How to recover your period after chemotherapy. Condition after chemotherapy

Cancer and its threat undoubtedly bring about many changes in a woman's life. One of the changes that a woman can undergo is the development of menopause symptoms.

Exactly how chemotherapy causes menopausal symptoms has not been studied exactly, but it is clear that such treatment can intermittently or permanently affect menstrual cyclecausing early menopause.

Chemotherapy leads to premature menopause in 30% of women who have undergone this treatment, and especially often those over forty years old. Symptoms of natural and premature menopause are the same, but they can progress in more acute formif the climax has come ahead of time... This happens because, in a natural process, the body adapts to future changes over several years, and an early menopause causes a sudden and sharp hormonal disruption.

The content of the article:

Effects of chemotherapy on the ovaries

The arrival of early menopause largely depends on the age of the patient.

Women are born with a limited number of eggs in their ovaries. As the body ages, the supply of eggs decreases. Certain types of chemotherapy can damage or destroy eggs, reducing these supplies even more. The effect of chemotherapy on female reproductive function depends on age, dosage and use of others drugs.

The incidence of early menopause after chemotherapy is difficult to determine because there are many possible influencing factors. The rate at which menopause occurs depends on the woman's age and the type of chemotherapy. The rate of early menopause can range from 0 to 100%, depending on the type of chemotherapy, age and number of eggs. In the case of young girls, this indicator can be from 21 to 71%, in the case of older girls - from 49 to 100%.

There are many chemotherapy drugs that can affect a woman's fertility. A group of drugs called alkylating agents is most likely to affect the egg production process.

Cyclophosphamide is one of the most commonly used drugs for the treatment of breast cancer and is an alkylating agent. Taxol, also used for breast cancer, has a similar effect on ovarian function.

The risk of menopause increases with age, most likely due to the fact that older women have fewer eggs than younger women. For example, chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (these three drugs are most commonly used to treat breast cancer) typically results in loss of ovarian function in 33% of women under 30, 50% of women between 30 and 35 years, 70% of women aged 35 to 40 years and 95% of women 40 years and older. Chemotherapy in combination with radiotherapy is also associated with an increased risk of menopause.

The effect of chemotherapy on the onset of menopause

After chemotherapy, menopause usually does not come immediately

During chemotherapy, a woman may have irregular menstrual cycles or amenorrhea (no menstrual cycles). Some medical suppliesused in chemotherapy can also damage the ovaries and lead to menopause symptoms.

Menopause can occur immediately or after a certain period of time, be temporary or permanent, when it is triggered by chemotherapy.

There is no way to know exactly when and how chemotherapy or other cancer treatments will affect menstrual cycles. However, we can confidently say that the likelihood of early menopause depends on a number of factors, which include:

• woman's age;

• the quality of ovarian function before treatment;

• the type and dose of chemotherapy that was applied;

• the dose of radiation that was received, as well as the area of \u200b\u200bthe body that was irradiated.

Menopause rarely occurs immediately after chemotherapy. When chemotherapy treatment begins, a woman may notice some of the symptoms of menopause, but these symptoms usually appear several months after treatment is started. It `s naturally.

Symptoms of menopause can continue for several years after treatment is completed.

Menstruation after chemotherapy

Every woman's menstrual cycle is different. Some women may experience less frequent menstrual periods than they had before chemotherapy. Sometimes menstruation may be absent, and sometimes the number of days between periods may increase. Other women may experience an increase in their periods. There are those who do not observe any changes in the duration, but the intensity of bleeding is not the same as before the use of chemotherapy (the number of days or the volume of blood may increase or decrease). A mixed picture of changes is also common: women may experience shorter cycles with more intense and heavier periods, or shorter ones with light periods and little blood.

Remember! Even though menstrual cycles tend to be irregular in the time before menopause, it is important to be aware of bleeding that is not normal for you. It is very important to call your healthcare professional if you experience heavy bleeding accompanied by weakness or dizziness.

Menstrual cycles resume after chemotherapy

Many women maintain or recover ovarian function and resume their menstrual cycles after completing chemotherapy.

Recovery depends on:

• the woman's age before treatment;

• the type of drugs she used during treatment.

Recent Research

Giving the ovaries rest when a young woman with breast cancer is undergoing chemotherapy can help prevent early menopause and preserve fertility. According to a 2011 study published in the Journal of the American Medical Association, stopping the ovaries with the hormone triptorelin during chemotherapy may prevent early menopause.

