The diagnosis may be an uncertain process and the prognosis is rarely conclusive because projections can only be expressed in terms of probabilities. Living with cancer involves living with uncertainty. It is always a long process with a series of stages (pre-diagnosis, acute or diagnosis, chronic or terminal), each with their own specific problems and characteristics.
Moreover, there is take into account that during the treatment must cope with several physical, emotional, psychosocial, and nutritional changes, and they must be familiar with these changes in order to manage them correctly.
Physical activity. It is important to maintain normal routines and practice some sort of exercise insofar as possible and provided that it is not contraindicated. Keeping active helps minimise the side effects associated with the treatment and promotes early recovery. Regular physical activity creates an increased sense of well-being, maintains muscle tone, decreases fatigue, increases appetite, regulates stress, reduces constipation and helps relax the mind. Similarly, physiotherapy exercises are very important after surgery and whenever patients lose muscle mass in their legs. It is vital to ask the doctor about the most appropriate level of activity.
Alcohol. Patients are advised not to drink alcohol, although it is not prohibited.
Diet. There is no scientific evidence to suggest that patients should avoid eating any specific foods. Therefore, no particular food is contraindicated, except on rare occasions due to interactions with certain drugs. Patients should whatever they feel like, but in small amounts and several times a day. It is important to maintain muscle body mass and avoid losing too much weight.
Patients can eat before and after receiving chemotherapy, but it really depends on how each individual feels. It is a good idea to eat light foods to encourage better tolerance.
General dietary recommendations
Eat at least 4–5 times a day: breakfast, mid-morning, lunch, mid-afternoon and dinner.
Eat small meals but with a high nutritional value.
Follow a balanced, varied diet that includes all the food groups.
Follow a regular timetable as closely as possible.
Use simple cooking methods to aid digestion and retain the food’s vitamins and minerals: steamed, boiled, in the oven, in the microwave, wrapped in foil and in a griddle pan at a low temperature. Soft stews prepared with vegetables such as pumpkins, carrots, onions, and so on, are another option.
Patients should eat only moderate amounts of fat, especially animal fats. It is preferable to read lean or white meats (chicken, lean steak, rabbit) and fish.
Eat fruit several times a day as they are rich in vitamins and minerals.
Eat fresh foods when they are in season.
Drink at least 2 litres of water per day (water, infusions, broths, fruit juices).
Ensure foods are prepared hygienically; wash all fruits and vegetables before peeling them, cover and store foods in the refrigerator, etc.
Patients should avoid consuming alcoholic or stimulating drinks.
Eat slowly and chew food thoroughly.
Medicines. Chemotherapy can interact with other treatments, so patients must inform their healthcare team about any medicines they are taking. Patients taking digoxin (a drug used to treat heart disease) must receive special attention as it can interfere with the absorption of other medicines. Oral anticoagulants (medicines used to treat heart disease) can increase the toxicity or decrease the effectiveness of drugs. Antivirals (medicines used in the treatment of HIV infection) can interact with some chemotherapy drugs. Interactions have also been observed with antiepileptic agents.
Personal hygiene. Most cancer treatments produce dermatological changes. Therefore, skincare is very important throughout treatment. Cleanliness and hydration are essential during this period. Skin is usually more sensitive and vulnerable to infections, so it is important to incorporate routine hygiene, hydration and sunscreen habits for both the face and body. It is also important to maintain good oral hygiene to prevent irritations or lesions of the mucous membrane.
Sexual intercourse. Patients can still practice sex as long as they generally feel well enough. It is important for women of childbearing age to take contraceptive measures, as they should not get pregnant during treatment.
Sleep. Patients should sleep between 6–8 hours. Patients should not worry if they sleep more during chemotherapy and the first month after surgery as the body is experiencing a stressful process and therefore may need more rest than usual. Bear in mind that older patients recover more slowly.
Smoking. Patients who smoke must quit as it aggravates the side effects associated with the treatments, decelerates tissue healing processes (in the case of surgical interventions), reduces appetite and decreases lung capacity.
Complementary therapies. Given the lack of solid evidence, patients should always check with their healthcare team beforehand.
Travelling. There are no contradictions against travelling for patients with cancer, the simply need to take into account the schedule for their chemotherapy sessions.