Table of Contents
Introduction.
Part I: Your Journey Through Cancer Treatments: Preparing for the Trip.
Chapter 1: Recognizing the Realities of Chemotherapy and Radiation.
Chapter 2: The Mutants Take Over: A Primer on Cancer.
Chapter 3: You Will Be Tested: What All Those Tests Show.
Part II: Your Choices along the Way: Making Good Ones.
Chapter 4: Defining Chemotherapy: The Anticancer Drugs.
Chapter 5: Defining Radiation: A Burning Issue.
Chapter 6: Setting New Standards: The Role of Clinical Trials.
Chapter 7: Getting a Second Chance: Bone Marrow Transplants.
Part III: Chemotherapy: What to Expect and How to Deal with Side Effects.
Chapter 8: What to Expect During Chemotherapy: A Head-to-Toe Mouthwash.
Chapter 9: Gimme a Boost: Immune and Bone Marrow Stimulants.
Chapter 10: Coping with Serious Side Effects of Chemotherapy.
Chapter 11: Coping with Less Serious Side Effects of Chemotherapy.
Part IV: Radiation: What to Expect and How to Deal with Side Effects.
Chapter 12: What to Expect During Radiation: Tattoos and Moisturizer.
Chapter 13: Coping with Side Effects of Radiation Therapy.
Part V: Your Success Strategies: Assembling Your Support Team.
Chapter 14: Your Health Professionals: Your Friends and Guides.
Chapter 15: Good Nutrition: Eating Right No Matter How You Feel.
Chapter 16: Meeting Spiritual Needs: Turning to Prayer and Meditation.
Chapter 17: Finding a Support Group: Realizing You Are Not Alone.
PartVI: Your Future after Cancer Treatments: Looking Ahead.
Chapter 18: Finishing Therapy: An End and a Beginning.
Chapter 19: Dealing with Recurrence: Here We Go Again.
Chapter 20: Defining Yourself after Cancer: The New Normal.
Part VII: The Part of Tens.
Chapter 21: Ten Myths about Cancer.
Chapter 22: Ten Ways for Family and Friends to Help You.
Chapter 23: Ten Things Beyond Your Control.
Chapter 24: Ten Ways Life Will Be Better after Cancer.
Chapter 25: Ten Sources for More Information.
Glossary.
Index.
Read a Sample Chapter
Chemotherapy and Radiation For Dummies
By Alan P. Lyss John Wiley & Sons
ISBN: 0-7645-7832-4
Chapter One
Recognizing the Realities of Chemotherapy and Radiation
In This Chapter
* Taking time to absorb the news
* Finding your way in a new culture
* Sorting out treatments and side effects
* Building a support team
* Changing to reflect a new perspective
You've been told that you have cancer. You may have seen it coming, but more likely this news came out of nowhere to frighten you and shake up your world.
Cancer! How can that be?
Here's how: The Centers for Disease Control reports that more than 18 million new cases of cancer have been diagnosed since 1990, and the government agency estimates that at least 1.3 million new cases will be diagnosed in 2005. One out of every four Americans dies of cancer. In fact, the American Cancer Society announced in January of 2005 that cancer has surpassed heart disease as the leading cause of death for people under 85 in the United States.
On the other hand, more than ever before the words cancer and death do not necessarily belong in the same sentence. Each day brings news of improvements in screening tests and in treatments. And, happily, survival rates for cancer are at an all-time high in the United States. So, instead of spending time and energy asking "Why me?", we encourage you to take a deep breath and get ready to begin your journey through cancer treatments.
Inthis chapter, we talk first about taking time to come to grips with your diagnosis. Then we offer suggestions on how to choose a doctor. Next, we present a road map of the rest of this book, where every twist and turn on your journey is clearly marked.
Making Peace with Your Diagnosis
The longest journey begins with a single step, or so an ancient Chinese proverb tells us. You have many steps in store as you make your way through the coming months. But before you take the first step, you have an important task.
Registering your emotions
"First," says one woman we know who was diagnosed with cancer in 1997, "you scream." She is right, even if that scream is silent. This is a logical emotional response. After all, you have never before heard the words, "You have cancer." When you do hear these terrifying words, you may have to ask that the doctor repeat the bad news. Some people recall that on first hearing them, these words sound dim and far away. Others report that their bodies begin to tremble involuntarily. And others appear to remain stonily silent, even as their minds race. Whatever your first reaction, you need time to make peace with your diagnosis.
Taking time to process the news
More likely than not, you won't be thinking clearly at first. You may start to tally up the people you know who have died of cancer, and you probably will wonder if you're going to die, too. At this point, you simply don't have enough information to know what the future holds. You may find yourself totally focused on the diagnosis, but that focus may be chaotic, with hope and fear fighting for your attention even as you try to frame important questions for your doctor.
