Re: [MOL] Information needed [01437] Medicine On Line


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Re: [MOL] Information needed



Nancy:  Welcome to our wonderful forum.  I hope that the information I have
enclosed will be of help to you.  Please let me know if you need further
information and we hope that you will join in on any chat in progress, this
is now your forum too.  Your friend, lillian


Side Effects Limiting Chemotherapy
April 28, 1999
WASHINGTON (AP) - Side effects may prevent up to one-fifth of patients from
getting the full-strength dose of chemotherapy needed for their best chance
of survival, says a study of the medical records of 15,000 patients.

Doctors prescribe the right amount, but may lower the dose mid-treatment or
postpone chemotherapy sessions when women suffer serious side effects, the
research found.

The findings may surprise doctors unaware that some efforts to ease side
effects could have a larger impact.

Switching to a newer combination of chemotherapy drugs could give patients a
better chance at tolerating the full dose, contends Dr. Garrett A. Smith of
the University of California, San Francisco, whose patients were among those
the study analyzed.

"This study should change practice patterns," he said. "Physicians all over
the country who use the older (chemotherapy) regimen had a terrible time
staying on track."

Project ChemoInsight was performed by Amgen Inc., which makes a treatment
for a chemotherapy side effect called neutropenia - a loss of white blood
cells that leaves patients vulnerable to serious infection.

At issue is "chemotherapy" Previous studies have found that the women who
fare best receive at least 85 percent of the chemotherapy "dose intensity" -
proper dose received during a certain amount of time. But side effects can
prevent that.

Amgen nurses gathered medical records from hundreds of oncologists to see
how often that happens. About 20 percent of patients got less than optimal
dose intensity, concludes data to be presented at an Oncology Nursing
Society meeting this week.

Neutropenia was the main culprit that prompted dose limiting. Researchers
are visiting doctors whose records were analyzed to discuss how their
patients fared.

Smith said his patients did well, and credits a newer chemotherapy cocktail
known as AC, for adriamycin-cyclophosphamide.

Many doctors believe AC is harder to tolerate than an older cocktail called
CMF, but Smith said Project ChemoInsight found CMF patients were more likely
to be undertreated because of side effects. He will present details at an
oncology meeting next month.

Dr. Claudine Isaacs of Georgetown University in Washington, D.C., called the
project important for illustrating what really happens to treated patients.

"There certainly is a perception out there that AC is more toxic," said
Isaacs. The study suggests "in fact it's easier to give ... on time and at
the dose intended, and that's important."

She already tells patients that AC causes more nausea, but new anti-nausea
drugs largely control that. AC also causes more hair loss than CMF and about
a 1 percent risk of heart toxicity, but lasts just three months. CMF takes
six months, causes mouth sores, diarrhea and may increase risk of premature
menopause.


 Are Side Effects the Same for Everyone?
The side effects of radiation treatment vary from patient to patient. You
may have no side effects or only a few mild ones through your course of
treatment. Or you may have more serious side effects. The side effects that
you have depend mostly on the treatment dose and the part of your body that
is treated. Your general health also can affect how your body reacts to
radiation therapy and whether you have side effects. Before beginning your
treatment, ask your doctor and nurse about the side effects you might
experience, how long they might last, and how serious they might be.

There are two main types of side effects: acute and chronic. Acute, or
short-term, side effects occur close to the time of the treatment and
usually are gone completely within a few weeks of finishing therapy.
Chronic, or long-term, side effects may take months or years to develop and
usually are permanent.

The most common side effects are fatigue, skin changes, and loss of
appetite. They can result from radiation to any treatment site. Other side
effects are related to treatment of specific areas. For example, temporary
or permanent hair loss may be a side effect of radiation treatment to the
head. This chapter discusses common side effects first. Then side effects
involving specific body parts are described.

Fortunately, most side effects will go away in time. In the meantime, there
are ways to reduce the discomfort they cause. If you have a side effect that
is particularly severe, the doctor may prescribe a break in your treatments
or change the kind of treatment you're receiving.

