Lymphoma

Living with Lymphoma

Reading time: 7 min
do not smoke

Give up smoking. If you smoke, it is very important that you quit as it aggravates the side effects associated with the treatments, such as loss of appetite and decreased lung capacity.

alcohol

Alcohol. As with smoking, you should not consume large amounts of alcohol, although drinking is not prohibited.

apple

Diet. There is no scientific evidence to suggest you should avoid eating proteins or sugars if you have cancer. No particular food is contraindicated, except on rare occasions due to interactions with certain drugs. Eat whatever you want but in small amounts and several times a day. It is important to maintain your muscular body mass and avoid losing too much weight.

Woman receiving acupuncture

Complementary therapies. They are not contraindicated; however, you should always discuss them with your doctor beforehand.

take part in regular physical exercise

Physical activity. Unless your doctor says otherwise, you should try to follow your normal routine and take part in physical exercise if possible. It will help minimise treatment-related side effects and accelerate recovery. Practising physical activity tends to produce a greater feeling of well-being. Ask your doctor about the most appropriate level of activity for you. Similarly, physiotherapy is very important after surgery and whenever patients suffer a loss of muscular mass in their legs.

Sexual relations

Sexual intercourse. As long as you generally feel well enough, then you can still practice sex. It is important for women of childbearing age to take contraceptive measures, as you should not get pregnant during treatment.

Emotional Support

Emotional support. There are different patient and family support groups that provide advice and support from people who have endured a similar situation. Ask staff at your health centre about this type of organisation.

How are the side effects treated?

The following symptoms may appear throughout treatment with chemotherapy:

nausea vomiting

Nausea and vomiting. Nausea and vomiting are the most common side effects and can even appear despite taking medicines to prevent them. It is important to remember that each course of chemotherapy is specific to each patient. Accordingly, the oncologist will inform you about the likelihood of experiencing these side effects and which medicines are bested suited to preventing them before you start treatment. In addition to drugs used to prevent vomiting and nausea (antiemetics), the use of antianxiety agents and relaxation techniques can also help by reducing the patient’s overall level of anxiety.

Mujer con una llaga en la lengua

Mucositis. Mucositis is inflammation of a mucous membrane and can produce painful sores and ulcers. It usually affects the oral mucous membrane, particularly the lips, tongue, palate and throat; although it can also occur in other areas, such as the anal, vulvar or virginal mucous membranes.If you notice pain or changes in your mouth during the cancer treatment, then you should discuss it with your doctor. Alleviation of the side effects is an important aspect of your cancer care and treatment.

chronic constipation

Constipation. Constipation is defined as defecating less than twice per week wherein the consistency of stools changes as they become hard and cause pain when expelled from the body. It is the most frequent intestinal complication in cancer patients and affects up to 40% when the disease is in an advanced stage and 90% of patients who take morphine, codeine or thebaine (opiates) to reduce pain or a cough. You should increase your fibre intake, reduce the consumption of astringent foods, e.g., rice, drink plenty of fluids, exercise or take laxatives. The presence of constipation can occasionally be indicative of a more serious problem that could require further tests and therefore it is a good idea to discuss any symptoms of constipation or changes with your healthcare team.

diarrhoea

Diarrhoea. When the chemotherapy affects the cells lining the intestine, then it may start to function differently. Consequently, the intestine loses its ability to absorb water and different nutrients, which gives rise to diarrhoea. The healthcare team will prescribe drugs to prevent the appearance of diarrhoea or which stop it as soon as possible. Following an astringent diet based around low-fibre foods (e.g., rice, boiled fish, baked apples, etc.), drinking fluids slowly, avoiding milk and dairy products, and abstaining from irritating drinks such as coffee or alcohol can all help control diarrhoea. Diarrhoea may sometimes be significant in terms of its duration and the number of bowel movements per day. In such cases, to avoid dehydration, it is vital that you contact your healthcare team so they may prescribe the most appropriate treatment.

thermometer fever

Fever. Fever can appear as a direct side effect of the drugs administered during chemotherapy. It generally appears in the first few hours after they are administered and disappears quickly. Fever may also be associated with an infection that arises due to the reduction in your defences (immunosuppression) induced by the actual treatment; this requires antibiotic therapy. If you experience a fever of above 38 °C, especially if it is accompanied by a cough with purulent phlegm, fatigue, pain or bleeding when urinating, catheter insertion site inflammation or any other associated symptom, then you should discuss it with you healthcare team as a matter of urgency.