Triptorelin is given to protect the ovaries by temporarily stopping their function, although it is not yet fully understood why this happens. The authors of the study found that 63% of women who use triptorelin during chemotherapy retain their menstrual periods, while those who use only chemotherapy, this rate is only 50%.

Researchers suggest that this fact may help women with breast cancer avoid early menopause. About 6% of women with breast cancer are diagnosed with this diagnosis before they turn forty.

Oncological diseases are increasingly affecting young and middle-aged people. It used to be that older people mostly died of cancer. Now this evil disease is mowing down everyone, even newborns. Stomach and lung cancer mainly affect men, breast cancer - the weaker sex. More and more asserting themselves malignant tumors skin, intestines. Causes? It is impossible to name one. But it is obvious that stress and abuse of the sun's rays are often pushed to the development of a tumor.

How to eat

Chemotherapy often adversely affects organs digestive tract... Patients who eat properly during this period tolerate side effects more easily.

If before the start of chemotherapy the patient had no diseases of the gastrointestinal tract, liver and pancreas, it is recommended to include in the diet protein, dairy, bread and cereals, and fruit and vegetable diets.

Protein group:beans and peas, nuts and soy products, eggs, fish, meat (veal, beef, pork, poultry), liver. It is advisable to eat foods of this group twice during the day. For example, eat a cup of boiled beans or 2 eggs, or 60-90 g of meat, fish, poultry, etc.

Dairy group:kefir, fresh yogurt, fermented baked milk, yogurt, cottage cheese, milk, cheese, butter, condensed milk - your choice. It is believed that lactic acid biokefira enriched with bifidobacteria, bifidok are more useful. You need to eat dairy products twice a day. For example, 1 glass of kefir or yogurt, 30 g of cheese or 90 g of cottage cheese, or 1 glass of milk, 1/3 cup of unsweetened condensed milk or 1/3 of an ice cream briquette.

Fruit and vegetable group:all types of raw and boiled vegetables, salads and fruits, as well as juices and dried fruits. This is especially helpful on days when anticancer drugs are administered. It is advisable to eat 4-5 times a day citrus fruits (grapefruits, tangerines or oranges), apples and vegetables containing vitamin C - zucchini, eggplants, cabbage (white, cauliflower, Brussels sprouts), bell peppers, beets, carrots are required. Greens are useful - lettuce, dill, parsley, green onions, celery. Start each meal with fresh fruit or a glass of fruit or vegetable juice (you can mix 1/2 cup each of carrot and beetroot juice) and a salad made from raw or cooked vegetables.

Bread and cereals group:bread, oatmeal, corn and wheat flakes, a variety of cereals, cookies. According to the degree of usefulness, cereals are arranged as follows: buckwheat, oatmeal, oatmeal, oatmeal, semolina, barley, Poltava, rice. It is necessary to eat such food 4 times a day.

Add creamy or vegetable oil, sour cream or mayonnaise to increase the calorie content of food.

With any diet during chemotherapy, in the intervals between courses and after its completion, be sure to take daily multivitamins, for example, "Decamevit", "Undevit", "Complivit" 1-2 pills per day, as well as concentrates of the drink "Golden Ball" ... From imported vitamins - complexes of multivitamins with microelements. It is advisable to combine the intake of multivitamins with ascorbic acid.

During chemotherapy, carrot, beet, tomato, raspberry, and lingonberry juices are especially helpful.

If there is no edema and kidney disease, in which the excretory function is impaired, drink 1.5-2 liters of liquid a day - mineral water, tea, milk, lemon and other drinks. If there is swelling and fluid in the abdominal or pleural cavities the amount of liquid drunk should not exceed the amount of excreted urine by more than 300 ml. Alcoholic drinks are excluded during the course of chemotherapy.

Decreased appetite

Patients can lose 1–2 kg of weight during chemotherapy sessions. But with proper nutrition they recover during a break between treatments. Appetite usually disappears on the day of the procedure, this is observed for several days. In such cases, eat as much as possible in between courses when your health improves.

If your appetite is very poor, eat the most high-calorie foods between meals: nuts, honey, eggs, whipped cream, chocolate, sweet creams, ice cream. Keep a light snack handy and eat it in small portions.