Be sure to tell your doctor, nurse, or radiation therapist about any side
effects that you notice. They can help you treat the problems and tell you
how to lessen the chances that the side effects will come back. The
information in this document can serve as a guide to handling some side
effects, but it cannot replace talking with your health care team.
Will Side Effects Limit My Activity?
Not necessarily. It will depend on what side effects you have and how severe
they are. Many patients are able to go to work, keep house, and enjoy
leisure activities while they are receiving radiation therapy. Others find
that they need more rest than usual and therefore cannot do as much. You
should try to do the things you enjoy as long as you don't become too tired.

Your doctor may suggest that you limit activities that might irritate the
area being treated. In most cases, you can have sexual relations if you
wish. Your desire for physical intimacy may be lower because radiation
therapy may cause you to feel more tired than usual. For most patients,
these feelings are temporary. (See Sexual Relations.)
What Causes Fatigue?
During radiation therapy, the body uses a lot of energy healing itself.
Stress related to your illness, daily trips for treatment, and the effects
of radiation on normal cells all may contribute to fatigue. Most people
begin to feel tired after a few weeks of radiation therapy. Feelings of
weakness or weariness will go away gradually after your treatment is
finished.

You can help yourself during radiation therapy by not trying to do too much.
If you feel tired, limit your activities and use your leisure time in a
restful way. Do not feel that you have to do all the things you normally do.
Try to get more sleep at night, and rest during the day if you can.

If you have been working a full-time job, you may want to continue.
Treatment visits are time consuming. You can ask your doctor's office or the
radiation therapy department to help by trying to schedule treatments with
your workday in mind.

Some patients prefer to take a few weeks off from work while they're
receiving radiation therapy; others work a reduced number of hours. You may
want to speak frankly with your employer about your needs and wishes during
this time. You may be able to agree on a part-time schedule. Perhaps you can
do some work at home.

Whether you're going to work or not, it's a good idea to ask family members
or friends to help with daily chores, shopping, child care, housework, or
driving. Neighbors may be able to help by picking up groceries for you when
they do their own shopping. You also could ask someone to drive you to and
from your treatment visits to help conserve your energy.
How Are Skin Problems Treated?
You may notice that your skin in the treatment area may begin to look
reddened, irritated, sunburned, or tanned. After a few weeks you may have
very dry skin from the therapy. Ask your doctor or nurse for advice on
relieving itching or discomfort. With some kinds of radiation therapy,
treated skin may develop a "moist reaction," especially in areas where there
are skin folds. When this happens, the skin is wet and it may become very
sore. It's important to notify your doctor or nurse if your skin develops a
moist reaction. They can give you suggestions on how to keep these areas
dry. (See Helpful Tips)

During radiation therapy you will need to be very gentle with the skin in
the treatment area. Avoid irritating treated skin. When you wash, use only
lukewarm water and mild soap. Don't wear tight clothing over the area. It's
important not to rub, scrub, or scratch any sensitive spots. Also avoid
putting any thing that is very hot or very cold, such as heating pads or ice
packs, on your treated skin. Don't use any powders, creams, perfumes,
deodorants, body oils, ointments, lotions, or home remedies in the treatment
area while you're being treated and for several week afterward (unless
approved by your doctor or nurse). Many skin products can leave a coating on
the skin that may interfere with radiation therapy or healing.

Avoid exposing the area to the sun during treatment and for at least 1 year
after your treatment is completed. If you expect to be in the sun for more
than a few minutes you will need to be very careful. Wear protective
clothing (such as a hat with a broad brim and a shirt with long sleeves) and
use a sunscreen. Ask your doctor or nurse about using sunblocking lotions.

