Journey to Recovery: A Breast Cancer Podcast Series Episode 4, Part 2: Managing the Side Effects of Chemotherapy Lorraine: I think women are so used to associating themselves with their looks and their hair. I still have hair conversations with my niece: it's always like, "Your hair, your hair, your hair." And then you look at yourself one day, and you don't have any. But I wound up getting this beautiful wig that, actually, people would stop me on the street and say, "Your hair is beautiful." And nobody ever told me my [laughing] hair was beautiful, until I wore that wig. Narrator: The road from cancer diagnosis to survivorship is a journey that offers many twists and turns. Some of these turns may be trying and difficult, and others may offer unexpected comfort. We at the American Cancer Society hope that this podcast series will let women who are dealing with breast cancer know that they are not alone. Welcome to Part II of our episode on chemotherapy and radiation. In this podcast our breast cancer survivors will explore the various side effects of chemotherapy. Their voices are woven throughout this episode, each providing a unique perspective from someone who has already experienced what you may currently be going through. Dr. Margaret Kemeny, a nationally renowned surgical oncologist from Queens Cancer Center of Queens Hospital, is here with us to make sense of some of the clinical information. Dr. Kemeny, thank you for joining us. Dr. Margaret Kemeny: Thank you for inviting me. Narrator: Dr. Kemeny, what should a patient expect in terms of side effects and life style changes because of chemotherapy? Dr. Kemeny: It is important to remember that not every woman will experience side effects from chemotherapy. But sometimes, treatments make women feel sick, because the chemo drugs are very strong, and they can damage normal, healthy cells, in addition to the cancer cells. You should talk to your doctor about what you can expect in terms of side effects, but some common complaints are nausea, vomiting, temporary hair loss, sores in the mouth, dry skin, fatigue, low blood cell counts, and early menopause. Fortunately, your doctor can give you other drugs to decrease nausea and vomiting and restore your blood cell counts. During treatment, it helps, both physically and emotionally, to stay active and eat a well balanced diet. And remember that the potential long term benefits usually far outweigh any
temporary discomfort you may have. If you do have a low white blood cell count, you are at higher risk for getting an infection. It is best to avoid crowds, and people who have infections and colds. Wash your hands often. If your platelet count is low you are likely to bruise or bleed easily. During these times, avoid activities that might result in injury. Chemotherapy can also affect sexuality. Sometimes sexual desire decreases for periods of time, and then returns. This may be caused by emotional factors, or may be a result of the chemotherapy affecting a woman's hormones.
Narrator: Now let's hear how our breast cancer survivors remember their encounter with the side effects of chemotherapy. First we will hear from Lorraine. Lorraine: I didn't get any major side effects from chemo -- except for my first treatment, because they put a steroid in my drip, Decadron, and it really made me feel like I was racing, to a point where I felt crazy. So I talked to the doctor, and she removed it for the balance of my treatments. And I felt like my teeth -- my first treatment, I felt like a grinding of the teeth, that was very uncomfortable. But then after that, once they removed that one drug, it was OK. And the funny thing about the chemo that I had is the first day I felt like cleaning my house, and the second day I would be totally exhausted. So it didn't really affect me physically the next day, it was the day after. And I would say for like a week, I didn't feel right. But I decided to work through my -- while I was sick, I worked. I could have taken off and been out, with disability, and I chose not to do that. So the week that I had chemo, I would take the week off, and then go back to work for three weeks. So I guess you can say -- I mean, I was a little tired, but you know what, I mean, I did it. I could definitely function fine, after the week was over. But I gave myself the week. I didn't want cancer to disrupt my life any more than it was, so I wanted my life to be as normal as I was used to having it, as much as possible. So basically, I really did live my life like I did normally, except it interrupted me for that one week. That's the way I tried to view it. I was never like one to sit home and put my feet up anyway. I like to be active, and without being active, I think it would've bothered me more. Narrator: A common concern for many women is the loss of hair that can be a side-effect of chemotherapy. Here's how Terri dealt with that. Terri: He goes, "Well, following this treatment, your hair is going to be missing completely. And I'll never forget walking into my downstairs bathroom, looking in the mirror, and taking the brush through my hair and it started to fall out. And I don't know how many hours, but I sat there. For some reason, the rest of my household was gone here, there, and everywhere, and I'm literally in the bathroom with a plastic bag in the sink, and just putting my hands through my hair and just stuffing the bag with my hair. The kids and I couldn't decide if we wanted to throw it away, if we wanted to save it, but by the time they came back that afternoon, probably 95 percent of my hair was gone. Lorraine: I think women are so used to associating themselves with their looks and their hair. I still have hair conversations with my niece: it's always like, "Your hair, your hair, your hair." And then you look at yourself one day, and you don't have any. But I wound up getting this beautiful wig that, actually, people would stop me on the street and say, "Your hair is beautiful." And nobody ever told me my [laughing] hair was beautiful, until I wore that wig. Which turned out to be really -- it was a joke amongst my friends, because the wig was fine, but after a while, it started to get hot, because it was the summer, it was very hot for me. It turned out not to be as bad as I thought it was going to be. It's very emotional, but it's hair. And you're at a point now where you're already gone for your treatment and you're trying to get well, so by the time your hair falls out, it's not as important as when you're anticipating it from the beginning, because now you know that's going to happen. And once it's gone, it's gone. There's nothing you can do. And you just try to -- you figure it stops you in your life. To get well and get back on track and to look the way you used to look and everything, it takes about a year. I think what really helped me through a lot of it, believe it or not, was reaching out to these strange women that I never met before and talking to them about their experiences. I did a lot of that. Like if someone said, "Oh, my girlfriend in Florida went through the same thing, " I would say, "Can I have her number? Call her and ask her if I can speak to her." [laughs] It was crazy. I don't know where it came from. So a lot of people would get back to me with phone numbers. And that's what I did, I did a lot of my own networking. And that got me through a lot, because then I knew I wasn't alone, I knew that there's life after cancer, I knew that I was going to be OK. [musical interlude] Narrator: However you get through your cancer experience, your strongest allies may be other women, like the ones whose stories you've just heard. Hearing a variety of viewpoints from women who've recovered from breast cancer, hopefully, will help you realize that what you're feeling is normal and can help you develop your own coping skills. The American Cancer Society is here for you, too. We can answer questions about your diagnosis. We have a variety of support programs to assist you, including Reach to Recovery, our program that can connect you with a local survivor. To learn more about programs available in your area, call us 24 hours a day, seven days a week, at 1-800-ACS- 2345. That's 1-800-ACS-2345. Or visit . Stay tuned for part three of episode four, which explores radiation, what it is, how it works, the side effects, and the recovery process. We know that hearing the words "You have breast cancer" can be a frightening and isolating experience. We hope these episodes will be a guiding hand, leading you to answers during this critical time. And rest assured, we're here for you, and you're never alone. Thanks for listening, and take good care. [closing music]
Manuscript of Review Article published in: MICROSCOPY RESEARCH and TECHNIQUE 2000; 48: 303-11 ROLE OF APOPTOSIS IN GASTRIC EPITHELIAL TURNOVER Axel von Herbay 1 , Jochen Rudi 2 1 Institute of Pathology, 2 Medizinische Klinik IV, University of Heidelberg, GermanyAddress for correspondance: Priv.-Doz. Dr. med. A. von Herbay, Pathologisches Institut,Universitätsklinikum, Im Neuenheimer F
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