Food should whet your appetite. Pay great attention to spices, sauces, and various seasonings. Low-fat meat and fish broths are desirable. Spices and aromatic plants - parsley, dill, cinnamon, cumin, juniper berries, cloves, coriander, lemon and orange peel, capers, mint, nutmeg - help to increase appetite, secretion of gastric juice and ensure good digestion. If there are no diseases of the oral cavity and gastrointestinal tract, pepper, mustard, wine or apple vinegar, as well as a decoction of chaga, tincture of wormwood herbs, trefoil leaves, centaury, oregano. If the liver is functioning normally and the attending physician does not prohibit it, then it is possible to use dry wine, Cahors, beer before meals between chemotherapy courses. Finally, pickled, sour and salty vegetables help to improve appetite. They can be eaten if there are no contraindications, as well as sour juices - lemon, cranberry, currant.

Nausea and vomiting

Treatment with many anticancer drugs is often accompanied by nausea and vomiting.

There are many antiemetic drugs available to prevent vomiting. In addition to numerous medications, nausea can be reduced if:

1.Sleep with an open window, and in the morning take walks in the fresh air.

2. Before breakfast, suck on a piece of ice, a slice of frozen lemon, sour plum, cherry plum or a few cranberries, lingonberries.

3. There are dry foods on an empty stomach: crackers, dryers, toasts, chips, cookies, etc.

4. Eat small meals throughout the day so that the stomach does not experience fullness.

5. Avoid food with a specific taste, do not eat foods with a strong odor.

6. Do not eat fried foods, especially fatty foods, milk sauces, whole milk. These meals can be reintroduced when the nausea is gone.

7. Don't eat too sweet foods.

8. Do not eat excessively salty, spicy and hot foods.

9. Eat chilled food: meat, cottage cheese, fruits. Sour foods such as lemons, cranberries, pickles, pickles and tomatoes, and popsicles can relieve nausea.

10. Avoid drinking fluids with meals to prevent the stomach from filling up with fluid. Drink more in between meals. Drink liquid at least one hour before meals. Drink cold, unsweetened drinks.

11. Take food slowly so that a large amount of food does not enter the stomach at the same time; chew food thoroughly.

12. Avoid eating immediately before the administration of drugs.

Stomatitis

An unpleasant consequence of the use of some anticancer drugs is damage to the oral mucosa - stomatitis. Inflammation can lead to painful sores and infections, and treating them requires hard work.

You can reduce the possibility of stomatitis by rinsing your mouth with tooth elixirs (pepsodent, elkadent), lubricating your lips with oily lipstick (men can use colorless hygienic lipstick). For tooth decay, if possible, have dental treatment done before starting chemotherapy. The risk of stomatitis is reduced by cooling the oral mucosa with pieces of ice.

Also try to avoid irritating your mouth with alcohol, spicy foods, hot and acidic foods, dry and salty foods, and vegetables and fruits that are high in acid. We are talking about tomatoes, grapefruits, lemons, sour apples, plums.

Rinse your mouth with a baking soda solution (1/2 teaspoon of baking soda in 1 glass of water), saline (1 teaspoon of salt per 1 liter of water), as well as an infusion of chamomile, sage, oak bark, St. John's wort.

For stomatitis, ready-made infant formula is recommended: meat, vegetable and fruit (non-acidic: bananas, apricots, peaches, only ripe fruits), cereals for children (for example, "Baby Dad"). In addition, cottage cheese, yoghurts, non-acidic jellies, soft mild cheeses, whipped cream will help in the treatment of stomatitis.

Instead of these delicacies, you can boil, heat and chop meat, vegetables, potatoes and mix them. Beat with a mixer, adding mild broth. Try dipping dry crispy food products in coffee, tea, milk.

It is better to include food and drinks at room temperature in the diet: oatmeal, milk soup, soft-boiled eggs, mashed potatoes, mashed potatoes, curd pudding (you can mash it with milk or cream), cream of eggs and milk, and other non-irritating foods. Citrus fruits or sour fruits can aggravate irritation.

Food should be soft. Prepare stews, boiled, mashed dishes - steamed meat, salads with rolled meat and poultry, casseroles, soufflés, puddings, soups and broths with a minimum amount of salt and no pepper. Creamy and dairy ice cream without nut and other solid additives and chocolate has excellent nutritional and taste qualities and is highly recommended for stomatitis.