The majority of skin reactions to radiation therapy should go away a few
weeks after treatment is finished. In some cases, though, the treated skin
will remain darker than it was before.
What Can Be Done About Hair Loss?
Radiation therapy can cause hair loss, also known as alopecia , but only in
the area being treated. For example, if you are receiving treatment to your
hip, you will not lose the hair from your head. However, radiation to your
head may cause you to lose some or all of the hair on your scalp. Many
patients find that their hair grows back again after the treatments are
finished, but accepting the loss of hair-whether from scalp, face, or
body-can be a hard adjustment. The amount of hair that grows back will
depend on how much radiation you receive and the type of radiation treatment
your doctor recommends. Other types of treatment, such as chemotherapy, also
can affect how your hair grows back. For example, if your radiation therapy
is for palliative care, your hair probably will grow back slowly. However,
if the goal of your radiation therapy is to cure rather than to relieve the
symptoms of your cancer, then your hair may not grow back, and if it does,
it probably will be very fine.

Although your scalp may be tender after the hair is lost, you may want to
cover your head with a hat, turban, or scarf while you're in treatment.
Also, you should wear a protective cap or scarf when you're in the sun. If
you prefer a wig or toupee, be sure the lining does not irritate your scalp.
A hairpiece that you need because of cancer treatment is a tax-deductible
expense and may be covered in part by your health insurance. If you plan to
buy a wig, it's a good idea to select it early in your treatment so that you
can match the color and style to your own hair.


What About Side Effects on the Blood?
Sometimes radiation therapy can cause low white blood cell counts or low
levels of platelets. These blood cells help your body fight infection and
prevent bleeding. If your blood tests show this side effect, treatment might
be delayed for about a week to allow your blood counts to increase.
What if There Are Eating Problems?
Many side effects can cause problems with eating and digesting food, but you
always should try to eat enough to help damaged tissues rebuild themselves.
It's very important not to lose weight during radiation therapy. Try to eat
small meals often and eat a variety of different foods. Your doctor or nurse
can tell you whether your treatment calls for a special diet, and a
dietitian will have a lot of ideas to help you maintain your weight.

Coping with short-term diet problems may be easier than you expect. There
are a number of diet guides and recipe booklets for patients who need help
with eating problems. An NCI booklet, Eating Hints, tells how to get more
calories and protein without eating more food and provides further tips to
help you enjoy eating. The recipes it contains can be used for the whole
family and are marked for people with special concerns, such as low-salt
diets. (See Resources. )

If you have pain when you chew and swallow, your doctor may advise you to
use a powdered or liquid diet supplement. Many of these products, available
at the drugstore without prescription, are made in a variety of flavors.
They are tasty when used alone, or combined with other foods such as pureed
fruit, or added to milkshakes. Some of the companies that make diet
supplements have produced recipe booklets to help you increase your nutrient
intake. Ask your dietitian or pharmacist for further information.

You may lose interest in food during your treatment. Loss of appetite can
happen when changes occur in normal cells. Some people just don't feel like
eating because of stress from their illness and treatment or because the
treatment changes the way foods taste. Even if you're not very hungry, it's
important to keep your protein and calorie intake high. Doctors have found
that patients who eat well can better handle both their cancer and the side
effects of treatment.

The list below suggests ways to perk up your appetite when it's poor and to
make the most of it when you do feel like eating.
Eat when you are hungry, even if it is not mealtime.
Eat several small meals during the day rather than three large ones.
Use soft lighting, quiet music, brightly colored table settings, or whatever
helps you feel good while eating.
Vary your diet and try new recipes. If you enjoy company while eating, try
to have meals with family or friends, or turn on the radio or television.
Ask your doctor or nurse whether you can have a glass of wine or beer with
your meal to increase your appetite. Keep in mind that in some cases,
alcohol may not be allowed because it could worsen the side effects of
treatment. This may be especially true if you are receiving radiation
therapy for cancer of the head or neck. (See more information on effects to
the mouth and throat)
When you feel up to it, make some simple meals in batches and freeze them to
use later.
Keep healthy snacks close by for nibbling when you get the urge.
If other people offer to cook for you, let them. And don't be shy about
telling them what you'd like to eat.
If you live alone, you might want to arrange for "Meals on Wheels" to bring
food to you. Ask your doctor, nurse, local American Cancer Society office,
or Cancer Information Service about "Meals on Wheels." This service is
active in most large communities.



