Krupa Parekh-Padia talks about the trials, tribulations and triumphs breast cancer patients face.
I spend a lot time with patients who are to begin chemo, as there are many fears and concerns associated with the treatment. The most common question is, “Will I lose my hair?” Hair for women is a feature that makes them feel beautiful, and because it’s an external feature, it especially contributes to self-esteem.
Although, it pains me to tell the truth, it’s important to understand that with certain types of chemo – hair loss is inevitable, but with others – hair thinning or minimal hair loss can be expected.
While I was a chemo nurse, one method used to prevent hair loss was cold caps. Also, known as scalp hypothermia, cold caps are used to try and prevent hair loss. When the cold cap is applied to the scalp, it causes the vessels under the skin to constrict, which prevents the chemo from reaching the hair follicles. Since this treatment is time sensitive; it must be applied about 30-50 minutes before chemo, for the duration of the drip, and after for it to be effective. They wouldn’t always work; it depended on the type of chemo the patient was on.
I’ll never forget a patient, who was diagnosed with ovarian cancer, and adored her hair. She was so crazy about her hair, she even had her hairdresser come to the unit to do a blow wave, prior to her surgery. When she was told, she needed chemo, she started using cold caps on her hair and eyebrows. As her treatment went on, her hair loss was minimal. Based on the chemo regimen she was on, it certainly helped prevent total hair loss.
I’ve heard conflicting emotions related to surgery. On one hand, some patients feel they need to rid their body of cancer and if surgery is what it takes to do that, then it must be done.
On the other hand, patients are anxious, scared and devastated that their breasts – the part of their body that could be their best feature, and what makes them feminine – need to be removed.
Not only are mastectomies physically altering, but for some, psychologically debilitating as well. Many women have an extremely hard time coping with body image with this change.
It’s important to meet with your surgeon(s) until you feel comfortable enough to go ahead with the surgery, even if it means several visits. Breast reconstruction or the use of internal or external prosthesis are also wonderful options to explore when discussing surgery. Seeing a navigator or the unit’s psychologist before going in for surgery is highly recommended.
To counter anxiety related to surgery, I encourage my patients to turn to spirituality, meditation, and light exercise. Reaching out to family and friends, joining a support group or speaking to someone who’s been through the process is also helpful.
No matter how much counselling one may have, some may never feel good about going through a mastectomy. However, to ease the situation, is to never bottle up feelings. It is vital to have open means of communication with those around you and allow them to help you through the process.
The hardest thing for a patient, who has endured surgery, chemo and radiation, is to hear they need to go through five to 10 years of endocrine therapy. I’m often asked, “Does it really need to be that long?” The answer is always the same – yes.
One of the more challenging aspects to work with are the side effects of tamoxifen. Many times, I have patients on the phone, asking for remedies to counter their hot flashes, decreased libido or vaginal dryness.
Fortunately, with the progress in care for survivors, these symptoms can be monitored and treated by oncology care physicians (doctors who treat overall care of patients who have completed cancer treatment).
To add to the challenge, compliance becomes an even bigger issue since some of the side effects become far too intolerable. I advise, that as opposed to stopping, to seek advice from your oncologist or breast surgeon before defaulting from treatment.
Tamoxifen has been one of the most significant advances in breast cancer research as it increases overall survival rate and decreases chances of recurrence. Countless studies have proven the efficacy of the medication in hormone-receptor positive patients.
MEET OUR EXPERT – Krupa Parekh-Padia
Krupa Parekh-Padia was born in South Africa and brought up in USA. She is a California State University, Los Angeles BSc. Nursing graduate. She started off her career at Keck Medical Centre of the University of Southern California where she specialised in surgical oncology. She is now working as your patient navigator at the Netcare Milpark Breast Care Centre of Excellence.