra pair of cuddly socks
    31. A charm or pendant. Many women enjoy different charms for a necklace or bracelet. Surprise them with a charm that encourages – choose one embossed with words like HOPE, FAITH or COURAGE.
    Gifts and thoughtful acts of kindness mean so much to anyone who has cancer. We, as cancer patients, are scared, anxious and are battling side effects. Yet, we carry on as best we can. Being remembered during these difficult times means the world to us.

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    Don't Say This to a Cancer Patient - Say This Instead

    We know that our friends, co-workers and family love us and want to help us, but sometimes, they don’t know what to say. They say something vague or insensitive without realizing that they missed the mark, and we end up feeling worse, instead of better.

    So … what are some of the things that we’d rather hear?
    The truth is that the general public doesn’t understand what having cancer is like — all of the medical appointments, the anxiety of waiting for test results or the intensity of our side effects. So the people around us say things that they “think” we’d like to hear, but their words don’t comfort us at all.
    Call me if there’s anything that I can do.
    Of course, we’re not going to call a friend and ask for help. Instead, here are some concrete tasks that you can volunteer to do.
    • Pick up her children after school on chemo day. • Get her grocery order from Walmart or Kroger. • Pick up medicines and personal items from the drug store. • Offer to mow the lawn. • Make a meal. • Host your children on a Saturday.
    You don’t look sick.
    If we don’t lose our hair and don’t lose a lot of weight, we may look pretty much that same as we always looked. I always put on makeup every day to boost my spirits, but that didn’t mean that I was okay. Sometimes, the “you don’t look sick
    ” might be taken as “I don’t think you’re that sick.” These are better things to say.
    • You look amazing. • I love your outfit. • I’m so glad to see you. • I’ve missed seeing you.

    Let me tell you about my aunt who had cancer.
    Every patient’s cancer experience is different. Treatments change so that what happened to your aunt fifteen years ago is no longer relevant. Instead of recounting a horror story, it’s best to say something like this.
    • I’m sorry that you’re having to face this. • I admire your strength. • You’ll be in my thoughts and prayers.

    How were you diagnosed?
    As we’ve all learned, cancer occurs in awkward, private parts of our body. Many patients are sensitive about the location of their cancer and don’t want to talk about the nitty, gritty details of their diagnosis. Respect your friend’s privacy. Instead, here are some ideas.
    • Do you feel like getting together for coffee this week? • It seems like cancer touches so many people. I hate that you’re facing this. • I want to bring over a casserole. What’s your favorite?

    What are the doctors saying?
    We can’t barely understand the medical jargon used in cancer treatment
    . The treatment of cancer is complex and fluid. A single test result can change someone’s treatment plan. Don’t pry and probe into the privacy of someone’s diagnosis. We disclose what we’re comfortable disclosing and prefer not to be bombarded with further questions. Here are some ideas for conversations.
    • We’ve been through some tough times together. If you ever need a sounding board, I’m here for you. • Know that I’m here for you. Text or email me if you’d like to get together. • Can I bring you something for lunch next week?

    Uncle Tommy didn’t like XYZ Cancer Center.
    Uncle Tommy may have been hard-to-please or he may have had an advanced cancer that didn’t respond to treatment. But if we are going to XYZ Cancer Center, please don’t criticize our decision. We’ve made the best decisions under our unique circumstances.
    • I know that you’re glad you’re not traveling 100 miles each way for treatments. • It’s good that your treatment is local. • I know that using XYZ Cancer Center is much easier with your children in school.

    You’re going to be fine. You can’t possibly know if any particular cancer patient is going to be “fine” or not. We, as cancer patients, are unique. We respond differently to treatment. Some of us have severe allergic reactions to our potentially life-saving medicines. We may not heal quickly after a surgery. We face unforeseeable circumstances that may limit our treatment options. You can’t assure us that we are going to be fine. Instead talk about the factors that can’t change.

    • Bob and I are always here for you. Don’t hesitate to call me if you need a ride to radiation. Let me put my cell phone number in your phone. • I can’t imagine how scary this is. You are always in my prayers.