If there is dryness or discomfort in the mouth or throat, when it is difficult to chew or swallow food, try drinking more fluids - up to 2 liters per day. Watermelon and melon should appear on your table regularly. Keep ice cubes or sugar-free lozenges in your mouth for a short time.

Loose stools

Damage to the cells of the gastrointestinal tract leads to frequent and loose stools - diarrhea (diarrhea).

You can stop diarrhea only by restoring the water-mineral, vitamin and protein balance. For this, it is important that the food is as gentle as possible for the intestinal mucosa. Eat easily digestible foods boiled in water or steamed, and in pure form.

At the first stage of treatment, the intestines need rest. Fatty meats and fish, smoked meats, marinades, canned food, hot spices and vegetables that irritate the intestinal tract - radish, onion, radish, garlic are excluded from the diet. Legumes, sorrel, spinach, sour varieties of berries and fruits, strong broths, fried and stewed dishes, fresh whole milk, as well as soft bread, pastries, pancakes, pies are not recommended.

It is recommended to include in the diet rice soup, rice porridge in water, mashed rice, bananas, mashed apples, mashed potatoes in water, boiled mashed pumpkin - all dishes of soft consistency, warm or at room temperature. Small portions are better absorbed. As the diarrhea subsides, you can add pureed meats, finely chopped vegetables, beef and lean fish meatballs to soups. It is recommended to steam vegetables and meat: meatloaf stuffed with rice or eggs, boiled meat pudding, steam cutlets, meatballs, meat or fish meatballs, steam omelet, rice and oatmeal porridge in diluted milk, mashed homemade cottage cheese. It is not harmful to eat soft-boiled chicken eggs 2-3 times a week. Useful juices, jelly and mousses from blueberries, bird cherry, chokeberry and black currant. Bananas have a firming effect.

Drink plenty of fluids. Drinks should be warm or at room temperature, hot or cold liquids will only make the diarrhea worse. You can drink mineral water: Borjomi, Narzan, "Smirnovskaya", "Slavyanskaya" without gas. Decoctions of dried pears, rose hips, pomegranate bark, St. John's wort, burnet roots, green apple peel are useful. With a large loss of liquid, you can prepare the following drink: add to 1 liter of boiled mineral water
1/2 - 1 tea spoon of salt, 1 tsp. a spoonful of soda, 4 tsp. tablespoons of sugar.

Constipation

After taking chemotherapy drugs, they rarely occur. But if constipation occurs, in the morning on an empty stomach drink 1 glass of cold water, plum, peach or apricot juice or a hot lemon drink, eat grated carrots, raw apple or yogurt, 5-7 prunes, washed and poured with boiling water in the evening. It is useful to eat raw vegetables and fruits. For example, apples with lemon, beet puree. Positive effect have prunes and figs soaked in water, boiled beets, dried fruit puree. Cook food not chopped, boil in water or steam, bake on steam. Of the first courses, soups, borscht and cabbage soup in vegetable broth are very useful. Use wheat and rye bran for stool relief.

Exclude smoked meats, pickles, marinades, cocoa, chocolate from food; fried dishes, sausages are limited. Eat less bread and baked goods made from premium wheat flour (especially fresh, soft), pasta, semolina dishes.

Spicy dishes, strong tea, cocoa, decoctions and jelly from pears, quince, onions, garlic, radish are contraindicated. Bread made from coarse flour, containing bran ("Barvikhinsky", "Doktorsky") or whole crushed grain (bread "Health"), facilitates bowel emptying. Fresh kefir and yogurt contribute to the normalization of stool.

Diet for liver dysfunction

Eliminate fried, spicy and salty foods from your diet. Avoid fatty meats and fish, marinades, sausages, ham, mushrooms and cholesterol-rich foods (brains, egg yolks, fish and mushroom soups, broths). During the period of exacerbation, turnips, radishes, rhubarb, onions, beans, peas are not recommended.

You can eat vegetarian soups, borscht, fresh cabbage soup, milk soups. From the second courses, steamed meat and fish cutlets, low-fat boiled meats (beef, chicken, turkey, tongue), low-fat boiled fish (cod, pike perch, carp, navaga, pike) are recommended. Include boiled vegetables (carrots, beets, cauliflower, pumpkin, zucchini), ripe fruits, berries, soaked dried apricots, prunes, baked apples, fruit and berry juices, rosehip broth, wheat bran. Milk porridges are recommended: oatmeal, rice, semolina with raisins or honey. Dairy and fermented milk products are especially useful: curdled milk, kefir, fermented baked milk, yoghurts, low-fat cottage cheese.

