Questions Teen Cancer Patients Would Like Doctors to Answer
Questions in no particular order…
Q. Will I lose my hair?
This can be a common side effect of chemotherapy. Your hair may become thinner or fall out. Hair loss may happen anywhere on your body that you have hair. It can happen right after you begin chemo, or several weeks later. It may not happen at all. Your hair will usually grow back when you stop your chemo treatments.
Q. Will I be able to go to school?
Chemotherapy has an effect on your immunity and it can make you feel weak. This differs from person to person. It also affects memory and concentration. Whenever possible and with high white blood cell levels , we encourage you to remain in school even for a short period or a few days a week to try and keep up with your school work as much as possible as guided by your doctor.. However, some patients receiving strong chemotherapy or bone marrow transplantation are not able to go to school until their health is stable and their immune system is stronger.
Q. Should I be on a special diet?
You may not feel like eating. This is normal. Remember that take-away foods contain high levels of salt, sugar or fats and should not be eaten regularly. Processed foods such as sausages, are also not recommended. In some cases, there are restrictions on certain foods, especially after a bone marrow transplantation. In cases of weight loss, nutritional supplements are often prescribed by your Oncologist. Patients who for example have the loss of a kidney must totally change their eating habits and adopt a low sodium diet. It is important to remember that your previous diet might be balanced, but for your current diagnosis and treatment plan, it might not be suitable. It is best to allow the dietitian to guide you as eating certain foods can affect your recovery.
Q. Can I still take vitamins or other supplements?
The nutrition specialists on your cancer care team work will work with you and your family concerning your nutritional needs. It is important to not add any supplements without informing/discussing it with the Oncologist. Some products must be totally avoided during treatment. You will be monitored via regular blood tests and if needed supplements may even be given via intravenous line/drip if not orally.
Q. Can I use traditional medicine to treat my cancer?
Some of the traditional medicines given will increase side effects such as diarrhea or nausea and should not be used in combination with chemotherapy treatment. Remember that any products that you wish to use should be discussed with your Oncologists first for your own safety, and to ensure that it won’t clash with the treatment they offer you.
Q. Can I still use facial / cosmetic products while on treatment?
Chemotherapy can cause dry skin. It can also cause other skin problems such as a rash, itching, redness, and sensitivity to the sun. It is important to keep your skin moisturized. Your nails may also peel, become yellow, or cracked. Wash your hands regularly and keep your nails clean. Discuss this with your Oncologist as some products might interfere with your treatment. In general, unfragranced Aqueous cream is a safe product to use with no side effects.
Q. Can cancer treatment affect my fertility?
This depends on the type of treatment location of the cancer. In some cases fertility is affected and in others it is not. Treatment can affect the fertility of both girls and boys. We often see children/adolescents with cancer, who survive cancer and have their own healthy children. Discuss this with your Oncologist if you have any queries.
Q. Will being on cancer treatment affect my growth or physical development?
When you are in a growth spurt at time of diagnosis, the doctors will address any additional risks or challenges that you might experience. Please tell them if you think you are experiencing any growing pains or other symptoms you are unsure of.
Q. Will I still have my period and will it change while I am on treatment? (Girls)?
Yes, most girl’s periods do continue and others stop for the duration of their treatment. Treatment may cause additional tiredness and affect your blood levels, causing them to be lower than usual. It is very important to discuss with your Oncologist if you are having your period during treatment as it can cause heavy blood loss due to the medication. They can prescribe medicine to assist you.
Q. Am I still able to continue playing sport?
Yes, you can continue with light exercise such as walking and stretching, but high energy and impact sports such as soccer, rugby, hockey, soccer etc. won’t be allowed. Please make sure that you discuss this with your Doctor.
Q. Can I still have a social life when I have cancer?
Yes you can, but it is safer to have visitors at home or outdoors and not in public places where you will be exposed to germs. Chemotherapy harms healthy white blood cells while trying to fight the cancer. A decrease in healthy white blood cells puts you at risk for infection. Please also remind your friends that if they or someone in their family has flu, it is best that they do not come and visit you.
Q. Am I still able to go to the mall or night clubs?
Going to the mall or night clubs is not advisable as the exposure to infectious diseases cannot be controlled. The risk of you getting sick and weakening your immune system is high.
Q. How can I protect myself from germs on public transport?
Always wear a scarf around your neck, so that if needed you can cover your mouth and nose to prevent exposure to another passengers coughing / sneezing. Make sure you wash your hands immediately afterwards or use hand sanitiser.
Q. Can I be in a sexual relationship while on treatment?
Any sexual relationship will expose you to health risks and you can never be too cautious. The side effects of treatment may also make sex painful as chemo can affect your sexual organs. Kissing and oral sex are always a risk of infection and contraction of HPV and Herpes. Due to the nature of cancer treatment and what your body is going through, it is not advisable to put your health at risk any further. In general, refrain from kissing anyone on the lips (even family members) while you are on treatment. If you are going to be kissing someone, please check for mouth sores and make sure you use antiseptic mouthwash or rinse your mouth afterwards. Always make sure that you are on contraception before engaging in sexual behaviours and remember to advise your doctor if you are on contraception when you are starting treatment.
Q. Is it safe for me to fall pregnant while on treatment?
It is dangerous for you to do so, as the treatment can have negative effects for you and the baby.
Q. May I continue with any planned cultural initiations while on treatment?
It is very important to discuss this with your Oncologist. In general, they will ask your family to delay any procedures while you are on treatment. Your immune system may be very low at this stage and any procedures such as circumcision might lead to a serious infection that you will have difficulty fighting off. You would also want to be strong and healthy to take part and adhere to the cultural requirements.
Q. How do I deal with the fears of the people in my school / community who avoid me?
You can ask your teacher at school to help you with this and speak to the learners and explain that cancer is not an infectious or contagious and that it is a treatable disease. It is important to know that cancer can be curable and that people of all ages and races can get cancer. It is also a good idea to speak to your family and neighbour’s so that they can have a better understanding of cancer and know that they can still have physical contact with you, like hugging, sitting in the lounge and shaking your hand. They can also use the same bathroom, plates and eating utensils as you without worrying about “catching’ cancer.
Q. What is a recurrent cancer?
A recurrent cancer is cancer that comes back after treatment. It may recur at the original site of the tumor or in another place. In short it will be called relapse.
Q. What are the cancer stages?
Staging is a way of describing a tumor, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the tumor’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis (chance of recovery). There are different stage descriptions for different types of tumors.
- Stage 0: Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer.
- Stage I: The tumor can be completely surgically removed, and has not spread to other areas of the body.
- Stage II: Cancer has spread to surrounding tissue or lymph nodes. Cancer cells may not be able to be completely removed from the surrounding tissue with surgery.
- Stage III: Cancer has spread to surrounding tissue, has affected several lymph nodes, is found in surrounding areas, and the entire tumor cannot be removed from the surrounding tissue with surgery.
- Stage IV: Cancer has spread to other organs, most commonly the lungs, liver, or brain.
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