Easing Side Effects of Vulvar Cancer Treatment
Anxiety and depression
You may feel blue, anxious, or distressed after being told you have cancer. These feelings are normal and may continue or come back throughout treatment. Taking these actions may ease your mental stress:
Consider getting a referral to talk with a social worker, psychologist, or psychiatrist.
If you can continue to eat well during cancer treatment, you are more likely to maintain your strength, be more active, and better able to lower your chance of infection. It's important to remember that your body needs energy to heal itself. Maintaining your weight is a good way to know if you are giving your body the energy it needs.
When you're being treated for cancer, a diet high in calories and protein is usually best. The problem is that side effects of treatment, especially chemotherapy, can make you not want to eat. Some chemotherapy treatments can change the way food tastes to you. If this is the case, focus on eating a balanced diet and maintaining your activity level. Ask your doctor for a referral to a registered dietitian if you are having trouble with your appetite or your weight.
Also, try these tips to stimulate your desire to eat:
If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue, and cancer treatments cause you to use more protein than usual.
To maintain your weight, eat high-calorie foods, such as margarine or butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing.
Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, fruit juices, and other liquids, try gelatin, pudding, soups, fruit bars, and ice cream.
Bleeding problems (thrombocytopenia)
Certain kinds of chemotherapy may reduce your blood platelet count. Without enough platelets, your blood may have trouble clotting and lead to a problem called thrombocytopenia. If your doctor tells you that your platelet count is low, take these actions to avoid causing injuries that could lead to bleeding problems:
Constipation, which includes difficult or infrequent bowel movements, can range from mildly uncomfortable to painful. Taking pain medications can lead to constipation so it's wise to take these preventive actions. These same steps will give you relief if you are already constipated:
Radiation and chemotherapy can cause bowel changes. Diarrhea, which includes loose or frequent bowel movements, or both, may lead to dehydration if you don't take these precautions. Try these steps:
Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.
Eat low-residue, low-fiber foods such as those found in the BRAT diet (bananas, rice, applesauce, and toast).
Many types of chemotherapy can cause hair loss. Losing your hair can be upsetting because thinning or baldness is a visible reminder that you are being treated for cancer. Keep in mind that your hair will grow back after treatment, though it may look different than it did before.
Try these coping tips:
Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair, and you'll be ready with head coverings, if you choose to use them.
A hot flash is also called a hot flush. It is a sudden rush of warmth, with or without sweating, to the face, neck, upper chest, and back. It can last for a few seconds to an hour or more. Hot flashes can occur with chemotherapy. Some women have mild symptoms, while others have more severe ones. In many cases, hot flashes stop when treatment stops. To ease them, try these tips:
Increased risk of infection
Many types of chemotherapy can cause a low white blood cell count, which is called neutropenia. Without enough white blood cells, your body may not be able to fight infection.
If your doctor tells you that your white blood cell count is low, take these actions to stay healthy:
Call your doctor right away if you have any of these signs of infection: a temperature of 100.5° F (38° C) or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.
Insomnia (trouble sleeping)
Insomnia can be caused by anxiety, depression, or your cancer treatment. Use these tips to improve your rest:
Surgery for vulvar cancer usually does not involve removal of the ovaries. Radiation treatment and some types of chemotherapy can damage the ovaries or cause menopausal symptoms in women who've not yet reached menopause. They include symptoms, such as hot flashes, vaginal dryness, mood swings, and weight changes. If you were premenopausal, periods may become irregular or may stop, and you may not be able to get pregnant. However, some women may still be able to get pregnant after treatment:
Talk with your doctor about ways to manage menopausal symptoms, such as using lubricants for vaginal dryness, exercising, and talking with a therapist about mood swings or signs of depression.
It's normal to experience emotional changes, both during and after cancer treatment. Even if cancer treatment is successful, many people experience fears about what the future holds. Talk with your doctor or nurse about ways to manage these changes and consider these tips as well:
Mouth sores and dryness
Some types of chemotherapy may cause mouth sores and dryness. Mouth sores may hurt and make it hard to eat. Chronic dryness can impair your ability to taste, chew, and even speak.
To prevent sores or to treat dryness in your mouth, take these actions:
To ease the pain if you get sores in your mouth, take these actions:
Nausea or vomiting
Nausea or vomiting as a result of chemotherapy and radiation treatment for vulvar cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea:
Anticipatory nausea and vomiting are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.
To prevent nausea, take these actions:
Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then, make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.
To help ease nausea or vomiting if you have it, try these tips:
Try eating foods and drinking beverages that were easy to take or made you feel better when you had the flu or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.
Drink 6 to 8 glasses of liquids, such as water, broth, or Gatorade, a day to avoid dehydration.
You may have pain following surgery. Try these tips to ease pain:
Use heat, cold, or relaxation techniques, such as yoga, meditation, or guided visualization. Ask your doctor or nurse where you can learn more about these.
Feelings of depression from having cancer, having all or part of your vulva removed or radiated, or fatigue from other treatments can have a negative impact on your sexual desires. Some women may experience negative body image after radical vulvectomy. After radiation therapy, a woman might find that her vulva has changed and her vagina is narrower and less flexible. Sexual intercourse may be difficult or painful because the vulvar skin in the treated area can be sensitive.
Here are some ways to cope so that you can better focus on your physical recovery:
Radiation treatment of the vulvar skin may produce a reaction similar to sunburn. Chemotherapy applied as an ointment may also irritate skin. Ask your radiation oncologist or radiation oncology nurse about a skin cream to provide relief.
If your doctor removes lymph nodes from your groin, you may have swelling in your legs or vulva. This is more likely if you also have radiation therapy to this area. Swelling may occur right after surgery, or it may happen later. It is caused when excess lymph collects in tissue. Swelling can also lead to pain and fatigue.
To reduce your risk of swelling or to reduce swelling, take these actions:
Watch for signs of infection, such as redness, pain, heat, swelling, and fever. Call the doctor immediately if any of these signs or symptoms appears.
To avoid injury and infection in your legs, take these precautions:
Thought or memory problems
You may have mild problems with concentration and memory during and after treatment. Fatigue and stress can make it worse. Taking these actions may help:
Tiredness or fatigue
Tiredness is a very common symptom and side effect from chemotherapy and radiation treatments. It is also a symptom of anemia, which is a low red blood cell count as noted from blood tests. Or it can be caused from a vitamin B12 or iron deficiency, which your doctor may also find in a blood test. Whatever the cause, you may feel only slightly tired or you may suffer from extreme fatigue.
Taking these actions may help increase your energy level:
You may have problems with urination following radiation therapy. This could lead to bladder spasms and frequent, urgent, or burning urination:
Vaginal dryness and other vaginal problems
If you have a hysterectomy, vaginal dryness may result. Lowered estrogen levels may also cause women to have vaginal thinning and difficult or painful intercourse. Lubricants can help with some of these problems. Vaginal infections may also occur more often. When you talk with your doctor about these problems, make sure he or she knows you've had cancer. Try these methods to ease symptoms:
Some women experience slow healing or other problems at the site of surgery:
After urinating or having a bowel movement, clean your vulva with warm water. You can do this by squeezing water onto your vulva with a plastic squeeze bottle. Again, dry thoroughly by gently patting or using a blow dryer.
Call your doctor or nurse if there is drainage that changes in odor, amount, or color, or if you have any fever.