Chemotherapy has proven effective at killing many types of cancer cells and is almost always part of mesothelioma treatment. Though researchers have worked to minimize the adverse side effects of the toxic, nausea, hair loss, mouth sores, and fatigue are still common, and the administration itself is time-consuming and uncomfortable. Being well-prepared for the physical, mental, and emotional impact can make a real difference.
Take Time to Learn About Your Chemotherapy Treatment
Chemotherapy is a common treatment for malignant pleural mesothelioma. It is frequently prescribed to prevent the disease’s tumors from spreading or to shrink tumors in preparation for surgery or to minimize symptoms. Patients diagnosed with peritoneal mesothelioma may be dosed with systemic chemotherapy in preparation for surgery, direct administration of chemotherapy into the surgical site immediately following cytoreductive surgery, and again after the procedure intraperitoneally to support the previous treatments.
Chemotherapy drugs are being developed and improved every day, and combinations of drugs are constantly being tested in clinical trials. The specific medications that your oncology team selects will be targeted to your mesothelioma diagnosis, and the more you know about the drugs being used, the better prepared you will be. If your physician doesn’t proactively offer patient education about the effects you can expect from your prescribed treatment, act as your own advocate and ask for the information. The more you know, the more comfortable you will be when you go for your treatment.
Tips for Getting Ready for Chemotherapy
Your medical team can offer you guidance on what to expect from a clinical perspective, but there’s nothing to replace advice from people who’ve been through the experience themselves. The following tips have been collected from patients who’ve shared their knowledge about preparing for the chemotherapy experience and what worked best to minimize stress and discomfort.
Get Plenty of Rest
Fatigue is a common symptom of mesothelioma and other cancers. It can be both physical and emotional, and chemotherapy treatment can make it even worse, completely draining you of energy.[1] Cancer-related fatigue is different from the fatigue felt by healthy individuals and can be so demoralizing and discouraging that cancer patients report it as having a greater negative impact on their quality of life than any other cancer-related side effects.[2]
The best way to prepare for mesothelioma chemotherapy fatigue is to let yourself rest and avoid trying to do too much. Even on days when you’re feeling well, take short naps throughout the day and try to conserve your energy for the things that are most important to you. If there are things you feel you must do, make a priority list and attend to them when you feel your best, and ask for help with the lower priority items.
It may seem counterintuitive, but studies have shown that getting moderate exercise can make a significant difference in managing cancer-related fatigue.[2] Walking, riding a bike, or swimming may prove helpful in alleviating fatigue, but any exercise that you undertake should be individualized and tailored to your specific condition and disease stage, and with your physician’s guidance and approval.
Take in Plenty of Liquids
Being dehydrated is a significant contributor to diminished energy levels, and it is both a side effect of many types of chemotherapy and a consequence of the diarrhea and vomiting that are the treatment’s other side effects.[3] The signs of dehydration include feeling thirsty, experiencing dry mouth, lips, gums, and nostrils, increased headaches, dizziness, and confusion.
The best way to avoid dehydration is to drink plenty of water and other liquids before and during your treatment. Some decaffeinated teas can both help hydrate you and help counter nausea, and juices and milk can help too, if you can tolerate them. Sports drinks and broth that contain sodium will help you balance your electrolytes.
It can be hard to remember to drink fluids, so ask those around you to spark your memory, and take advantage of technology by investing in a smart water bottle or by adding an app to your smartphone or watch that reminds you and logs your intake. Your fluid needs will be affected by both your treatment and the type of cancer you have: a dietitian can help you calculate your individual hydration needs, as well as your caloric and protein needs.
Eat What You Can, When You Can
Nausea and appetite loss commonly accompany chemotherapy and so does a metallic aftertaste that can make eating much less appealing. Still, taking in enough nutrition will help you manage treatment side effects, increase energy, preserve immune function, and reduce inflammation. To avoid the negative effects of insufficient caloric and protein intake, eat normally before your treatment, focusing on foods that are high in protein, healthy fats, whole grains, and vitamins and minerals. Plant-based proteins like beans, legumes, nuts, and seeds all contain high levels of vitamins and minerals, and avocados, olive oil, and walnuts are high in omega-3 fatty acids that will help minimize inflammation.[4]
If you’re not hungry once treatment has begun, focus on eating small meals or nutritious snacks, and add a fiber supplement and water to avoid constipation.