If you are able to eat only small amounts of food, you can increase the
calories per serving by trying the following!
Add butter or margarine if you like the flavor.
Mix canned cream soups with milk or half-and-half rather than water.
Drink eggnog, milkshakes, or prepared liquid supplements between meals.
Add cream sauce or melted cheese to your favorite vegetables.
Some people find they can handle large amounts of liquids even when they
don't feel like eating solid foods. If this is the case for you, try to get
the most from each glassful by making drinks enriched with powdered milk,
yogurt, honey, or prepared liquid supplements.
Does Radiation Therapy Affect the Emotions?
Nearly all patients treated for cancer feel some degree of emotional upset.
It's not unusual to feel depressed, afraid, angry, frustrated, alone, or
helpless. Radiation therapy may affect the emotions indirectly through
fatigue or changes in hormone balance, but the treatment itself is not a
direct cause of mental distress.

Many patients help themselves by talking about their feelings with a close
friend, family member, chaplain, nurse, social worker, or psychologist with
whom they feel at ease. You may want to ask your doctor or nurse about
meditation or relaxation exercises that could help you unwind and feel
better.

American Cancer Society nationwide programs can provide support. Groups such
as the United Ostomy Association and the Lost Chord Club offer opportunities
to meet with others who share the same problems and concerns. Some medical
centers have formed peer support groups so that patients can meet to discuss
their feelings and inspire each other.

There are several helpful books and other materials on this subject. The
Cancer Information Service can direct you to reading matter and other
resources in your area. (See Resources)
What Side Effects Occur With Radiation Therapy
to the Head and Neck Area?
Some people who receive radiation to the head and neck experience redness
and irritation in the mouth, a dry mouth, difficulty in swallowing, changes
in taste, or nausea. Try not to let these symptoms keep you from eating.

Other problems that may occur during treatment to the head and neck are a
loss of taste, earaches (caused by hardening of ear wax), and swelling or
drooping of skin under the chin. There may be changes in your skin texture.
Your jaw may also feels stiff and you may be unable to open your mouth as
wide as before your treatment. Jaw exercise may help this problem. Report
any side effects to your doctor or nurse and ask what you should do about
them.

If you are receiving radiation therapy to the head or neck, you need to take
especially good care of you teeth, gums, mouth, and throat. Side effects
from treatment to these areas most often involve the mouth, which may be
sore and dry.

Here are a few tips that may help you manage mouth problems:
Avoid spices and coarse foods such as raw vegetables, dry crackers, and
nuts.
Don't smoke, chew tobacco, or drink alcohol.
Stay away from sugary snacks that promote tooth decay.
Clean your mouth and teeth often, using the method your dentist or doctor
recommends.
Do not use a commercial mouthwash; the alcohol content has a drying effect
on mouth tissues.


Dental Care
Radiation treatment for head and neck cancer can increase your chances of
getting cavities. Mouth care designed to prevent problems will be a very
important part of your treatment. Before starting radiation therapy, notify
your dentist and arrange for a complete dental/oral checkup. Ask your
dentist to consult with your radiation oncologist before your radiation
treatments begin.