REMEMBER
Give yourself a break. Adjusting to the news that you have cancer takes time. Complete acceptance - if there is such a thing - won't come in a day or a week or even a month, but gradually, you will adjust to the diagnosis. Long before that happens, you may find yourself heading into the operating room for cancer surgery or preparing for your first chemotherapy or radiation 10 Part I: Your Journey Through Cancer Treatments: Preparing for the Trip appointment. Don't be surprised if, from time to time, you experience the same shock and fear all over again that you felt when you first heard the news.
Experiencing a range of emotions
About that recurring shock and fear: These are completely normal emotions. In fact, you likely will go through repeated periods of denial, anger, bargaining, depression, and acceptance. You may recognize these as the stages that people experience when confronting death. In this instance, you are experiencing the loss of life as you know it, the loss of good health, and the loss of feelings of immortality, so it makes sense that you experience these stages, even if you have treatable cancer.
TIP
Expect to take more than one ride on the emotional roller coaster as you move back and forth between a range of feelings. This process definitely involves taking two steps forward and one back.
Over time, you will come to recognize when your emotional well-being is at risk, and you will take comfort in knowing that a period of emotional upset most likely will be followed by a period of calm.
Telling family and friends
Early on, after you have processed the news about your diagnosis and are ready to talk about it, you likely will want to tell family members and close friends so they can make themselves available to provide emotional support - and practical help as well. Many people who are newly diagnosed also want to speak with someone who has had cancer, someone who already has been through treatments and lived to tell the tale. In fact, you may find yourself having an exceptionally keen interest in hearing these tales! If you don't know who to call, you may want to ask your doctor if she can have a survivor get in touch with you.
REMEMBER
This is a good time, as you begin to gather information about your diagnosis and potential treatments, to talk with someone who has been there. That said, every individual - for a variety of reasons - experiences cancer and the treatments differently, so remember that the details of someone else's story may not apply to you at all.
You also may want to speak with your boss, as your work schedule and obligations may be directly affected by your treatments. Who else needs to know?
That depends on what type of person you are: The type who needs to tell as many people as possible, or the type who wants to tell as few people as possible. You know yourself best and will act accordingly.
Gathering Information
Knowledge is power! In Part I of this book, we help you get acquainted with the facts about cancer - which actually is more than 100 different diseases - and we describe the tests available to help determine the best treatment for you.
Up until the moment of your diagnosis, you may not have known much about cancer - what it is or how it works (which we discuss in Chapter 2). Now, of course, you want to find out more so you can have an idea about what the coming year holds for you. That's a good, positive approach. A poster passed among people going through cancer treatments reads, "When you know the facts, you can make a plan."
Before you make your plan, your doctor will provide you with specific information about your cancer and recommend appropriate treatments. A number of sources can supply general information, including
This book
Other books
Free booklets published by health agencies
Web sites (see Chapter 25 for some recommendations)
Newspaper and magazine articles
Some people whip through every bit of reading material available on the type of cancer that they have. Others confine their reading to material that specifically relates to the immediate situation. (We think the latter is a wiser approach.)
REMEMBER
You don't have to learn enough to earn a degree in cancer, and you don't have to mold yourself into the perfect patient. Your job is to educate yourself about your specific cancer, get through your treatment, and get on with your life.
Shopping for Cancer Specialists
When we say that it is your job to educate yourself about your cancer and your treatments, please don't think that the responsibility rests entirely on your shoulders. You will have help - a lot of it. Some people first learn that they have cancer from a surgeon or another specialist. When it comes time to do the tests that determine the extent of the cancer - and you can read more about these tests and how to assess your results in Chapter 3 - you need to see a medical oncologist, a medical specialist who treats cancer. If radiation therapy is recommended for you, your medical oncologist will refer you to a radiation oncologist, a medical specialist who treats cancer patients with radiation therapy.
Finding good doctors
These cancer specialists and other doctors along the way will direct your care and serve as important members of your support team. In Chapter 14, we offer some suggestions for building good relationships with your doctors. Of course, before you can build relationships, you have to choose the doctors. A number of factors come into play, including
The type of cancer you have
Your age
Your general health
The number of doctors or medical centers available where you live
Your insurance coverage - or lack of it
Obviously, you want the best care that you can get. Given the state of healthcare today, some choices will be up to you and some will not, no matter what your specific circumstances. In any case, you most likely don't want to choose a doctor simply by opening the telephone book and picking one with an office close to your home.
Here are some sources to help you choose your cancer doctors:
Your primary care doctor (internist or family doctor) or surgeon
The referral department of a large medical center
our local medical society
Professional medical associations
A relative or friend who has personal experience with cancer
When you have a name or two in hand, make an appointment for a consultation. Ask the receptionist what you need to do to make any test results, x-rays, or surgical reports available to the doctor. After that information is gathered, sit down with the doctor and hear what he has to say.
