Collateral Damage

Like many cancer patients, one of Laura Volpini’s biggest fears about her treatment were the side effects she had heard so much about.

Diagnosed with breast cancer, she would undergo radiation therapy following her lumpectomy, and then chemotherapy. She’d heard horror stories of exhaustion, chemo brain, and extreme weight loss, and thought she knew what to expect. “I have family members that have had cancer who were always sick…I had seen all the side effects, the constant nausea, the weakness, the not being able to remember things. I had kind of braced myself for that,” she recalled.

Laura Volpini
Laura Volpini

In reality, Volpini was taken aback when she experience minimal effects, including some nausea. This disappeared when she discussed it with her doctor and was prescribed a powerful new medication, which completely counteracted it. “I was surprised, I was eating my regular meals and I had no serious side effects.” She experienced hair loss and some fatigue, other common issues, but this didn’t phase her.

The effects were so minimal that Volpini was able to continue working part time while she underwent treatment. She found that she could conserve energy by pacing herself. Working from home allowed her the freedom to take breaks and rest when she needed it. Six years later, she’s thrilled to be cancer free. She’s still on an estrogen blocker to prevent recurrence, but has experienced no lasting effects from her chemo or radiation.

Her physician, Dr. Ravi Patel of the Comprehensive Blood and Cancer Center explained that it’s not unusual to hear stories like hers. “The side effects of chemotherapy and radiation therapy over a period of time have gotten better to control and have improved since the treatment delivery and the ability to control the side effects have gotten better.”

A patient visits with family as they receive treatment.
A patient visits with family as they receive treatment.

Other good news is that newer drugs can be targeted to spare normal bodily tissue and focus only on the cancer cells themselves, another way that patients today are receiving better, safer care than ever.

Some of these side effects are nausea and vomiting, and lowered red and white blood cell counts for chemo. Radiation can bring mouth sores, cough, and skin irritation or pain. Even if patients experience these issues, there are many ways to mitigate them. New medications can increase white blood cell count, allowing patients to visit with their families without the fear of getting sick. Antibiotics can also be used to help prevent infections, and meds can curtail 90 to 95 percent of the nausea and vomiting.

“Chemo brain” is one of the most common fears that Dr. Patel hears from newly-diagnosed patients. But, he shared that a lot of the associated symptoms (brain fog, memory loss) have more to do with stress and feeling overwhelmed, coupled with exhaustion caused by the treatment itself.

To counteract this, he suggested that patients keep their mind occupied and engaged, and stay active.

While someone’s immune system may be weakened while undergoing treatment, there’s no reason for them to be cut off from the outside world. “Cancer patients worry that if they’re getting chemotherapy that they should not go out or they will risk infection, but…in more than 90 percent [of cases] we can let them continue doing what they want to.” He went on to say, “Patients should remember that even if they do get chemotherapy, they can still go to work, socialize with the family, enjoy their life, and can live very meaningful lives during the time that they are getting chemotherapy.”

Advancements in chemotherapy have helped make treatment more effective, while causing minimal adverse effects.
Advancements in chemotherapy have helped make treatment more effective, while causing minimal adverse effects.

While it can often feel like you are powerless when it comes to cancer, that’s definitely not the case. Making lifestyle changes such as eating healthy and getting exercise can be beneficial whether you’re undergoing treatment or looking to cut your risk of developing the disease. Colorectal cancer in particular is associated with high animal fat intake, so Dr. Patel recommends cutting back on red meat, and eating more fruits and vegetables, which are safe to eat for cancer patients as long as they are thoroughly washed. He recommends eating hormone-free chicken, more fish, and white meat. Other changes like maintaining a healthy weight or quitting smoking can also make a significant difference.

A common misconception is that patients shouldn’t continue to work out, but this isn’t the case. “It’s okay to exercise, there are medicines that you can be given so that you don’t get fatigued. But overall there’s been a beneficial connection related to exercise. Whenever you exercise, it increases your endurance and even in cancer patients there’s indications that it has an overall beneficial effect for protecting them from a variety of complications related to treatment.” As long as you have your doctor’s go ahead, exercise could be a powerful tool to make sure your body stays in fighting shape.

Dr. Everardo Cobos of Kern Medical agreed and emphasized the importance of taking a positive approach to your treatment. “Really, the best thing to do is eat healthy [and] get plenty of rest.” From there, “doctors and nurses will instruct the patient on specific side effects to look for and what to do. Keep in mind that we now have over one hundred different types of treatments.” These many options include immunotherapy, which harnesses the body’s own immune system to help fight cancer. Much like how your body would normally defend against a cold or virus, these treatments help stimulate a patient’s own immune system to attack cancer’s fast-growing cells. “Immunotherapy uses medications (drugs) which can activate our own immune system to attack cancer. Typically the immune system does not attack cancer because they arise in our own body and the immune system was not designed to attack us. These novel drugs activate [and] reprogram the immune system to recognize and attack cancer.”

Since immunotherapy is much different from other treatment options such as chemotherapy and radiation, it has different side effects. Sometimes the immune system can end up targeting non-cancerous tissue such as the skin, lungs, and liver—similar to mild Lupus-like symptoms, or other autoimmune diseases.

Besides immunotherapy, there are many forms of oral chemo drugs, which target a chemical process or specific mutation of cancer cells, thus sparing healthy ones and cutting down on unwanted effects. “There are many patients who go through treatment with minimal effects, the treatments are much more effective and for many patients they are able to carry out their daily activities and some even continue to work.” Dr. Cobos emphasized that if you do experience a side effect such as nausea or tiredness, “Communicate with the staff what you are experiencing to allow them to take steps to minimize the symptoms.”

Not only are treatments more powerful and targeted, but there are also less side effects, and more options for reducing them. Even if you’re faced with this life-changing illness, being diagnosed with cancer doesn’t have to put the brakes on your life; you have more control than ever to live your life to the fullest.

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