Prepare for Hair Loss
Hair loss starting one to three weeks after the first treatment is a common side effect of many mesothelioma chemotherapy drugs. Ask your physician whether this is something you should expect from the drugs you’re being given, and if the answer is yes, consider cutting your hair short, or shaving your head. Doing so can be less emotionally traumatic than waking up to clumps of hair on your pillow. Before you begin treatment is also a good time to invest in wigs, scarves, turbans, or hats — there are plenty of websites that specialize in headgear specially designed to be soft and comfortable for chemotherapy patients.
See Your Dentist
Like hair loss, dental and mouth issues are common side effects of chemotherapy: The drugs are designed to attack rapidly dividing cells, and that has the unfortunate side effect of leading to mouth sores and ulcers, tooth decay, bleeding gums, and mouth infections like thrush that generally develop five to ten days following the first treatment.[5]
Chemo mouth is uncomfortable but preventable. Before you begin treatment, ask your dentist if they have experience with treating cancer patients. If the answer is yes, make an appointment to see them before your first treatment, and if the answer is no, ask your oncologist for a referral to another dentist.
Before you begin treatment, make up a mixture of 4 cups of water and one teaspoon each of baking soda and salt. This rinse can be used daily, swishing, gargling, and then spitting it out. This mixture should not be kept for more than a day, so make up a new batch each morning. Address any dental work at least one month before you begin treatment so your mouth has time to heal.
Once you’ve begun treatment, avoid spicy or acid foods and turn to popsicles or similar icy drinks and cold fruits for relief. Eat soft foods, use a soft-bristle toothbrush, and replace it with a new one 48 hours after you’ve completed treatment. If you wear dentures, keep them out as often as possible.[5]
If you do develop mouth sores, don’t suffer in silence. Ask your oncologist for help – they will probably prescribe one of several prescription rinses that are referred to as “magic mouthwash” that have been shown to help.
Prepare Your Chemo Bag
Ask any chemotherapy patient what was most valuable to them during their treatment and they’re likely to point to their chemotherapy bag. A chemo bag is an invaluable resource to help you get through the hours you’ll spend during a mesothelioma chemotherapy session. It can contain anything from snacks and water to things to do to comfort items. Start assembling your list of items ahead of time so that you’ll know how big a bag to use, but it’s a good idea to choose something bigger than you think you’ll need so you can add as you learn more about your personal experience.
Items that chemotherapy veterans recommend include:
- Books, electronic book, and magazines
- Cell phone and a charger
- Coloring books and markers or colored pencils
- Laptop or tablet (and charger)
- Hard candy to counter dry mouth
- Headphones to listen to music, white noise, or audiobooks/podcasts
- A favorite blanket and pillow (infusion rooms are often chilly)
- Lip balm
- Hand wipes/hand sanitizer
- Puzzles and brain teasers
- Sleep mask and ear plugs – Infusion rooms are often noisy, and you may want to doze off, especially if you’ve been given medication before your treatment.
- Socks or slippers with anti-grip bottoms
- Water bottle or mug
- Snacks
- Journal and pen
- Nausea medications and acupressure wristbands
- Peppermint oil to address nausea
- Lotion to soothe dry skin
- Comfort items. These may be spiritual items, notes of encouragement from friends and family, or anything else that makes you feel better to hold or look at.
In addition to all of these recommendations, it’s recommended that you dress comfortably and bring along your patience. If you can (and you want to), bring along a friend or family member for support.
Additional Advice
Everyone’s experience with chemotherapy is different, but there are tremendous benefits to be gained from other patients’ experiences. Some additional advice includes:
- Make and attend any other health-related appointments you need before beginning treatment and have all your prescriptions filled.
- Figure out how you want your bed and bedside arranged before you begin, as well as anyplace else you might sit at home, and get it set up. Lots of pillows and an extra side table are often helpful for making yourself comfortable and reaching medication, and make sure that you can easily reach and control your light source. Make sure there’s room for water, books and magazines, remote control, reading glasses, and eating. Have tissues, lotions, lip balm, hard candy, and other items already in place.
- Make sure that your laundry is done and your house is clean before your treatment.
- Prepare foods and keep them in the freezer to make reheating and eating easier.
- Stock up on Powerade, Gatorade, Ensure Clear, and saltines.
- If anything heavy needs to be moved, do it ahead of your treatments.
- Consider buying extra socks and underwear so that you don’t need to do laundry when you feel ill.
People who have already gone through chemotherapy can be your best source of information and support. If you can, speak with other mesothelioma patients to see what helped them manage their chemotherapy treatment challenges. The facility where you’re being treated may offer a mesothelioma support group that can provide guidance. It always helps to talk to somebody who understands what you’re going through.
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