Diet in case of dysfunction of the urinary system

Limit salt drastically. Dairy dishes are recommended, including cheeses and curd spreads, vegetable, eggplant and squash caviar, cooked without hot spices, ghee and vegetable oil, and pasta. From the first courses - borscht, beetroot soup, vegetable, fruit and cereal soups without hot spices with a small amount of salt. Meat of various varieties is recommended to be consumed in limited quantities. Raw vegetables are especially useful - carrots, white cabbage, fresh cucumbers, fresh green peas, parsley, rosehip broth.

In severe cases, a potato and egg diet without meat and fish is recommended. If your condition improves, include meat and fish in the menu, which you boil during cooking, and then bake and fry without salt. Avoid eating ordinary baked bread (that is, with salt), meat, fish and mushroom broths, as well as sausages, sausages, pickles and marinades, mushrooms, horseradish, mustard, chocolate.

For cystitis caused by chemotherapy drugs, drink plenty of fluids. Herbal decoctions are useful - kidney tea, bearberry, corn silk.

Milk, milk tea, alkaline mineral water, warm non-acidic compote. Watermelons and melons are especially useful. Exclude alcoholic beverages, spicy foods, sauces, seasonings, smoked meats, canned food. It's better to forget about salt, at least in acute stage diseases.

Chemotherapy and sex

Patients are usually embarrassed to discuss this topic, and doctors, due to lack of time, do not consider it necessary to touch on it, considering it secondary.

Women often pay attention to changes in the menstrual cycle. In some, menstruation becomes irregular, while in others it stops altogether during the period of chemotherapy. Many patients complain of hot flashes, insomnia, and other symptoms of menopause. The hormonal changes caused by chemotherapy can lead to an itchy, burning, or dry vagina. Your oncologist or gynecologist should recommend a cream or ointment to relieve these symptoms. With prolonged use of some anticancer drugs, temporary or permanent infertility may occur, depending on age.

Pregnancy during treatment is highly undesirable; it is strongly discouraged to allow it. If a neoplasm is found when the woman was already pregnant, the question of terminating the pregnancy, surgery or prescribing chemotherapy is decided by a council of doctors.

Hair loss

Hair loss is the most common side effect of chemotherapy, but not all anti-cancer drugs cause it. Usually, the oncologist warns the patient in advance when prescribing treatment for such a complication. Hair becomes thin and shedding intensively (usually after the second course of treatment). Many people complain that their hair becomes "sensitive" before falling out.

Depending on the nature of the chemotherapy, hair loss begins one to three weeks after starting treatment. Hair fades and begins to fall out, the skin on the head and all over the body becomes dry and flaky, sometimes redness and itching appear, and dandruff increases.

Hair loss occurs throughout the body, including the head, face, arms, legs, axillary and groin areas. This is due to the fact that the anti-cancer drug kills not only tumor cells, but also damages healthy tissues, including hair follicles, inhibiting hair growth and nutrition. Radiation treatment (radiation) also destroys hair follicles, but unlike chemotherapy, hair loss occurs only in the areas through which the radiation beam passes. The intensity of the radiation affects both the degree of hair loss and the rate of hair restoration.

Hair falls out differently from person to person. It can begin several weeks after starting treatment, but more often appears after the second and subsequent courses of chemotherapy. Hair often falls out in bunches. And some, especially women, may have some parts of the body where the hair is preserved.

Unfortunately, there are no drugs yet that could prevent hair loss in the treatment of tumors, and no external cosmetics - shampoos, creams or hair growth stimulants - slow down this process. Moreover, one must be very careful about their use.

Even before starting treatment, you need to prepare yourself mentally for the upcoming trials. Be sure to ask your doctor if the chemotherapy prescribed will cause hair loss. Find out when to expect massive hair loss, how much hair you will lose, and when hair will start growing again.

Ask an experienced hairdresser for advice on how best to hide hair loss.

If you have long hair, cut it short before treatment, this will make the process less painful.

