| Chemotherapy
Chemotherapy is a treatment using drugs that cure
or control cancer. These drugs are used on their own or in combination.
Chemotherapy can be used to treat melanoma that has spread to other
parts of the body at time of diagnosis or melanoma that recurs following
initial treatment. Most patients with melanoma who need chemotherapy
will get a combination of three or four drugs. Chemotherapy may
be given before or after radiotherapy. It can also be given after
surgery.
The drugs used in chemotherapy travel through the
blood stream to almost every part of the body. They are often given
in cycles such as once every 2 to 4 weeks. There is usually a rest
period between each course of treatment. This allows the body time
to recover from the effects of the drugs. Each visit to hospital
for treatment is called a cycle. The number of cycles you have will
depend on how well the melanoma is responding to treatment.
Chemotherapy may be given by direct route into a
vein as an injection or through an intravenous infusion (drip).
It may also be given in tablet form. You may have to stay in hospital
overnight for treatment. However, some treatments are given in day-care.
The drugs used include Dacarbazine, Cisplatin and
Carmustine. Before your chemotherapy is given, your doctor will
discuss your treatment options with you.
Side
effects of treatment
The side effects of chemotherapy vary from one person
to another and depend on the drugs used. It is possible to have
this treatment and have side effects that are well controlled with
medication. These unwanted effects happen because while the chemotherapy
is working on the cancer cells it can have an effect on normal cells
too.
Before you start your treatment ask your doctor
about any side effects that may occur. Do tell your doctor about
the way you are feeling during your treatment as most side effects
can be eased with medication. In most cases, the side effects go
away when the
treatment ends or soon after. Your doctor or nurse can give you
something to stop most of them or make them easier to cope with.
Infection
Chemotherapy can make you more likely to get infections.
This happens because most chemotherapy drugs affect the bone marrow,
which makes the white blood cells that fight infection. If you do
not have enough white cells, even a minor infection such as a cold
or a sore throat could make you quite ill. During each treatment
cycle you will have blood tests to make sure that you have enough
white blood cells.
Your doctor will ask you to watch out for signs
of infection at all times especially if your white cell count is
low. These signs could include feeling shivery and unwell or running
a high temperature of 38º Celsius (100.3 Farenheit) or higher.
If this happens tell your doctor straight away. He or she will tell
you what to do. Some hospitals prefer you to ring them directly.
Check this out with your nurse or doctor before you start treatment.
If you have a high temperature or feel unwell, you will need to
have a blood test to check if your white cells are low. You may
need medication to treat the infection.
As you will be more at risk of picking up infections
while on treatment, try to avoid close contact (such as hugging
or kissing) with people who have colds or flu and other infections
such as chicken pox, shingles or measles. Let your doctor know if
you are in contact with these or any other infections. Wash your
hands often during the day, especially before you eat and after
going to the toilet. Infection is a serious complication of chemotherapy.
You will need treatment as soon as possible. Talk to your doctor
or nurse. They will give you more information.
Feeling
sick (nausea) or wanting to be sick
Not everyone feels sick or gets sick with chemotherapy,
but if you do it can happen before, during or after treatment. It
may last for several hours. There are very effective drugs available
now that prevent or reduce nausea and vomiting. Ask your doctor
to give
you medication to stop you feeling sick. Take your medication as
directed by your doctor.
Let your doctor or nurse know if the drugs are not
working as they can be changed.
Sore
mouth
Some drugs used to treat melanoma can cause a sore
mouth. They can also cause little ulcers to appear on the tongue,
gums and inside the cheeks of your mouth. Try to keep your teeth,
gums and mouth very clean, as this will reduce the risk of getting
a mouth
infection. Clean your teeth after each meal. Use a soft toothbrush.
If you have dentures remove them if your gums are sore. There are
special mouthwashes that you can use. Your nurse will show you how
to use them properly.
Not
wanting to eat
It is best to eat as much you can while on chemotherapy.
You may become tired and unwell if you are not eating properly.
Eat smaller amounts more often. If you do not feel like eating during
treatment, you could try replacing some meals with special food
supplements. The dietician will be available to advise you. For more information on diet and nutrition, please refer to Cancerbackup's Eating Well Section
Fatigue
You may feel
very tired. This tiredness can last for some weeks after treatment
has ended. If this happens take things easier. Do less than you
would normally do. Rest more if you can. Ask your family or friends
to help you at work or at home. For more information on fatigue please
click
here.
Numbness
or pins and needles in the hands and feet
Some chemotherapy drugs used to treat cancer can
cause tingling or burning sensations in your hands and feet. You
may also have trouble in picking up small objects or buttoning up
a shirt or cardigan. This effect is almost always temporary and
goes away
after treatment stops. However, do tell your doctor if this happens,
as some changes may need to be made to your treatment.
Hair
loss (alopecia)
You may notice that your hair thins out a little.
It is not usual for your hair to fall out completely. If you do
lose your hair it normally occurs about 2-3 weeks after your first
cycle of chemotherapy. Try not to worry, as your hair will start
to grow again when treatment stops. You may feel upset at the thought
of losing your hair. Talk to your nurse or social worker about your
feelings. He or she will help you find ways to cope with hair loss.
You can get a wig when this happens or you may prefer to wear a
hat, turban or scarf.
If you would like a wig, talk to your social worker
or nurse. He or she will provide you with the names and addresses
of wig fitters. Your local hairdresser may also help. In some cases
it is possible to get financial assistance towards the cost of a
wig. Ask your social worker or nurse. For most patients the amount
of hair loss is small. A wig is not always needed.
Factsheet: Hairloss
If you are concerned
about other side effects or symptoms, talk to your doctor or nurse
straight away. He or she will tell you what to do. You may also
wish to contact the National
Cancer Helpline 1800 200 700 to speak to a
specialist cancer nurse.
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