Your dentist probably will want to see you often over the course of your
radiation therapy to give you detailed instructions about caring for your
mouth and teeth to reduce the risk of tooth decay and help deal with
possible problems such as soreness of the tissues in your mouth. It is
important to your total well-being that you follow the dentist's advice
while you're receiving radiation therapy. Most likely, you will be advised
to:
Clean teeth and gums thoroughly with a soft brush after meals and at least
once more each day.
Use a fluoride toothpaste that contains no abrasives.
Floss gently between teeth daily, especially if you flossed regularly before
your illness.
Use a disclosing solution or tablet after brushing to reveal plaque that
you've missed.
Rinse your mouth well with a salt and baking soda solution after you brush.
Use 1/2 teaspoon of salt and 1/2 teaspoon of baking soda in 1 quart of
water.
Apply fluoride regularly as prescribed by your dentist.
Your dentist can explain how to use disclosing tablets, how to mix the salt
and baking soda mouthwash, and how to use the fluoride treatment method that
best suits your needs. Most likely you can get printed instructions for
proper dental care at the dentist's office.


Handling Mouth or Throat Problems
Soreness in your mouth or throat may appear in the second or third week of
external radiation therapy. It is likely to decrease from the fifth week on
and end a month or so after your treatment ends. You may have trouble
swallowing during this time because your mouth feels dry. Your doctor or
dentist can prescribe medicine for mouth discomfort and advise you about
methods to relieve other mouth problems.

If you wear dentures you may notice that they no longer fit well. This may
happen if the radiation causes swelling in your gums. It's important not to
let your dentures cause gum sores that may become infected. You may need to
stop wearing your dentures until your radiation therapy is over.

Your glands may produce less saliva than usual, making your mouth feel dry.
It's helpful to sip cool drinks often throughout the day. Water probably is
your best choice. In the morning, fill up a large cup or glass with ice, add
water, and carry it with you so you have something to drink during the day.
Keep a glass of cool water at your bedside at night, too. Many radiation
therapy patients say that drinking carbonated beverages helps relieve dry
mouth. Sugar-free candy or gum also may help. Avoid tobacco and alcoholic
drinks because they will dry and irritate your mouth tissues even more.
Moisten food with gravies and sauces to make eating easier. If these
measures are not enough, ask your dentist about artificial saliva. Dry mouth
may continue to be a problem even after treatment is over.


Tips on Eating
If you are having radiation therapy to the chest, you may find swallowing
difficult or painful. Some patients say that it feels like something is
stuck in their throat.

Soreness or dryness in your mouth or throat can make it hard to eat.
However, there are several ways to ease your discomfort:
Choose foods that taste good to you and are easy to eat.
Try changing the consistency of foods by adding fluids and using sauces and
gravies to make them softer.
Avoid highly spiced foods and textures that are dry and rough, such as
crackers.
Eat small meals, and eat more frequently than usual.
Cut your food into small, bite-sized pieces.
Ask your doctor for special liquid medicines that can help you eat and
swallow more easily by reducing the pain in your throat.
Ask your doctor about liquid food supplements. These can help you meet your
energy needs.
If you are being treated for lung cancer, and you get your doctor's okay,
try to drink extra fluids. This will help keep mucus and other secretions
thin and manageable.
If your sense of taste changes during radiation therapy, try different
methods of food preparation.


Also, many helpful suggestions can be found in the NCI booklet, Eating
Hints.
(See Resources )
What Side Effects Occur With Radiation Therapy
to the Breast and Chest?
Radiation treatment to the chest may cause several changes. You will notice
some of these changes yourself, and your treatment team will keep an eye on
these and others. For example, you may find that it is hard to swallow or
that swallowing hurts. You may develop a cough. Or you may develop a fever,
notice a change in the color or amount of mucus when you cough, or feel
short of breath. It is important to let your treatment team know right away
if you have any of these symptoms. Your doctor also may check your blood
counts regularly, especially if the radiation treatment area on your body is
large. Just keep in mind that your doctor and nurse will be alert for these
changes and help you deal with them.

If you are receiving radiation therapy after a lumpectomy or mastectomy,
it's a good idea to go without wearing a bra whenever possible. If this is
not possible, wear a soft cotton bra without underwires. This will help
reduce the irritation to your skin in the treatment area. You may have
several other side effects if you are receiving radiation therapy for breast
cancer. For example, you may notice a lump in your throat or develop a dry
cough. Or, your shoulder may feel stiff; if so, ask your doctor or nurse
about exercises to keep your arm moving freely. Other side effects that may
appear are breast soreness and swelling from fluid buildup in the treated
area. These side effects, as well as skin reddening or tanning, most likely
will disappear in 4 to 6 weeks. If fluid buildup continues to be a problem,
your doctor will tell you what steps to take.

