EXCERPTS from MAKING THE CHEMOTHERAPY DECISION
From CHAPTER 1:
As you begin this book, you may not have begun chemotherapy treatments. Or you might feel you need help to fight your way through to the end of your treatment for cancer, which may be many months away. You or your family may fear the unknown physical and emotional shocks that lie ahead. You may be grappling to discover just exactly what life will hold when chemotherapy is finally complete, and you're ready to move on.
Unfortunately, it is still commonly believed that chemotherapy offers no real hope of curing cancer. Exactly the opposite is true. Chemotherapy is the most rapidly changing and dynamic area of modern cancer treatment, and new chemotherapy drugs and breakthroughs in treatment techniques continue to occur. A dozen new chemotherapy drugs were approved for use by the U.S. Food and Drug Administration in 2013. “Targeted” chemotherapy drugs programmed to attack only cancer cells are in use and produce few or no side effects. Chemotherapy vaccines as well as oral forms of several chemotherapy drugs (which are easier to take and also have fewer side effects) have begun to appear. Americans such as movie star Angelina Jolie have utilized the science of genetic testing to predict cancer risk for inherited cancers, and chemotherapy drugs are being used to help prevent particular cancers. Complementary therapies such as acupuncture and meditation are routinely offered to patients in major cancer centers, and new methods to deliver drugs for breakthrough pain are being employed to manage the side effects of treatment.
The good news is that chemotherapy treatment has become quite sophisticated. Many, many thousands of people receive chemotherapy today, and many find that their treatments result in fewer and milder side effects than they imagined. New anti-cancer drugs, new anti-nausea and pain medications, and new medical technologies have created a more comfortable and efficient healing environment. Practical new stress-relieving techniques and new holistic treatment strategies have made the physical and emotional side effects of chemotherapy less disruptive to most people's lives than ever before.
As you read this book, you may be surprised to learn that a great many people have only minor side effects from chemotherapy. Many people don't lose weight, and not everyone loses all his or her hair.
That said, it is important to note that, like many medical treatments, chemotherapy has not attained perfection. You still might have serious side effects, and you might well experience significant emotional and social stress before your treatment program is over.
This book provides you with information to make chemotherapy treatments more manageable. Included are practical suggestions to help you through the complex problems you may encounter, including the physical, social, psychological, and even spiritual repercussions of chemotherapy. At the very least, reading this book gives you a foundation of knowledge with which to discuss your treatment with your medical team. And certainly in medical treatment, as in life, a bit of knowledge properly applied can alleviate a great deal of pain and suffering …CONTINUED in MAKING THE CHEMOTHERAPY DECISION
From CHAPTER 2:
Although we don’t yet fully understand the biology of cancer, medical science already knows how to drive it into remission most of the time. This chapter describes how cancer begins inside your body, develops, spreads, and is identified prior to treatment. Comprehending cancer will help you understand how medical treatment can control it.
If you are like a lot of people, you already know cancer is serious. You may have encountered bits of information in magazine articles or on television newscasts, but these fragments of information probably don't add up to a clear picture of this mysterious disease.
Think of cancer as a nest of termites inside your sturdy old wooden farmhouse. The termites don't appear to be a problem at first. In fact, you probably don't even know you have termites for a long time. But termites cause problems if they multiply and spread, because they eat away roof support beams, which eventually will bring your wooden house crashing to the ground. Remember that termites can't destroy your house if you discover them early and get your house fumigated, which is what chemotherapy can do to cancer.
Dealing with cancer isn't easy. Modern medicine works miracles, but receiving medical treatment may make you feel as if you've been swept onto the set of a science fiction movie like Star Wars. You may feel small, powerless, and confused as you trek into a universe of pungent medicinal smells, where medical people come and go in smocks, rubber gloves, and face masks, exchanging medical terms you don't understand. Understand that this book will demystify your medical treatment—whose purpose, after all, is only to help you. It's all right to feel apprehensive. Just understand that the next few months will be easier and less threatening if you take steps to educate and help yourself.
A lot of people get cancer. Health organizations estimate that one in every three persons now alive will be diagnosed with cancer in their lifetime. No group is immune. Corporate titans, star athletes, health nuts, homemakers, and couch potatoes ... people from every walk of life are treated for cancer. One reason that incidences of cancer are rising has to do with the very success of modern medicine, which has conquered many previously fatal diseases like polio, tuberculosis, and smallpox, thus allowing us all to live the longer lives that also allow for an increased chance of developing cancer. Unfortunately, incidences of cancer do become more frequent as people age. The American Cancer Society estimates that 60 percent of all cancers occur in people over the age of sixty-five, and incidences are higher in the highest age groups. Nonetheless, a few types of cancers, such as testicular cancer or Hodgkin's disease, are far more likely to occur in children or young people.
Cancer is an old disease. References to cancer may be found in the writings of ancient Egyptians. The word itself can be traced to the writings of Hippocrates. In the fifth century B.C., more than two thousand years ago, Hippocrates applied the Greek word for crab, karkinoma, to the long and distended veins extending out from untreated breast cancers, which he apparently thought resembled the extended claws of a crab. The Latin word for crab, cancer, is still used today.
Cancer is actually a generic term for a group of about two hundred similar but distinctive diseases that all advance and spread in slightly different ways. This includes more than twenty identified types of leukemia, which are all cancers of the white blood cells but with different characteristics. Some cancers progress slowly, and some rapidly… CONTINUED in MAKING THE CHEMOTHERAPY DECISION
From CHAPTER 3:
Chemotherapy basically means medical treatment with chemicals, and it is one of the primary methods of treating cancer. This chapter explains how doctors use chemotherapy in combination with other treatments, how chemotherapy works, and why combinations of chemotherapy drugs can be effective.