    Really, be honest, how are you doing?
    People on the outside don’t have a clue what many cancer patients endure. Some of us put up a good front because that’s the best option for us. But the truth is that outsiders don’t need to know or want to know the reality of cancer treatment.
    They don’t want to hear about our nausea or our mouth sores or the fatigue that sleep doesn’t fix. So here are some better options for conversations.
    • I’m not sure how to help. Can I come over and water your hanging baskets for you? • I’m sure that you might be tired. Could I get your car and have it serviced? • Do you need anything from the drugstore? I’m going to Walgreen’s tomorrow.

    What caused your cancer?
    This question suggests to many cancer patients that they did something wrong which caused their cancer. While there are common risk factors for many cancers, researchers have yet to determine what causes cancer. If the experts don’t know, then please don’t ask a cancer patient what caused their cancer. These are good alternatives when talking to your friend who has cancer.
    • Cancer seems so random. It’s hard to understand why bad things happen to good people. • I’m so sorry that this has happened to you.
    • Bro, I’m going fishing on Saturday. Do you feel up to coming along?

    Don’t eat sugar. I’ve heard that cancer feeds on sugar.
    If I hear that statement one more time, I’m going to cram my Dixie Crystals bag of sugar down their throat. Researchers don’t yet understand the complex set of circumstances that allow cancer to happen in one person but not another person. Please don’t blame me because I ate something. Our choice of foods while we’re in treatment is often based on what we can tolerate because of chemotherapy or radiation side effects. These are more appropriate conversations to start.
    • I’d love to bring you something. What can you eat? • Is there anything you can’t eat? I’d love to bring you a casserole for the weekend.

    The Bottom Line … Always be kind and encouraging.
    Since 1 out of every three people will be diagnosed with cancer at some time in their lives, think before you speak. Although the old saying of “sticks and stones may break my bones, but words will never hurt me”
    isn’t appropriate when talking to people who have cancer. We’re in the midst of a major health crisis in our lives. If you can’t say something nice, then don’t say anything at all. Words can hurt us.

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    Prostate Cancer Facts and Statistics

    Almost 175,000 men in the United States will be diagnosed with prostate annually, making prostate cancer the most common cancer in men (except for skin cancer). About 60 percent of men diagnosed with prostate cancer are over the age of 60. Average age for diagnosis is 66.

    Prostate cancer is about 60 percent higher in African-American men than white men. About 90 percent of prostate cancer is diagnosed when it is localized or has spread to nearby organs (regional disease). Five-year survival rates for these cancer is almost 100 percent.
    When prostate cancer spreads to distant parts of the body, the five-year survival rates drops dramatically. Prostate cancer accounts for over 31,500 deaths annually in the U.S. PSA screenings to detect prostate cancer early have helped reduce death rates by almost half from 1993 to 2016.
    What is prostate cancer?
    This walnut-sized gland is located behind the base of a man’s penis. It is in front of the rectum and below the bladder and surrounds the urethra, the tube that carries urine and sperm through the penis. The prostate manufactures seminal fluid, the fluid that protects and transports sperm.

    Prostate cancer occurs when cells within the prostate gland grow out of control and form a tumor. Prostate cancer is different from most cancers that produce tumors. Prostate cancer tumors usually grow very slowly and may cause few, if any, symptoms. Even men with advanced prostate cancer may live many years with a good quality of life.
    What are the risk factors?
    Most risk factors for prostate cancer are factors that can’t be changed. Our best defense against prostate cancer is appropriate screenings, including regular PSA testing.
     Age. More than 80 percent of men diagnosed with prostate cancer are over 65.
     Agent Orange exposure. Veterans who were exposed to Agent Orange are at increased risk for prostate cancer. The Department of Veteran Affairs provides more information on the link between Agent Orange and prostate cancer.

     Family history. Prostate cancer may run in families — it’s called familial prostate cancer and accounts for about 20 percent of prostate cancer diagnoses. Hereditary prostate cancer (when the cancer is “directly” inherited from a relative) is rare, accounting for about 5 percent of prostate cancer cases. If you have three first degree relatives (father, son or brother) who have had prostate cancer, be sure to tell your doctor. Also, if there has been prostate cancer in 3 generations on the same side of the family or if two or more close relatives on the same side of the family, be sure to tell your doctor. They will advise you on more aggressive screenings to help ensure that any problem is detected early.
     Hereditary breast and ovarian cancer (HBOC) syndrome. If your family history includes women who developed breast or ovarian cancer, you might be at increased risk of prostate cancer.
     Race/ethnicity. Black men experience a higher rate of prostate cancer — it’s diagnosed earlier and may be more aggressive. Hispanic men have a lower rate of prostate cancer than non-Hispanic white men. Prostate cancer is on the rise in Asian men living in urbanized areas like Hong Kong and Singapore as well as in American and European urban areas.

