Decisions about chemotherapy for bowel (colorectal) cancer
Chemotherapy is a treatment which uses drugs to destroy cancer cells. Because cancer cells are dividing quickly they are particularly susceptible to chemotherapy which disrupts...
Many people worry about having chemotherapy because of the possible side effects. These can range in intensity from mild to severe and may include fatigue, nausea, vomiting, diarrhoea, mouth ulcers, hair loss, sore skin on the hands and feet, and increased susceptibility to infection. There is no way to predict exactly which side effects any one person might experience or how severe they might be.
For many people chemotherapy also presents emotional and psychological challenges. Specialist oncology nurses can provide information and support for people undergoing chemotherapy.
The majority of people said they had been given a lot of information about chemotherapy and its possible side effects before they started their treatment although this only partially prepared them for the experience. They also felt well-supported and cared for by their oncology nurses.
People with stomas were not always adequately prepared for the effects that chemotherapy might have on them. One man with a colostomy spoke of “running to the toilet about 20 times a day” to change his bag when his chemotherapy caused severe diarrhoea. Another man with an ileostomy felt that the impact of side effects on stoma patients was not adequately recognised:
For those given chemotherapy into a vein (intravenously) devices like Hickman lines, PICC lines and portacaths (central lines that are inserted and then left in place so that drugs can be given and blood taken without having to repeatedly insert new needles), often made it easier for people to deal with their chemotherapy. For a man who was anxious about injections having a PICC line made a tremendous difference.
Some people said that their fears about chemotherapy were worse than what they actually experienced. One man had nursed his late wife through chemotherapy for leukaemia and feared his own treatment would be as severe. He explains how discussing his concerns with an oncology nurse reassured him.
Several people were especially worried about losing their hair, though the most anyone did experience was substantial thinning. One young woman explains how she feared hair loss as an unmistakeable sign of cancer:
Others felt unprepared for the severity of their side effects. One woman describes how incapacitated she was despite having been told that she could go back to work:
Those who did experience substantial side effects often found that they became worse as the treatment progressed. Several people had their treatment stopped or the dosage adjusted when they told their oncologist or oncology nurse about how bad their side effects had become.
For many, the period of their chemotherapy was a low point in their cancer experience. Some people became depressed while others were demoralised by the severity of their side effects. One man was repelled by the thought of poison going into his body and found that even the smell of the clinic upset him. Another woman described feeling as if her head was “being grilled”.
Several people described the shock of going to the cancer clinic and being surrounded by so many other sick people. For many it was the moment when the seriousness of their situation finally hit them (Interview 18).
Chemotherapy is a treatment which uses drugs to destroy cancer cells. Because cancer cells are dividing quickly they are particularly susceptible to chemotherapy which disrupts...
Advanced bowel (colorectal) cancer usually means the disease has spread from the large bowel to the liver or lungs. Treatment with chemotherapy is unlikely to...