How to help your hair

Use mild shampoos and mild hairbrushes. Brush gently without pinching your hair. Avoid round brushes that hurt your hair, perfumed cosmetics and soaps. Wash your hair with warm, but not hot water.

When blow-drying your hair, use the lowest possible air temperature. Do not dry your hair, use dye, curlers, heat perm, or straighten your hair.

During hair loss, protect your scalp from cold and direct sunlight by using sunscreen, hats or kerchiefs.

Try not to use cosmetics. They are designed for healthy skin, and during treatment they can act in the most unexpected way. Talk to your doctor or nurse about what cosmetics can be used during chemotherapy.

New hair growth can be expected 4–6 weeks after chemotherapy ends. But it will take several more months, sometimes up to a year, until they recover completely. At first, the hair is thin and brittle. Sometimes they change their usual color or turn gray. However, over time, both hair color and texture will recover.

To help your hair, you need to try to stimulate its growth, but at the same time not damage the revitalizing hair follicles:

* Wash your hair twice a week with a mild moisturizing shampoo;

* massage the scalp to improve blood circulation;

* avoid exposing the scalp to excessive heat, such as electric drying or thermal curling;

* carefully use different hair styling products - curlers, hairpins, use only light, gentle gels and sprays that avoid hair sticking;

* exclude hair dye products, do not try to curl them.

Loss of hair on the head and all over the body, of course, is taken very hard. You may become depressed or overly irritable because of this, and such a reaction, unfortunately, will be fully justified. However, another thing is also true: hair loss is temporary, hair will grow back, and let the disease never return to your home.

Behavior during chemotherapy

* Physical exercise and gymnastic exercise during chemotherapy and in between treatments is acceptable and even desirable.

They improve emotional mood, reduce nausea and constipation, and increase muscle strength and volume. But choose the “right” exercises. For example, those undergoing radiation therapy should not go to the pool as chlorine will irritate the skin. For patients with very severe fatigue, it is beneficial to do 10-minute warm-ups daily until the vitality is restored.

* Strong alcoholic drinks during the course of chemotherapy excluded, as well as tobacco.

* In sunny weather, you cannot stay on the banks of the river or sea. Staying under an awning is not recommended, as the sun's rays, reflecting from the waves, can reach you. Long sleeves and wide-brimmed hats are advised. When working in garden plots and vegetable gardens, your clothing should protect from sunlight.

* Benefit contrast shower for patients receiving chemotherapy has not been established. It is not recommended to use hot water. Physiotherapy and thermal procedures are prohibited: Charcot douche, diathermy, UHF therapy, ultraviolet and infrared radiation, mud therapy, ozokerite and paraffin therapy, as well as massage. Mustard plasters and banks only as a last resort.

* When coldsoften occurring during chemotherapy, use honey - up to 60 g per day - and raspberry jam. It is allowed to use antipyretics, various herbal decoctions, and, if necessary, sulfa drugs and antibiotics.

K. A. Shilov, oncologist

All about chemotherapy, chances are you will be surprised to learn that it no longer causes automatic side effects in the form of severe nausea and vomiting. Medical progress for last years helped reduce the effect of chemotherapy on the body in several ways. However, while the therapy itself has improved significantly over the past few decades, public perception has essentially remained the same. Therefore, an important task for oncologists is to refute common misconceptions.

Misconception 1: There is only one type of chemotherapy, and all types of cancer are treated with it.

Many people believe that any type of cancer can be treated with the same chemotherapy medication. However, it is not. Different drugs fight different cancerous tumors and work according to different principles: some kill cancer cells, others shrink tumors, and others relieve the symptoms of advanced cancer. These medications are taken in combination with other treatments.

Misconception 2: Chemotherapy is only given intravenously.

When imagining a chemotherapy session, most people imagine a drip that is given to a patient during an extended inpatient treatment... In fact, many of today's chemotherapy drugs are taken orally. There are also medicines for local application and for injection. If the dose of chemotherapy needs to be given intravenously, the patient usually comes to the session and returns home immediately after it ends. Therapy no longer disrupts the patient's rhythm of life as it used to.

Misconception 3: Chemotherapy causes severe nausea and vomiting.

Only 20 years ago, chemotherapy was associated with severe nausea and vomiting. As the oncologists admit, this reputation was well deserved. Many medicines today are designed so that some of their ingredients prevent nausea and vomiting - or reduce the intensity of these side effects.

