When a person is diagnosed with cancer, the individual isn’t ready to face it in most instances. While some cancers could be cured, the impact of others could be controlled. However, everything depends on how the patient deals with the ailment. Chemotherapy is a recommended option that many patients fear, simply due to its evident side effects
such as hair loss.
In this edition of the Health Capsule, we spoke to Dr. Wasantha Rathnayake, Consultant Clinical Oncologist at Apeksha Hospital, Maharagama who shed light on why a patient should opt for chemotherapy as a remedy for cancer.
What is chemotherapy?
“Cancer cells are dividing cells and chemotherapeutic agents are toxic agents that avoid production of DNA and RNA in these cells,” said Dr. Rathnayake in his opening remarks. “When their pathway is blocked, new cells can’t grow. Cancer cells could form in hair follicles, mucous membranes or in sperms or ovaries. Since the cells are rapidly proliferating, chemotherapeutic agents work in these places. However, abnormal cells cannot be replaced.”
When is it required?
Some cancers respond to chemo while others don’t. “In conditions such as breast cancer, chemo could be administered before or after surgery,” he continued. “When there are big tumours, conducting a surgery isn’t possible. Therefore neoadjuvant chemotherapy is where medicines are administered before a surgery in order to reduce the tumour. Once the tumour is reduced, the patient could proceed with the surgery. Some other cases include cancers of the mouth, neck and cheek. Adjuvant chemotherapy is given within three to six weeks post surgery,” he said.
Preparing a patient for chemotherapy
Dr. Rathnayake also said that before conducting chemotherapy, a patient should be assessed. “If a very old patient is admitted we don’t do chemotherapy because their cells are weakening. On the other hand, children can tolerate high levels of chemo and that is why paediatric tumours are curable. We also check if the patient’s heart, kidneys and liver are functioning well. Their body weight and height are also taken into consideration. Since the patient could experience certain side effects we discuss them with the patient prior to conducting chemotherapy.”
Since chemotherapy includes toxic agents and the patients are informed of potential risks. The patient is given one cycle of chemo. And if the patient wants to continue with treatment the individual can proceed. Usually it would take six to eight cycles depending on the intensity of the cancer.
The most common side effect of chemotherapy is vomiting. “So when they visit the clinic the next time, they can experience recall vomiting,” he added. “The other common side effect is hair loss. This cannot be avoided, but after chemo is complete hair would grow. Other side effects include mouth ulcers, diarrhoea, abdominal pain and reduction of renal fluids.”
According to him, chemotherapy helps a surgeon to reduce both the size of a tumour and the pain. “Back in the day, there was no cure for cancer and in cases like osteosarcoma, the doctors had to amputate the legs. With that the survival rate was only 10%. Today, around 62-70% of cases could be completely cured.”
Watch the diet
When a person falls ill, he or she needs to control the diet. “Usually after chemotherapy a patient would have low immunity,” explained Dr. Rathnayake. “If they are exposed to germs they could fall sick. If they have heart problems they shouldn’t take salt, if they have liver problems they shouldn’t consume proteins and oils. Basically, patients need to eat cooked food. Cooking will remove germs. Therefore, even green leaves need to be cooked.
If they want to eat fruits they should peel off the thick skin first. Therefore they cannot eat fruits such as grapes, jambu or veralu. Some may also have a doubt regarding the intake of sugar and proteins since the cancer cells mainly feed on these nutrients. But remember that the other cells in the body too need to be nourished. If not, the body becomes weak.”
He also said that during the first few days, patients would have a low appetite.
“They will also experience nausea. In order to avoid that we recommend the intake of dry food such as toasted bread, bananas etc and other items that the patient could digest easily,” he added. It is also important to keep in mind that when a patient is getting a lot of chemotherapy, it will have an effect on the kidneys. Therefore patients are advised to drink a lot of water.
“After all, chemotherapy is a curative option,” he said in his concluding remarks. “What is quite important is the flexibility of the consultant. The patient is immuno-compromised and therefore requires the assistant of the consultant. Therefore he should be available at all times.”