Women who have radiation therapy after a lumpectomy may notice other changes
in the breast after therapy. These long-term side effects may continue for a
year or longer after treatment. The redness of the skin will fade, and your
skin may be slightly darker, just as when a sunburn fades to a sun tan. The
pores may be enlarged and more noticeable. Some women report increased
sensitivity of the skin on the breast; others have decreased feeling. The
skin and the fatty tissue of the breast may feel thicker and firmer than it
was before your radiation treatment. Sometimes the size of your breast
changes-it may become larger because of fluid buildup or smaller because of
the development of fibrous tissue. Many women have little or no change in
size.

Your radiation therapy plan may include implants of radioactive material a
week or two after external treatment is completed. The implants may cause
breast tenderness or a feeling of tightness. After they are removed, you are
likely to notice some of the same effects that occur with external
treatment. If so, follow the advice given above and let your doctor know
about any problems that persist.

After 10 to 12 months, no further changes are likely to be caused by the
radiation therapy. If you see new changes in breast size, shape, appearance,
or texture after this time, report them to your doctor at once.
What Side Effects Occur With Radiation Therapy
to the Stomach and Abdomen?
If you are having radiation treatment to the stomach or some portion of the
abdomen, you may have to deal with an upset stomach, nausea, or diarrhea.
Your doctor can prescribe medicines to relieve these problems. Do not take
any home remedies during your treatment unless you first check with your
doctor or nurse.


Managing Nausea
Some patients report feeling queasy for a few hours right after radiation
therapy to the stomach or abdomen. If you have this problem, do not eat for
several hours before your treatment time. You may be able to handle the
treatment better on an empty stomach. After treatment, you may find it
helpful to wait 1 to 2 hours before eating again. If the problem persists,
ask your doctor to prescribe a medicine (an antiemetic ) to prevent nausea.
If antiemetics are prescribed, try to take them when your doctor suggests,
even if you sometimes feel that they are not needed.

If your stomach feels upset just before your treatment, eat a bland snack
such as toast or crackers and apple juice before your appointment. This type
of side effect may be related to your emotions and concerns about treatment.
Try to unwind a bit before you have your treatment. Reading a book, writing
letters, or working a crossword puzzle may help you relax.
Here are some tips to help an unsettled stomach:
Stick to any special diet that your doctor or dietitian gives you.
Eat small meals.
Eat often and try to eat and drink slowly.
Avoid foods that are fried or are high in fat.
Drink cool liquids between meals.
Eat foods that have only a mild aroma and can be served cool or at room
temperature.
For a severe upset stomach, try a clear liquid diet (broth and juices) or
bland foods that are easy to digest, such as dry toast and gelatin.


How To Handle Diarrhea
Diarrhea most often begins in the third or fourth week of radiation therapy.
Your doctor may suggest you change your diet, prescribe medicine, or give
you special instructions to help with the problem. Tell the doctor or nurse
if these changes fail to control your diarrhea.

The following changes in your diet also may help:
Try a clear liquid diet (water, weak tea, apple juice, clear broth, plain
gelatin) as soon as diarrhea starts or when you feel that it's going to
start.
Ask your doctor or nurse to advise you about liquids that won't make your
diarrhea worse. Apple juice, peach nectar, weak tea, and clear broth are
frequent suggestions.
Avoid foods that are high in fiber or can cause cramps or a gassy feeling
such as raw fruits and vegetables, coffee, beans, cabbage, whole grain
breads and cereals, sweets, and spicy foods.
Eat frequent small meals.
Avoid milk and milk products if they irritate your bowels.
When the diarrhea starts to improve, try eating small amounts of low-fiber
foods such as rice, bananas, applesauce, mashed potatoes, low-fat cottage
cheese, and dry toast.
Be sure your diet includes foods that are high in potassium (bananas,
potatoes, apricots), an important mineral that you may lose through
diarrhea.


