Germ Cell Tumors Health Article

Coping with cancer treatment

The use of chemotherapy and radiation therapy in addition to surgery has greatly increased the numbers of germ cell tumor patients that survive; but both of these treatments unavoidably result in damage to some healthy tissues and other undesirable side effects. Some of the more common side effects of chemotherapy include:

• hair loss (alopecia)
• fatigue and weakness
• nausea and vomiting
• bed wetting

Hair loss is a very common side effect of many drugs used to treat cancer. Getting a sample of hair before hair loss begins is desirable in case a wig is desired after hair loss begins. The patient's hair color and texture could then be more closely matched. Hair may thin out gradually or it may come out in big clumps. To slow down the rate of hair loss, avoid any unnecessary sources of damage to the hair, like curling, blow-drying, or chemical treatments.

Hair loss is a difficult part of dealing with cancer for all patients past infancy, especially for teenage patients. Children should be given the right to choose their own way of coping and their choices should be supported. Children may choose to remain bald, or may want to choose hats or scarves instead of wigs. Schools may need to be persuaded to allow a child to wear some kind of head covering. It is important to assure the child that loss of hair is a sign that the medication is doing its job, and that hair loss is temporary.

Hair usually begins regrowth within a few months of the end of intensive chemotherapy, although it may begin to thin out again during the course of maintenance drugs. Sometimes hair comes in a different color or texture than the original hair. It may be a good idea to prepare a child for that possibility.

Fatigue and weakness are other common side effects of chemotherapy. Side effects of the chemotherapy medications, along with the natural depletion of the body's resources as it fights off the disease and normal psychological consequences of the disease such as depression combine to make fatigue a very significant part of coping with cancer treatment.

The best way to deal with these symptoms is to cut back on activities and allow plenty of time for resting to let the body heal. Patients should avoid as much extra stress as possible, limiting visitors if necessary in order to avoid being overtired. Children should not be forced into the role of invalid. Children must be allowed to pursue normal activities and hobbies as much as possible. Parents can best manage this by helping to select those activities that the child considers most important, and by providing a backup plan for times when the child does become too fatigued, such as alternate means of mobility (for example, a stroller, wheel chair or other acceptable and safe vehicle). It is also important to make sure that a well-balanced diet is provided.

Nausea and vomiting are also fairly common side effects of many chemotherapy drugs. Radiation to the brain or the GI tract can also cause nause and vomiting. After a few courses of chemotherapy drugs, some patients will become nauseated just from the thought of an upcoming treatment, or from smelling certain odors that act as nausea triggers. Drugs that combat nausea and vomiting can be prescribed, but are often not effective for anticipatory nausea. There are self-help measures that can be tried. If nausea and vomiting are a problem, heavy, regular meals should be avoided in favor of small, frequent snacks made up of light but nourishing foods like soup. Avoiding food smells and other strong odors may help.

Desensitization, hypnosis, guided imagery, and relaxation techniques may be used if nausea and vomiting are severe. These techniques help to identify the causes which trigger the nausea and vomiting, decrease patient anxiety, and distract the patient from thinking about getting sick. In children, activities like playing video games can be offered as very effective means of distraction.

Bedwetting is another common side effect of anticancer drugs, and one which can be especially distressing for older children. A child who experiences this problem should be reassured that the problem is temporary and will go away when the drug treatment is over. Parents can help the child cope by keeping extra linens ready or covering the wet spot with towels kept handy and most of all, by conveying an attitude that wetting the bed is not a big deal. Children should never be punished. It may also help to limit drinks for a couple of hours before bedtime, or to wake the child at regular intervals overnight to use the bathroom.

The biggest problem for those undergoing radiation therapy is the development of dry, sore, "burned" skin in the area being treated. Radiation does not hurt during treatment and does not make the person radioactive. Skin in the treatment area will become red, get itchy and sore, and may blister and peel, becoming painful. Patients with fair skin, or those who have undergone previous chemotherapy have a greater risk of more serious reactions. Dry, itchy or sore skin is temporary; but affected skin may be more sensitive to sun exposure for the rest of the patient's lifetime, so a good sunscreen should be used whenever affected skin is exposed to sunlight.

Fear and anxiety are major factors in coping with cancer, including cancer treatments. The feelings are completely normal. Some patients find that concentrating on restful, pleasurable activities like hobbies, prayer, or meditation is helpful in decreasing negative emotions. Support groups are another useful tool, since they provide an environment where fears can be freely expressed and understood.