TIP
If you have a friend or family member who can accompany you for your first visit to the oncologist, take advantage of that help. Another pair of oars could be helpful as you navigate these unfamiliar waters!
Afterwards, think about what you heard. Think about how you felt while you were hearing it. Think about spending the next several months carrying out a treatment plan under the direction of this particular doctor. If you have found a good fit for you, then proceed.
TIP
If for any reason you're not satisfied with what you hear, or you are uncomfortable about how you feel, make an appointment with the next doctor on your list.
Second opinions are common in oncology, and most oncologists expect and encourage you to seek one, just so you are comfortable as you proceed with your treatment. A good closing question with the oncologist is "Who would you go to see if you were me and you wanted to be sure that you were on the right path?" If you think that the doctor is uncomfortable with this question, move on!
Preparing to embrace a new culture
After you have chosen a doctor, you quickly will become aware that not only are you in the hands of a new medical professional, but you are entering what may seem like an entirely new culture full of people who speak a new language. (For a crash course in the language, see the glossary in the appendix.) There is much to learn about your particular cancer, of course, but that is just the beginning.
What's next?
Tests to take
Treatments to undergo
Side effects to endure
Strategies to implement to manage those side effects
More specifically, just to give you a few examples, you will find yourself wondering about the following:
Your blood cell count
Survival statistics
How radiation works
Long-term effects of chemotherapy
How to avoid nausea
Where to buy a wig
Long-term effects of radiation
How to care for your skin
Clinical trials of new and (potentially) better treatments
And that's just part of your new culture!
Sound confusing? That's why you have this book. We walk you through every step. But first, we have some advice. While you are learning the new language and sorting out your place in the new culture, you also want to keep your eye on the future.
TIP
When you have a treatment plan in place, grab a calendar and mark on it the proposed schedule for your chemotherapy and/or radiation treatments. Seeing exactly how long all this will take also allows you to see all those dates left on the calendar after treatment, when your life will once again be your own.
Considering Options
Part II of this book is all about options - treatment options, choices regarding delivery of treatments, and the possibility of participating in a clinical trial. Here too you can find complete information on bone marrow and stem cell transplants.
Understanding chemotherapy and radiation
Medical science is currently learning about and testing some ways to turn off the misguided cells that undergo a mutation and get busy transforming into cancer cells that attack the body. Today, chemotherapy and radiation are the time-tested standard treatments for most cancers. Many people diagnosed with cancer have both treatments, sometimes concurrently and sometimes one after the other. Some people have just one.
Basically, most chemotherapy is systemic; it involves any number of anticancer drugs that sweep through every cell in the body. In contrast, most radiation therapy is local or regional, meaning treatments are aimed specifically at the site of a tumor or at nearby places the tumor may have spread.
How do these two treatments work? Check out Chapter 4 for details on chemotherapy. We discuss more than half a dozen different types of anticancer drugs. Also, though most chemotherapy drugs are delivered directly into a vein, some are injected into a muscle or a tumor. Some chemotherapy drugs even come in pill form. Who knew? Well, if you didn't, see Chapter 4.
Looking for the inside story on radiation therapy? In Chapter 5, you find out about the two main types of radiation therapy - external beam radiation and brachytherapy - as well as some additional types of treatment.
TIP
Sometimes your doctors provide you with information and allow you to decide which treatment to pursue. Don't hesitate to ask what choice the doctor would make for a family member, as that may help you with your decision.
In any case, carefully evaluate the benefits and risks of all your treatment options. The decisions you make today may well affect the rest of your life.
REMEMBER
Treatments for life-threatening diseases often carry long-term physical costs, such as decreased organ function now or increased risk for other diseases ten years down the road. Paying the price is always easier if you are wellinformed before you begin treatments.
Looking into clinical trials
One important option to consider is whether to participate in a clinical trial. These trials, or tests, of new treatments or new combinations of tested treatments lead the way in cancer research. That means the participants in clinical trials are on the cutting edge of medical science. We spell out the pros and cons in Chapter 6, where you also find questions you may want to ask your doctors, as well as reports from participants who have chosen to be part of clinical trials.
Taking a chance on a transplant
Sometimes, in cases where cancer does not respond completely and permanently to standard treatments, doctors recommend bone marrow and stem cell transplants. This is serious stuff, medical miracles of the first order - or so we hear from individuals whose lives have been saved as a result of a transplant. Chapter 7 tells you everything you need to know about the purpose of transplants, the different types, how transplants are done, what to expect afterwards, and how to prepare yourself emotionally.
Exploring Virtual Chemotherapy
There is nothing like the real thing, of course, but in Part III of this book, you come as close to experiencing chemotherapy and all the side effects as you can without actually feeling the powerful anticancer drugs drip into your body.
(Continues...)
Excerpted from Chemotherapy and Radiation For Dummies by Alan P. Lyss Excerpted by permission.
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