Coping With Chemotherapy Side Effects
- Actress Shannen Doherty, 52, has revealed a moment she’s “really proud of” in her career, a time when she worked with director and screenwriter James Cullen Bressack amid her cancer treatment. She recalls forgetting her lines in the 2017 American horror film, also starring Tom Green, Stefanie Estes and Zack Ward, something which was very unlike her.
- Doherty has battled breast cancer since 2015. Although the cancer went into remission in 2017, it returned as stage 4 cancer in 2019, meaning it has spread to other body parts, including her brain. She underwent brain surgery to remove a tumor last year. Since the surgery, Doherty’s remained in good spirits and an inspiration to anyone battling cancer.
- Chemotherapy stops cancerous cells from growing, dividing, and spreading to other organs. It works by traveling through the bloodstream, killing cancerous cells. However, the process also impacts healthy cells, leading to side effects.
- Many cancer survivors have reported experiencing something called “chemo brain,” when people have difficulty with the cognitive ability to mentally process or understand things after chemotherapy and other cancer treatments.
- Ways to manage chemo brain include writing important information down, planning your day ahead of time, getting plenty of sleep, exercising your mind with puzzles or games, and working with a social worker for more support.
- For more on how to manage chemotherapy side effects, check out SurvivorNet’s digital guide.
On a recent episode of Doherty’s podcast “Let’s Be Clear,” the “Charmed” actress recounted a time when she was working with director and screenwriter James Cullen Bressack amid her cancer treatment, and how she dealt with the enormous challenges of her disease and treatment.
Read MoreDoherty credited some of her perseverance through working with cancer to the trust she had with Bressack, as she acted in the 2017 American horror film, also starring Tom Green, Stefanie Estes and Zack Ward. According to IMBD, “Bethany” is a “story of a woman returning to her childhood home, which stirs up memories of maternal abuse and fear. The full story of her past unfolds throughout and is not until the end that we find out the truth.”View this post on Instagram
“One thing I love about working with the same people, especially with working with you is, every time you work with somebody, it’s like you’re learning their language. Every person in entertainment, in a creative art, speaks a different language. And so when you learn that person’s language and you learn how to communicate with them … and you become family,” Bressack said, referring to the connection both he and Doherty have with each other as they worked on “Bethany.”
“I think that trust went both ways when we did ‘Bethany,’ because I remember right before the first day of filming on ‘Bethany,’ you had gotten the cancer diagnosis, like or that week, and you had called me and you just started meds, and you were like, ‘I’m not sure if I can do this.'”
Bressack continued, after Doherty chimed in to say she was “worried” during that time, “I told you, look, if you can’t do it we’ll figure it out and I’ll get somebody else, but I think you’re going to want to get your mind off of it and do it, and if you do, I’ll send you the call sheet, you’ll be there and if you don’t show up I’ll know that you can’t do it and I’ll get a replacement, don’t worry about us.
“And you showed up … you did it, and I remember there was the one time, ’cause I guess the meds were messing with you a little, you had that one speech that you had to give, when you were looking at your face in the mirror.”
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Doherty explained, “It was a weird speech to begin with. The way that it was written, it didn’t come out and then it was obviously, literally like a week or two weeks after getting diagnosed, just starting meds, my brain was on overdrive thinking about cancer, and what is this mean and what are the next steps.”
She recounted how she got the “super intense monologue” which didn’t make sense to her and how she had trouble memorizing the lines, something which never happens as she claims to have a “photographic memory.”
When Doherty suggested to “convey” the lines with “just a look,” Bressack recalled her doing it perfectly without words, adding, “You didn’t have to say anything. It was all on your face right there and I think that really showed trust on both of our sides.”
Agreeing with Bressack, Doherty admitted, “I think it’s actually, if I just take that scene, you know I don’t have a website but if I did I would put it there as a moment that I’m really proud of as an actor… I would put that on, because I felt like it’s much harder to convey everything through a look.”
Bressack pointed out how there was such an “authentic raw vulnerability at that point” in Doherty’s life, in addition to that moment on camera, therefore he also dubbed that as one of his “proudest moments as a director.”
Shannen Doherty’s Cancer Battle
Shannen Doherty first received a breast cancer diagnosis in 2015 after she discovered a lump in her breast. For treatments the first time around, she underwent hormone therapy, a single mastectomy (the removal of all breast tissue from one breast), chemotherapy and radiation.
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Then in 2017, Doherty was deemed to be in remission, however, the cancer returned just two years later in 2019 as metastatic, or stage four, breast cancer.
There is technically no cure for metastatic breast cancer, but that doesn’t mean people can’t live good, long lives with this stage of disease, thanks to hormone therapy, chemotherapy, targeted drugs and immunotherapy, as well as a combination of treatments.
Doherty took to Instagram earlier this year to recap how her cancer fight is going. She underwent her first round of radiation to her head on Jan. 12, 2023, followed by brain surgery to remove and biopsy a tumor on Jan. 16, 2023. The surgery she underwent is called a craniotomy.
