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    A Moment with Maria

    Maria Licoudis, R.N. & Care Manager at Home Care Assistance Montreal

    Chemotherapy in the Elderly - June 2015

    Chemotherapy drugs are powerful and effectively kill cancer cells. At the same time, they harm and kill healthy cells as well. There are multiple chemotherapy drugs, that, depending on the dosages and the treatment, have varying side effects. Since cancer increases with age, it is important for us as caregivers to be familiar with the side effects of cancer or chemo so we can better care for our clients.

    Chemotherapy affects the circulatory system and harms red blood cells (RBCs) and bone marrow. Because red blood cells carry oxygen to tissues, anemia can occur with chemotherapeutic drugs, making our patients feel weak, lightheaded, cold, and prone to infection.

    The immune system becomes depressed due to the chemotherapeutic drugs destroying white blood cells, which protect us and fight bacteria and viruses. More common side effects include nausea, vomiting, mouth sores, difficulty chewing and swallowing due to dry mouth, white-yellow coating of the tongue and mouth, metallic tastes in the mouth, constipation and/or diarrhea, loss of appetite and weight loss.

    Side effects of the integumentary systems (skin) include loss of hair, skin dryness, itchiness, nail brittleness and skin sun sensitivity.

    The kidneys work harder to excrete the chemotherapeutic drugs causing decreased urination, swelling of hands and feet, urinary frequency and burning, and potential kidney failure. In addition bone loss can occur since calcium levels drop. Bone and spinal fractures can occur more readily even with minimal movement and mobility.

    Chemo drugs also affect memory and concentration as well. This is referred to as “chemo fog”. Tingling, weakness, and numbness can occur in all extremities. Reflexes and motor capacity are slowed and delayed.

    Patients dealing with chemotherapy and its side effects, as well as the uncertainty of their diagnosis, can experience fear, stress, anxiety and depression.

    A caregiver must be alert to all these and any other individual side effects that may occur. Nausea and vomiting can be treated with antiemetics, ginger supplementation, eating smaller amounts more often, and having carbonated drinks available at all times. Hair loss usually causes distress to some, and the psychological impact can be great. Cancer support groups can refer to wig stores or one can simply wear a hat if they feel the need to. Reassure patients that the hair will grow back after the treatment. Fatigue and weakness can be dealt with by minimal exercise, minimal activity, frequent rest periods and proper eating and hydration. Doctors may prescribe vitamins and other supplementations. Eating protein, beans, and dark green leafy vegetables can increase RBC. Hygiene, cleanliness and proper hand washing can keep bacteria at bay and decrease the possibility of transference of infection. Visitors who are ill should stay away or wear masks and gloves to be able to visit and have contact with their loved ones. If the patient has any open skin sores, they must be kept clean, dry, and covered. Patients receiving chemo who develop any sign of infection must be treated immediately – the doctor must be called or they may go to an emergency room. Mouth care is critical to decrease pain when eating and drinking. Keeping hydrated increases mucosal plumpness. Teeth brushing, mouthwash and glycerin swabs should be daily rituals.

    A multi-disciplinary team approach is critical to relieve patients of any discomfort during the chemotherapeutic process. Every person experiences chemo differently, but with advances in medicine and a loving supportive environment, we should be able to provide a smooth transition to a more comfortable state of well-being.

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