    Screening tests include a digital rectal exam (DRE) and the PSA (prostate-specific antigen) test. Controversy exists on the frequency of these tests and the age, at which these tests should be discontinued. Every man should have a frank discussion with their physician over their risk factors and decide on the frequency of prostate cancer screenings.
    Staging and Grades
    Although the standard stages of cancer (Stages I through IV still exist), the Gleason score provides clinicians additional information to help guide their treatment. The Gleason score provides information on how aggressive a particular patient’s prostate cancer is.
    The Gleason score is based on how much the cancer cells look like normal cells. The more they look like normal cells, the lower the Gleason score. Well-differentiated cancer cells look more like normal cells and receive the lowest score of 6. A Gleason score of 7 is a medium grade. Gleason scores of 8, 9 and 10 are poorly-differentiated and more likely to require more aggressive treatment.
    The NCCN (National Comprehensive Cancer Network) developed five risk categories, again to help direct your medical team in how aggressive treatment should be.
     Very low risk – the tumor is so small that it can’t be felt with a DRE or seen on imaging tests, and the Gleason score is 6. The PSA is less than 10.
     Low risk – the tumor is still small but may be felt during a DRE. PSA is less than 10. Gleason score is still a 6.
     Intermediate risk – the tumor is large enough to be felt with a DRE. PSA is between 10 and 20. The Gleason score is 7.
     High risk – the tumor has grown through the prostate or into the seminal vesicles. PSA is higher than 20. The Gleason score is between 8 and 10.
    Very high risk – the tumor has grown into the seminal vesicles or other adjoining structures, including the rectum, bladder or pelvic wall. Gleason scores are between 8 and 10.
    The lower your NCCN score, the less likely the prostate cancer will grow and spread. Prostate cancer in the news.
    The Prostate Cancer Foundation provides men and their caregivers the latest information about diagnosis and detection of prostate cancer, treatments and treatment side effects (including sexual side effects) and news about the causes and treatment of advanced prostate cancer.
    Download their new 2019 Prostate Cancer Patient Guide.

    African-American men are twice as likely to die from prostate cancer as non-Hispanic white men. Download their new guide, Additional Facts for African American Men and Their Families.
    Learn more about new treatments — from fewer radiation treatments to active surveillance to new targeted treatments for advanced prostate cancer.
    When detected early, prostate cancer can be cured.

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    Alternative Vs. Complimentary Treatments For Cancer

     It is disturbing that so much disinformation floats around about cancer treatment. Misinformation creates fear in many newly-diagnosed patients — they have heard “horror” stories about chemo and “terror” tales about radiation. Well-meaning friends and relatives buy books and forward emails about all sorts of “natural” cures, juicing, supplements or diets to cure cancer.

    How many people believe that alternative treatments cure cancer?

    According to the American Society of Clinical Oncology (ASCO), nearly four out of every ten people believe that cancer can be cured with alternative treatments.
    ASCO commissioned a Harris Poll survey in August 2018, polling over 4,800 people, including over 1,000 patients who currently had cancer or had cancer in the past. The results were astonishing.
    Almost four out of 10 U.S. citizens (39%) believed that cancer could be cured just with alternative treatments – treatments including diet, vitamins, supplements, enzyme and oxygen therapy, or minerals. They held this belief despite studies that show a significantly higher mortality rate for people who sought alternative treatments.
    A recent study published in the Journal of the National Cancer Institute showed that patients who chose alternative methods for treatment of the four most common types of cancer (breast, colorectal, lung and prostate) had a 2.5 times as high mortality rate as patients who chose conventional treatment.
    Adults under the age of 53 are most likely to hold these beliefs (47% of adults 18-37 and 44% of adults 38-53). Belief in alternative treatments may stem from social media and high internet use. “Miracle cures” abound. Three of the most common, highly publicized cures that have not been proven are: cannabis oil, laetrile (aka apricot pits) and changing PH levels within the body by diet.
    What are complementary treatments for cancer?
    Complementary therapies are treatments used along with conventional cancer treatment (CCT) to help ease side effects from treatment and symptoms caused by the cancer itself. Complementary treatments
    combined with traditional treatments is referred to as integrative medicine — in other words, treating the whole patient — so that we can tolerate our cancer treatment with minimum side effects.
    What can complementary medicine help? The American Society of Clinical Oncologists tells us about these complementary treatments may help cancer patients during and after their treatment.