Diet planning is a very important part of radiation treatment of the stomach
and abdomen. Keep in mind that these problems will be reduced greatly when
treatment is over. In the meantime, try to pack the highest possible food
value into even small meals so that you will have enough calories and vital
nutrients.
What Side Effects Occur With Radiation Therapy to the Pelvis?
If you are having radiation therapy to any part of the pelvis (the area
between your hips), you might have one or more of the digestive problems
already described. You also may have some irritation to your bladder. This
can cause discomfort or frequent urination. Drinking fluids can help relieve
some of your discomfort. Your doctor can prescribe some medicine to deal
with these problems.

There are also certain side effects that occur only in the reproductive
organs. The effects of radiation therapy on sexual and reproductive
functions depend on which organs are treated. Some of the more common side
effects for both men and women do not last long after treatment. Others may
be long-term or permanent. Before your treatment begins, ask your doctor
about possible side effects and how long they might last.


Effects on Fertility
Scientists are still studying how radiation treatment affects fertility. If
you are a women in your childbearing years, you should discuss birth control
measures with your doctor. It is not a good idea to become pregnant during
radiation therapy. Radiation may injure the fetus. In addition, pregnancy,
childbirth, and caring for a very young child can add to the physical and
emotional stress of having cancer. If you are pregnant before beginning
radiation therapy, special steps should be taken to protect the fetus from
radiation.

Depending on the radiation dose, women having radiation therapy in the
pelvic area may stop menstruating and may have other symptoms of menopause.
Treatment also can result in vaginal itching, burning, and dryness. You
should report these symptoms to your doctor or nurse, who can suggest
treatment.

For men, radiation therapy to an area that includes the testes can reduce
both the number of sperm and their effectiveness. This does not mean that
conception cannot occur, however. If you're having this type of treatment,
discuss your concerns and your birth control measures with your doctor. If
you want to father a child and are concerned about reduced fertility, you
can look into the option of banking your sperm before treatment.

Sexual Relations
During treatment to the pelvis, some women are advised not to have
intercourse. Others may find that intercourse is painful. You most likely
will be able to resume having sex within a few weeks after your treatment
ends.

Some shrinking of vaginal tissues occurs during radiation therapy. After
your radiation therapy is finished your doctor will advise you about sexual
intercourse and how to use a dilator, a device that gently stretches the
tissues of the vagina.

With most types of radiation therapy, neither men nor women are likely to
suffer any change in their ability to enjoy sex. Both sexes, however, may
notice a decrease in their level of desire. This is more likely to be due to
the stress of having cancer than to the effects of radiation therapy. This
effect most likely will go away when the treatment ends, so it should not
become a major concern. A booklet on sexuality and cancer is available
without charge from your local American Cancer Society office. There are
different versions for male and female patients.

----------------------------------------------------------------------------
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----- Original Message -----
From: <LiNeyes@AOL.COM>
To: <mol-cancer@lists.meds.com>
Sent: Tuesday, August 31, 1999 7:10 PM
Subject: [MOL] Information needed


> Where could I find on the internet information as to the side effects of
> chemo and radiation?  I had the surgery in April, started chemo shortly
> thereafter, had to stop it once because I was hospitalized with
neutrapenia.
> Now, I am going through radiation, still with severe side effects, on
lomotil
> and peragoric (?) every two hours,
> had to stop radiation for a week, during that time had another scope only
to
> find a stricture and very irritated lining.
>
> I would like information concerning these side effects, or even a support
> group on line to help with some information.
>
>
> Thank you,
> Nancy Blanco
> Richmond, Virginia
> ------------------------------------------------------------------------


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