Misconception 4: Chemotherapy can cause severe, life-threatening infections.

Severe infections are no longer common among patients undergoing chemotherapy. This fact is largely predetermined by the fact that modern drugs do not lead to immunosuppression - they lead to myelosuppression. This means that instead of suppressing the body's immune response, the activity of the bone marrow is limited, as a result of which there is a decrease in the production of red blood cells, leukocytes and platelets. Because the immune system does not suffer, the body still has a full arsenal of tools to fight infection.

Misconception 5: If your hair does not fall out during chemotherapy, then it is not working.

Although hair loss remains a common side effect of chemotherapy, it does not affect all patients. Some medications are more likely to cause hair loss than other medications. Risk indicators also range from absolute zero to 90% probability. Hair usually falls out 2 or 3 weeks after starting treatment. But this side effect has nothing to do with the effectiveness of therapy.

Misconception 6: Chemotherapy leads to weight loss.

In fact, the opposite happens more often - especially when chemotherapy is prescribed after surgical operation for the prevention of recurrence of breast cancer. Doctors note that many breast cancer patients expect to lose weight during chemotherapy, and are surprised when they are told about a possible increase of 2.5-5 kg. Weight gain usually indicates that the drugs are working.

Misconception 7: After chemotherapy, you will no longer be able to have children.

This misconception is based on a simple fact: during chemotherapy, many women stop bleeding. However, if a woman is only slightly over 20, 30 or even 40 years old, her period is likely to return after treatment ends. If a pregnant woman is diagnosed with cancer, she will be prescribed certain chemotherapy drugs that are harmless to the fetus, so pregnancy should also not interfere with cancer treatment.

Since chemotherapy has improved significantly in recent years, while remaining an important part of the treatment plan for many cancer patients, patients need to understand this method of dealing with the disease.

Details of modern methods chemotherapy, you will find on the Assuta website

The degree of toxic damage to the sex glands caused by chemotherapy, varies.
Histological examination of ovarian tissue after treatment with cytotoxic drugs, they show a wide variety of damage: from a decrease in the number of follicles to their absence and fibrosis. The frequency of ovarian dysfunction under the influence of chemotherapy is difficult to establish with sufficient accuracy, since many other factors also have a toxic effect on the ovaries.

Cytotoxic drugs can damage maturing, primordial follicles, disrupt follicular maturation, or have a combined effect. Damage to maturing follicles leads to temporary amenorrhea, while damage to primordial follicles leads to permanent amenorrhea due to dysfunction of the ovaries.

Considered the primary target individual cytotoxic drugs there are either granulosa cells of the ovary or oocytes. It is difficult to say exactly what exactly suffers in the first place, since the structural and functional interaction of ovarian granular cells with oocytes is so close that the destruction of one type of cells leads to damage to another.

Disruption of the menstrual cyclethat occurs after chemotherapy is not always a direct result of drug toxicity on the ovaries. Severe illness, malnutrition, mental and physical stress can cause dysfunctions of the hypothalamic-pituitary-ovarian system. Short-term menstrual irregularities are also more often the result of damage to growing, rather than primordial follicles.

Defeat all developing follicles delays menstruation by at least 3 months, since the primordial follicle reaches ovulation in about 85 days.

The most significant risk factors for damage to the sex glands - patient's age, class medication and the cumulative dose of the drug. The risk of damage to the gonads increases with the age of the woman. Most likely, this is due to the paucity of preserved oocytes in older women as compared to younger women.

According to one research, in patients suffering from Hodgkin's disease and receiving novembichine (mechlorethamine), vincristine, procarbazine and prednisone (the so-called MOPP method), subsequent amenorrhea occurred in 20% of women under 25 years old compared with 45% of women aged 25 years and older. In another study, the incidence of PYN after MOPP chemotherapy was 61%.

Various cytotoxic chemotherapy drugs have varying degrees of gonadotoxicity. Non-specific cytostatics used in chemotherapy are considered more gonadotoxic than specific ones. In women receiving high doses of alkylating nonspecific cytostatics (in high degree gonadotoxic) used in chemotherapy, there is the greatest risk of PJI. In this group of cytostatics, cyclophosphamide is considered the most gonadotoxic drug.

What is chemotherapy?