Alopecia, Baldness, Falling Hair

Skin, nails and hair follicles. Chemotherapy can affect the skin, nails and hair follicles. Even though the level of toxicity is not usually very severe and the effects are reversible, its management is still very important as it affects the patient’s quality of life and impacts on their body image. 

  • Hair loss (alopecia). Alopecia occurs due to the action of the different drugs on the hair follicles, causing their destruction and subsequently hair loss. Hair loss is not always a side effect of chemotherapy since it depends on the type of drugs being used. There is also a chance that hair loss will be generalised, i.e., it not only affects the scalp but other parts of the body as well, such as the armpits, arms, legs, eyebrows, eyelashes, etc. It is a reversible side effect, but your hair may grow back with different characteristics than before (colour, texture, etc.).
  • Itchiness (pruritus), redness (erythema), dryness and flaking skin. These symptoms are not usually very significant, but they should still be monitored. If you notice sudden or intense itchiness on your skin, rashes, hives or difficulty breathing, then these could be signs of an allergic reaction that requires immediate medical attention.
  • Nails sometimes become very dark in colour and brittle, they break easily and vertical stripes may appear.
pill with warning sign

Incompatibilities with other medicines. You must inform your healthcare team about any other treatments you are following as they could interact with the chemotherapy. Patients taking digoxin (a drug used to treat heart diseases) must receive special attention as it can interfere with the absorption of other medicines. Oral anticoagulants (medicines used to treat heart diseases) can increase the toxicity or decrease the effectiveness of chemotherapy drugs that are eliminated. Antivirals (medicines used to treat people infected with HIV) can interact with some of the drugs used during chemotherapy. Interactions have also been observed with antiepileptic drugs.

 

 

portacath

Peripherally inserted central catheters (PICC line) and Port-a-Cath®. Chemotherapy is usually administered intravenously. Different devices are available for patients whose veins are difficult to access so that the nursing team can avoid repeatedly puncturing and damaging peripheral veins. A Port-a-Cath® and a peripherally inserted central catheter (PICC line) are the most used devices in cases of lung cancer.

  • PICC line is a catheter introduced through a vein in the upper arm. The end of the catheter finishes in a large vein close to the heart. It is inserted by making a small incision in the skin under the effect of a local anaesthetic. Once in place, the catheter is fixed to the arm to keep it in place. The healthcare team will then take an X-ray to ensure it is in the correct position. Once the PICC has been placed, the patient can go home without any complications. The catheter is protected with a waterproof dressing but it is still a good idea to avoid wetting it directly as it could become detached. Your healthcare centre will replace the dressing once a week.

  • The Port-a-Cath® is in the shape of a plastic disc and is inserted beneath the skin on the chest or on the arm, and connects with the blood stream via a catheter. The insertion of a Port-a-Cath® involves a short surgical procedure with local anaesthesia. Once the Port-a-Cath® and the catheter are inserted correctly and the incision has healed, only a small bump beneath the skin is noticed. It should not cause any discomfort, but is recommended to consult the health team before carrying out any activity that may involve excessive or repetitive physical movement. When no treatment is received, on not having a needle inserted, it does not require any special maintenance and the patient may wash and bathe normally. When treatment is received, the needle is covered with a dressing to fix it and keep the puncture area clean. The dressing must be kept clean and dry. The injection area must be examined regularly. If it moves, swells or reddening or a haematoma appears, it must be mentioned to the health team.

Substantiated information by:

Julio Delgado
Jaume Güell

Published: 20 February 2018
Updated: 20 February 2018

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