    Acupuncture – may relieve pain, help nausea, hot flashes and dry mouth.
    Massage – reduces pain and decreases stress and tension. Eases anxiety and depression. Helps insomnia.
    Meditation – helps calm the mind and relax the body. Enhances mindfulness.
    Music therapy
    – helps many patients in hospital settings or in palliative care.
    Nutrition – management of weight changes and symptoms like nausea. Helps patients recover from difficult surgeries through proper nutrition.
    Physical Activity – reduces fatigue and stress, builds endurance and strength and relieves anxiety and depression. Exercise improves longevity.
    Tai Chi – this ancient technique combines movement and deep breathing to strengthen the body and soothe the soul.
    Yoga – yoga employs ancient poses to stretch muscles while employing deep breathing. Yoga
    helps reduce pain, inflammation and fatigue.
    The Bottom Line … There is no substitute for conventional cancer treatment.
    Every one of us at WhatNext.com
    who are NED (no evidence of disease) or who have been stable for several years have gotten to that place with conventional cancer treatment. None of us know anyone who refused traditional treatment and chose juicing, herbs or extreme dietary changes who survived. Yes, some people claim that on the internet, but the claims are false — no scientific evidence to back up their claims — no clinical trials.

    Cancer treatment is scary. Were we scared? Yes, we were.

    But we listened carefully to what our doctors proposed. Many of us obtained second opinions to feel confident that we were on the right path of treatment. We studied the NCCN patient guidelines — treatment guidelines based on most effective treatments from 28 cancer treatment centers in the U.S.
    Another danger of substituting alternative treatment for conventional cancer treatment is that a person’s cancer may progress and worsen. By the time that a person realizes that their alternative treatment isn’t working, their conventional treatment choices may be limited by the progression of their cancer.
    Our best option for curing our cancer is conventional cancer treatment (CCT). Using complementary treatments for symptom and side effects relief is safe and effective, but don’t omit any part of your conventional treatment plan because you are using complementary treatments — complementary treatments are just that — to complement what your conventional treatment plan utilizes.
    It’s tempting to hear that something easier than conventional cancer treatment will cure our cancer. But cancer is a complex disease and requires a complex, multidisciplinary approach to treatment.
    Have you used alternative or complementary therapy? What have you tried and how did it work?
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    14 Weird Side Effects of Cancer Treatments

    Weird Side Effects

    When we begin cancer treatment, we are sailing into “uncharted waters” — we’re about to being something that we’ve never done before. We’re nervous, even scared, about the side effects.
    Most of us already know about the common side effects of cancer treatment:
    Fatigue Nausea or vomiting Weight loss Hair loss Diarrhea Compromised immune system

    Many patients have a chemo orientation or their oncologist gives them a list of their medications and possible side effects (also available on ChemoCare.com). Our radiology oncologist or their nurse should advise us of potential side effects. But they can’t tell you every uncommon side effect that we might experience.
    14 Weird Side Effects of Cancer Treatment
    There are several uncommon side effects that we may not associate with our cancer treatment. That’s why it’s important to know about these so you can let your oncologist know.
    Hiccups. Some patients experience non-stop hiccups after a chemotherapy infusion. This strange side effect is usually caused by dexamethasone (a steroid) given to help prevent nausea and vomiting. Hiccups may also be caused by Cisplatin, a platinum-based chemotherapy drug used most often to treat metastatic ovarian, bladder and testicular cancer.
    1st Bite Syndrome. This unusual side effect is associated with the platinum-based chemotherapy drug called Oxaliplatin. 1st bite syndrome is jaw spasm that occurs when a patient takes their first bite of food after infusion. I can personally attest to this one – it was intense, but resolved within about a minute, and I was able to eat the rest of my meal, and it happened at the first meal after every infusion.