Remember that 8 million Americans are alive today who have been diagnosed with cancer, including 4 million diagnosed within the past five years. Sophisticated medical treatment is the reason why most of these people are expected to survive and live normal life spans.
The three basic treatments for cancer are surgery, radiation therapy, and chemotherapy. These three treatment modalities have cured thousands and thousands of cases of cancer, relieved much pain and suffering, and extended many lives far beyond what could have been reasonably expected if the cancer was left untreated.
The three treatments may be used separately, but they are often used in tandem to treat particular types of cancer, a strategy known as multimodality therapy. A fourth well-publicized but still primarily investigational treatment is immunotherapy, which involves the use of purified proteins such as interferon and inter-leukin-2 to strengthen the immune system. Immunotherapy is sometimes used together with chemotherapy, a treatment known as chemo immunotherapy.
When a ship full of American sailors carrying deadly mustard gas exploded in Bari Harbor, Italy, during World War II, pathologists were amazed by the damage to the lymph systems and bone marrow of the sailors who had died. After the war, physicians at Yale University experimented with a related substance, nitrogen mustard, to treat cancers of the blood and lymph system. These doctors were delighted to find that the treatment markedly (but temporarily) reduced the size of tumors. Thus, chemotherapy was born. Over the years, more than a quarter of a million different drugs have been tested in government-sponsored testing programs.
Chemotherapy is the newest of the three major cancer treatments, and it remains the most rapidly evolving area of cancer control. Chemotherapy treats cancer with "anticancer" drugs, agents or chemicals introduced into the body, either one at a time or in particular combinations. Although the rate of discovery for new anticancer agents has slowed, new drugs…CONTINUED in MAKING THE CHEMOTHERAPY DECISION
From CHAPTER 4:
Unfortunately, many people’s ideas about chemotherapy, or even cancer, are based on things they saw or overheard many years ago. Chemotherapy is a relatively new treatment for cancer, and much has changed in the years since chemotherapy was first employed for the treatment of cancer.
What follows is a list of some myths surrounding chemotherapy and cancer. Knowing the myths may help you recognize these attitudes in another person. Do you suspect your friends are afraid they will "catch" cancer? Consider it your duty to set anyone straight if you hear one of these myths repeated. Speaking the truth will clear the air, and it may well make your life easier, too.
“Nobody ever survives chemotherapy, because chemotherapy is only given to people who are going to die.”
Wrong. There is no medically accepted cancer treatment that doesn't produce survivors. While this may have often been true many years ago when chemotherapy was an experimental treatment, chemotherapy is now being successfully used earlier than ever before, such as before surgery or radiation to shrink cancer. Chemotherapy completely cures many people, and extends the life span of many more. Treatment methods are improved a bit every year and survival rates are climbing, meaning more people are living.
“Chemotherapy injections are very painful."
Wrong. Receiving chemotherapy treatments is painless, except for the rare cases when there is leakage of the anticancer medication out of the vein during treatment. Physical side effects, if they come at all, typically come hours or days afterward and are also frequently not painful.
“You always go bald when you get chemotherapy."
Maybe. Not every drug or combination of drugs causes hair loss, which is usually only temporary. The extent of hair loss varies quite a lot from person to person, and is not predictable. You can learn ways to minimize hair loss, as well as other side effects. Remember that even if you lose your hair, the hair almost always grows back—and sometimes thicker than before…CONTINUED in MAKING THE CHEMOTHERAPY DECISION
From CHAPTER 5:
Your decision to have chemotherapy comes only at the end of a kind of informational dance between you and your doctor. Your doctor must understand your health as well as the type and stage of your cancer before recommending treatment, which involves interpreting your test results. You must understand something about your disease and the risks and benefits of what chemotherapy can achieve before you approve your treatment plan. After this exchange of information, which can take a few days or a few weeks, the medical treatment can begin. Ultimately the decision to undertake a particular regimen of chemotherapy treatments is yours.
After you have been diagnosed with cancer, but before you actually begin chemotherapy, your medical oncologist will present you with a range of treatment options, including the risks and benefits of each option. If your oncologist recommends a particular course of chemotherapy, you should clearly understand what the doctor hopes will be the end result of treatment.
In most cases you should seek another doctor's opinion before you decide to proceed with chemotherapy. Tell your doctor you wish to do this. Receiving a second opinion should give you more confidence in your doctor's diagnosis, and illuminate more clearly the path down which you should proceed.
Remember that chemotherapy is used against cancer because it works. But a number of variables factor into the probable success of chemotherapy, such as the age of the patient, the stage of the disease, and the types of anticancer agents chosen to treat the disease. It is important to remember that no two cases of cancer are exactly the same.
Oncologists can predict the direction in which your tumor might spread, but they cannot predict the speed at which it will move, which can be either faster or slower than most. Oncologists realize that different individuals can respond somewhat differently to chemotherapy, making cancer frustrating to treat.
Before you make the decision to begin chemotherapy, you should make two important vows to yourself:
1--I vow that I want to get well.
2--I vow that I will participate in my treatment even if it means enduring physical or emotional changes in my life.
Ideally, you will also resolve to educate yourself about ways to deal with chemotherapy's impact on you, and to take some action to help you control the process…CONTINUED in MAKING THE CHEMOTHERAPY DECISION
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