Chemotherapy is used to prevent breast cancer from recurring. For localized breast cancer, confined to the breast or lymph nodes, chemotherapy is given after a lumpectomy or mastectomy.

If the breast tumor is large, chemotherapy may be given prior to surgery to shrink the tumor and perform a lumpectomy instead of a mastectomy.

Chemotherapy can also be prescribed for metastatic breast cancer.

Chemotherapy uses drugs that can kill or slow the growth of rapidly growing cancer cells.

A course of chemotherapy usually consists of a combination of drugs needed for optimal results.

How does chemotherapy work?

Chemotherapy drugs are given intravenously (directly into a vein) or by mouth. Once the drugs enter the bloodstream, they travel to all organs to reach cancer cells that may have spread outside the breast - therefore, chemotherapy is considered a "systemic" form of breast cancer treatment.

Chemotherapy is designed for cycles followed by a recovery period. The entire course of chemotherapy usually lasts from several months to a year, depending on the type of drugs given.

When should you receive treatment?

When breast cancer is confined to the breast or lymph nodes, chemotherapy may be given after a lumpectomy or mastectomy. In this case, chemotherapy is used as complementary treatment and helps reduce the likelihood of relapse.

Chemotherapy can also be prescribed as the main treatment when cancer has spread to other parts of the body, called metastatic cancer, and occurs in a small number of women.

Will I be able to work while undergoing chemotherapy?

Yes. Most people are able to continue working during treatment, but you may need to reconsider your schedule, especially if you are prone to side effects of treatment.

How do I know about the results of chemotherapy?

Some patients think that chemotherapy is not effective if they do not notice the side effects, but this is not the case.

If you are undergoing chemotherapy (after surgical removal tumor), it will be enough for the doctor to determine how effective the treatment is, since there is no tumor to study. However, studies have shown that recurrence of the disease occurs more often in those who do not receive this treatment.

After the treatment, the doctor will be able to evaluate the results of the course with the help of periodic medical examinations, mammography, and special examinations. If you are undergoing treatment for metastatic disease, the results will be monitored using blood tests and / or X-rays.

Potential side effects of chemotherapy?

The side effects you may experience depend on the type and amount of medications you take. The most common side effects include:

Nausea and vomiting.

Loss of appetite.

Hair loss.

Sickness.

Changes in the menstrual cycle.

Higher susceptibility to infections (due to decreased white blood cell count).

Bruising or bleeding.

Fatigue.

Your doctor will talk with you about any possible side effects that may concern you.

How does chemotherapy affect the menstrual cycle?

Cancer and its treatments will undoubtedly bring about many changes in your life. One change you may experience is an alteration in the menstrual cycle, from irregular bleeding to symptoms of menopause (the end of menstruation).

Experts do not fully understand the effects of chemotherapy on the female reproductive system, but this article will help you find out:

How does chemotherapy cause or contribute to menopause?

How does chemotherapy affect the menstrual cycle?

Is pregnancy possible after chemotherapy?

What is menopause?

Menopause is a normal stage in a woman's life and is commonly used to describe any changes a woman experiences when her periods stop. As menopause approaches, the ovaries produce less estrogen, causing changes in the menstrual cycle and other physical changes.

Technically, menopause is the end of a woman's reproductive phase, when the ovaries no longer produce eggs.

How does chemotherapy affect the onset of menopause?

During chemotherapy, women may have irregular menstrual cycles or amenorrhea (disappearance of menstruation). Some drugs used in chemotherapy can also damage the ovaries, leading to menopausal symptoms or menopause.

Chemotherapy-induced menopause can be immediate or delayed, permanent or temporary. Unfortunately, there is no exact way to determine the potential impact on the menstrual cycle.

However, menopause can rarely be a sudden reaction to treatment, usually you may notice some menopausal symptoms within a few months of starting the course. These symptoms can continue for many years after treatment ends.

The most common symptoms of menopause are hot flashes, emotional changes, vaginal changes, changes in sexual desire, and weight gain.

Will my period change after chemotherapy?

Menstrual cycles can be affected by different factors, including from the individual characteristics of patients. Some women will notice frequent menstruation, while others, on the contrary, will notice more frequent periods.

The number of menstrual days may change or it may feel sore. Although your menstrual cycle may become irregular after chemotherapy, other suspicious changes (painful bleeding with weakness or dizziness) should be discussed with your doctor.