    Nail Changes. Fingernails seem to be affected more than toenails. The nails get weak and fall off (most common with Taxol and Taxotere). Other nail problems include peeling off in layers, development of either horizontal or vertical lines in your nails or a change in the shape of your nail, so that it has a concave appearance, like a spoon. Rarely, a patient may lose their toenails.
    Partial Hair Loss. Patients getting radiation for brain tumors or head and neck cancer may experience partial hair loss. Most hair loss occurs where the radiation is beam, but some patients lose hair where the radiation beam exists. Our WhatNext patient leader experienced this — he lost the hair on each side of his head, leaving with hair on the top of his head, like a Mohawk.
    Pink Eye. You may remember “pink eye” from your childhood days. Pink eye is the common name for conjunctivitis — an inflammation of the conjunctiva (the clear, thin membrane that covers the white of the eye). Some chemotherapy drugs (capecitabine, carmustine, epirubicin, methotrexate, and oprevelkin) may cause pink eye.
    Flatulence. Flatulence is the “fancy” word for gas. And yes, it can be caused by chemotherapy. Chemo may change the speed that food passes through our intestines (called motility). Food may speed up (causing diarrhea) or slow down (causing constipation). Chemo also affects the good bacteria found in our gut — killing off the good bacteria may cause cramping and the production of gas.
    Hand-Foot Syndrome. Yes, this one is real — almost sounds like “hoof-and-mouth disease.” But hand-foot syndrome (palmar-plantar erythrodysesthesia) is an uncomfortable side effect of some cancer treatments. Symptoms include redness, swelling, and pain on the palms of the hands and/or the soles of the feet. Patients may develop blisters too, making walking extremely painful. Xeloda, an oral chemo used for colorectal, anal, breast and other cancers is notorious for this side effect.
    Nose Bleed. Nose bleeds may occur if our platelet counts are low. A targeted therapy, Avastin, used in many types of metastatic cancer, can also cause nose bleeds.
    Acne. Some targeted therapies cause a skin rash that may be severe. It looks just like acne and affects the scalp, face, neck, chest, and upper back. It is usually worse at the beginning of treatment. When treatment ends, our skin heals and recovers within 4-to-6 weeks.
    Vaginal Stenosis. Vaginal stenosis frequently causes painful intercourse and may prevent a woman from being able to have a pelvic exam. Vaginal stenosis is caused by pelvic radiation to treat cervical, ovarian, uterine, rectal and anal cancers.
    Personality Change. When our loved ones experience a personality or mood change, don’t automatically blame it on the patient — that they are moody or depressed just because they have cancer. Steroids given before chemotherapy to help prevent side effects can change a patient’s personality, even causing anger and lashing out at their caregiver. Rarely, chemo may cause depression, psychosis or mania. If these symptoms appear suddenly and are uncharacteristic, be sure to talk to your oncologist.
    Low Blood Pressure. Hypotension is the medical name for low blood pressure. We don’t normally think about low blood pressure as being a problem. However, if it drops too low, this condition may cause serious problems like fainting. Chemotherapy and biologic drugs that can cause low blood pressure include rituximab, paclitaxel, bleomycin and interleukin.
    Darkening of Skin. Also called hyperpigmentation, this weird side effect may appear 2-to-3 weeks after the start of chemotherapy. Usually, a patient’s skin returns to normal about three months after treatment.
    Ringing in the Ears. Tinnitus, the medical term for abnormal sounds in the ear, includes sounds like roaring, hissing, or humming too. Patients complain that this disturbs their sleep. Platinum-based chemotherapy drugs including cisplatin and carboplatin are the usual culprits of this unusual side effect. Tell your health care provider if you experience ringing in your ears.

    The Bottom Line …
    Never assume that a new medical issue that crops up isn’t cancer-related. Cancer treatment affects our entire body. Chemotherapy, targeted therapy, immunotherapy and radiotherapy may cause serious adverse events. Although rare, patients can experience heart-related side effects including weakening of the heart muscle (cardiomyopathy), heart rhythm problems (arrhythmia), heart attack, stroke, high blood pressure and blood clots.
    Go to the ER if you experience chest pain, palpitations, swollen feet, ankles or legs, intense leg pain, shortness of breath, sweating/nausea/vomiting or irregular heartbeats/fluttering. Don’t take a chance. Be sure to tell the ER that you are in active treatment for cancer and the treatment you are receiving.
    Better to be safe than sorry when it comes to serious treatment-related side effects. 
    What oddball or weird side effects have you experienced? List them in the comments below.
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