So many questions come to mind when someone is diagnosed with cancer. Karen Evennett put the top ones to John Newlands at Macmillan Cancer Support
Q Why is it so important to avoid infections such as colds?
Chemo drugs suppress the immune system so there’s a much greater risk of a mild infection developing into something far more serious like sepsis, which affects the bones and blood.
For this reason, we say to avoid crowds, groups of small children (they could carry infections such as chickenpox as well as colds), and, obviously, anyone with a streaming cold.
Take sensible precautions, such as washing your hands regularly, keep warm and hydrated (drink plenty), and stick with your own personal towel so other people’s germs can’t get on it.
Q Can I take immune-boosting herbs such as echinacea?
You can – but you should speak to your treatment team first. They need to know about anything you plan to take.
While echinacea may help to shorten a cold’s duration, it may struggle to do so when you’re on chemo; and it’s unlikely to prevent you catching one in the first place.
Q Are there any foods I should avoid?
It’s best to avoid takeaway foods as well as shellfish, raw eggs and pâté – all of which can harbour bugs and put you at risk of infection.
We also recommend cutting out fatty foods and red meat because they’re hard to digest and can make you more nauseous.
Q Will any particular foods boost my energy?
We don’t recommend any particular ‘superfoods’, but advise sticking to a fresh, unprocessed diet of fruit and vegetables with white meat and fish that are easily digestible.
If you’re tired and lacking in appetite, big meals may become a problem – so you may find it easier to graze on foods that pack a lot of energy into a tiny nibble – try honey, plain nuts, cream and ice cream.
If someone else can cook for you, let them – it will save on your energy. If it’s all down to you, seize energetic moments and cook batches of food that you can freeze in small quantities.
The first few days after your chemo delivery are likely to be the worst for fatigue.
Q Should I avoid eating added sugar?
Sugar’s controversial at the moment, with some people saying it fuels cancer. The fact is that all cells use a sugar called glucose as an energy source – and cancer cells use more than most because they’re so active.
But that doesn’t mean that sugar will make your cancer grow any faster. It’s a useful source of energy at a time when this is what you’re lacking, but we say natural sources, such as honey, are better for you than sugar itself.
Q Can I exercise as I usually would?
Hard gym work may be tiring and also expose you to other people’s bugs, but staying active – going for walks, dancing or gentle gardening – is important.
It stretches your muscles, gets the blood pumping around your body, and boosts your mood. All these things can make you feel a lot better.
Q What can I do to help me through nausea?
Your team will prescribe anti-nausea drugs and if these don’t work, ask for something else, as there are plenty of options. Acupressure Sea-Bands and ginger in most forms (from ginger tea to ginger-nut biscuits) also help some people.
Q Will cancer treatment affect my sleep?
It can do – especially if you’re taking steroids, so take these early in the day. The odd catnap can help you catch up with lost sleep if you’re tired.
But don’t get into the habit of sleeping too long during the day.
Q Is it OK to carry on working as usual?
Yes – but be realistic and expect to cut down your hours. If your job is physically intensive, try to swap to a desk-based role. If you use equipment that could injure you – for example if you cook – that may also need to change, as an injury could lead to infection.
Employers are legally bound to make reasonable adaptations for staff going through cancer treatment, so speak to your HR department or manager.
Q How can I protect my hair and nails?
Whether or not you lose your hair will depend on the types of chemo drugs needed. You may be offered cold-cap treatment to help prevent the loss – but it only works for around 50% of users.
✤ Don’t brush too vigorously and wash hair infrequently (once a week) with a gentle shampoo.
✤ Don’t wear false nails – they could mask signs of infection (such as black nails), and could also breakand put you at risk of infection.
Use nail-strengthening creams and an emery board instead of scissors (which could cut you and again risk infection). Use rubber gloves for housework to protect your nails.
Q Will I be more prone to mouth ulcers?
Yes, sadly, you will be, and that’s because chemo drugs can affect the sensitive lining of your mouth. Good oral hygiene can help, and you should avoid cigarettes, alcohol and spicy foods.
Your team can also recommend mouthwashes and prescribe specialist mouth-ulcer treatments that you can’t buy over the counter.
Q How long will it take me to get back to normal once chemo is finished?
You should be pretty much back to your old self after six months. Fewer than 10% of people have ongoing problems, such as fatigue, that last longer.
Some of this may be psychological too, as there can be delayed emotional fallout when the shock of what you have been through sinks in.
You may also find it hard to cope with the fact that you’re suddenly on your own, without your cancer team and regular hospital visits.
Devising your own rehab programme can help enormously, as can keeping physically active and making sure you get out to meet friends.
If you’re feeling vulnerable, call the Macmillan Support Line on 0808 808 0000. You can just say you’re having a bad day and someone will be there for you.
The helpline can also offer practical and financial advice.For more information, visit macmillan.org.uk