Follow-up appointments for young people with cancer
During and after treatment for cancer, patients will need to have a continuing series of tests. These may include blood tests, body scans, x-rays etc....
“…it was kind of strange that chemotherapy makes you better, but it makes, it seems to make you more ill, before you get better. So that’s quite a hard thing to get your head round. I think it took me a while to get my head round that”. – Interview 08
Chemotherapy is where you have chemical substances put into your body to fight the cancer. It can often cause unwanted effects, though some people are lucky and get through relatively easily. Common side effects of chemotherapy are feeling sick, being sick, being tired, headaches, hair loss, depression, mouth ulcers and changes to the way that you taste things. Women who have already begun to have their periods are likely to find that their periods stop or become irregular. Different types of chemotherapy have different unwanted effects and some of these can be controlled by taking other medicines.
Young people usually knew little about chemotherapy and its unwanted effects before they received treatment, although some were aware that cancer patients could lose their hair. Consultants and/or nurses usually talked to the young people with cancer about side effects and what would help deal with these effects. However one mother did complain that the doctors had not warned them about the side effects her son would experience. She said that it was frightening because they didn’t know what was happening to him.
Some of those we interviewed decided to cut their hair short or shave it off even before being treated. Although boys sometimes thought that hair loss would be worse for girls, hair loss can affect everyone’s self-image and social life. Those who spent months in hospital sometimes felt very self-conscious and uncomfortable about their absence of hair when they first started going out into public places. Although your hair tends to start to grow back as soon as your treatment finishes it can grow back in a different form – curlier or straighter or even a different colour (see ’Body image during and after the cancer’).
Boys and girls both coped with hair loss when going outside the house by using a hat or a baseball cup. Most girls preferred a hat, saying that the hospital wigs were for ‘old ladies’! And teenagers of both genders said that they didn’t let anyone, including their mums, see them with their head uncovered.
Chemotherapy can also affect the hair on your face and body. This is because chemotherapy attacks cells in your body that grow rapidly and this affects not only your cancer cells but also the cells responsible for hair growth as well. Although some of the young men who were interviewed didn’t mind losing their hair from their heads they did find it strange to be losing hair from more ‘sensitive areas’ of their body. One girl even complained that it wasn’t fair that her head was bald but her legs were still hairy!
Both feeling sick and actually being sick are relatively common when being treated with chemotherapy and can be hard to bear. For some, the first course of treatment was sometimes the worst for being sick, but others felt nauseous throughout the course of their treatment. Ginger can help (either ginger root or ginger drinks) and anti-sickness tablets can also be very effective, but these can also occasionally cause side effects of their own, for example dizziness and tiredness. Different types of anti-sickness medication are available so if one doesn’t work it is worth trying another one.
Steroids are another medication which may be used during a course of chemotherapy, for a number of different reasons. People who have leukaemia or are having treatment to shrink a brain tumour may be given steroids at a high dose. These high dose steroids can cause people to feel energetic (even hyperactive) or be unable to sleep. Some young people also reported puffiness, an increase in appetite and weight gain or mood swings.
Some experienced pain whilst having chemotherapy. Usually this pain was a reaction to a specific drug in the treatment and tended to last no more than a day or two. Luckily there are very good ‘pain control therapies’ and the key is to let nurses and doctors know that you are in pain early on, whilst having therapy.
Having ulcers in the mouth is another fairly common side effect of chemotherapy and can make it hard to eat if really bad. For some, these mouth ulcers were their worst side effect – and could last throughout the whole of chemotherapy. Curiously some chemotherapy also leaves people with a strange, metallic taste in the mouth or makes certain foods taste different.
It is no surprise that during their treatment, people often feel exhausted and had little energy do to anything, although they usually started to feel better a few days later.
It is certainly worth remembering that almost all unwanted effects are short term and gradually disappear after the treatment. In one case, one young man began to experience hearing problems following chemotherapy and his doctor said that it might last from six months to two years.
Young people can be philosophical and even funny when talking about the side effects of their treatment(s) and of having to take many medications in order to alleviate or control their symptoms.
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