Several neurosurgeons tell SurvivorNet that the procedure can allow patients with cancer in their brain to live longer, more vibrant lives, and this appears to be the case with Doherty who has recently been taken to Instagram to share photos and videos of time spent with friends and recent interviews of her podcast “Lets Be Clear.”
Working Through Cancer
Shannen Doherty’s decision to continue acting throughout cancer treatment is something many SurvivorNet experts recommend patients do if they can continue to work.
“We always encourage people to continue to work if they can,” says Sarah Stapleton, a clinical social worker at Montefiore Medical Center. “I think it creates a sense of normalcy for patients.”
WATCH: Choosing to Work During Cancer Treatment
If you’re able to work, you’ll be busy, and you may not be worrying all the time about how your treatment is going, Stapleton adds.
Sometimes, cancer can make you feel isolated and lonely, and being around people for work can alleviate feelings of loneliness. It would be best to talk with your doctor before continuing to work during treatment. Ask your physician what you can and cannot do so you don’t disrupt ongoing treatment.
Remember, sometimes cancer treatment can cause fatigue, leaving you unable to fulfill your duties as you once could. Fortunately, some on-the-job accommodations can make working during cancer treatment much easier.
The Rehabilitation Act or the Americans with Disabilities Act protects people with job problems related to cancer. The Family and Medical Leave Act (FMLA) may also benefit others. This law allows many people with serious illnesses to take unpaid leave to get medical care or manage their symptoms.
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Your human resources department should be able to share with you your options.
In some situations, employers must accommodate a qualified applicant or employee with a disability unless the employer can show it would be an undue hardship to do so. This could mean making changes to work schedules, equipment, or policies.
Laurie Ostacher, a behavioral health clinician at Stanford Health Care, recommends that cancer patients discuss accommodations they may need upon returning to work with their employers.
“Patients need to let their employer know [they’re] going to need some flexibility… Because there are going to be days when you’re not as energetic or feeling as well as other days,” Ostacher explained.
Managing Chemotherapy and Its Side Effects
Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.
Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle, previously told SurvivorNet.
“Neuropathy is probably one of the most challenging side effects,” explains, Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”
Hair loss is another side effect of chemotherapy.
WATCH: Coping with hair loss.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment. It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.
Most patients can expect regrowth four to six weeks after treatment. However, it is possible when your hair grows back, you may notice some changes in its color and texture.
How to Deal With the Side Effects of Chemotherapy
Chemo Brain Is Real
“Chemo brain is real,” ovarian cancer survivor and stand-up comedian Karen Mills previously told SurvivorNet. She explained how she once “pulled into the drive-thru lane at the bank and told the teller, ‘I’m here to pick up my prescription.'”
According to the National Cancer Institute (NCI), chemo brain is “a term commonly used to describe thinking and memory problems that a patient with cancer may have before, during, or after cancer treatment.”
“Signs and symptoms of chemo brain include disorganized behavior or thinking, confusion, memory loss, and trouble concentrating, paying attention, learning, and making decisions,” the institute explains.
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Managing Chemotherapy Side Effects
The NCI states that this condition could be brief or last for many years and researchers say chemo isn’t the sole culprit of chemo brain.
“From many sources of data, we now know patients experience impairments not just after chemo, but after surgery, radiation, hormonal therapy,” and other treatments, said Dr. Patricia Ganz, an oncologist and director of Cancer Prevention and Control Research at UCLA’s Jonsson Comprehensive Cancer Center, previously told the National Cancer Institute.
Dr. Douglas Blayney, a medical oncologist at Stanford Health Care, has done research on the condition and says “the dysfunction is usually temporary and clears within a year of starting treatment. For some people, its effects are more long-lasting, and may never completely resolve.”
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These patients “have to work harder,” Dr. Ganz said. “Often they’ll get the answer right on a neuropsychology test, but it takes much more effort for them to come up with that” than people who haven’t been exposed to treatment.
Dr. Ganz believes inflammation may be a factor, adding, “If we could identify people who might be more susceptible biologically to this long-term treatment, we could test whether an intervention might be helpful,” she said.
Managing Chemo Brain
There are many tools survivors can use to help cope with chemo brain. The NCI suggests the following ways:
- Get rest and plenty of sleep at night.
- Plan your day ahead of time.
- Keep up with light physical activity (your doctor can help you come up with a plan that makes sense for you).
- Exercise your mind through meditation, puzzles or games.
- Write things down or keep lists of important information.
- Talk with a social worker for additional resources and support
What To Ask Your Doctor
If you have been diagnosed with breast cancer, you may have questions about keeping your strength through treatment. Here are a few questions to help you begin the conversation with your doctor:
- What treatment will I be receiving?
- What side effects are associated with this treatment?
- Are there steps I can take daily to help minimize these side effects?
- What physical activity routine do you recommend for me during treatment?
- Do you have recommendations for someone who doesn’t particularly enjoy exercise?
- Can you recommend a dietician who can help me with healthy eating tips and weight maintenance?
- I’ve been having trouble sleeping. Do you have any treatment recommendations?
Contributing: SurvivorNet Staff
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