Yes, you CAN escape the nastiest side-effects of treating cancer: As NHS rolls out new way to protect prostate patients, we take a look at the other high and lo-tech innovations that can make all the difference
More people than ever are living with cancer — as many as 2.5 million in the UK, according to Macmillan Cancer Support.
But therapies to keep the disease under control can be gruelling, with side-effects including sickness, nerve damage and hair loss. In fact, one in 12 patients refuses to have chemotherapy as a result.
But innovative approaches to counter these problems are emerging all the time: just last month, the NHS announced it was rolling out a technique for protecting prostate cancer patients during radiotherapy, where a liquid gel ‘spacer’ is injected between the prostate and rectum to reduce damage to healthy tissue.
Here, we look at a range of pioneering approaches to help minimise the side-effects of cancer treatment . . .
Radiotherapy uses beams of radiation to damage cancer cells, and is highly effective against breast cancer — but it can raise the risk of heart attack. The heart lies just behind the left breast and, when directed at a breast tumour, radiotherapy can also damage the heart [File photo]
Hold your breath to protect heart
Radiotherapy uses beams of radiation to damage cancer cells, and is highly effective against breast cancer — but it can raise the risk of heart attack.
The heart lies just behind the left breast and, when directed at a breast tumour, radiotherapy can also damage the heart, over time causing inflammation that may block blood supply and lead to heart disease or heart attack.
A technique called deep inspiration breath hold can protect patients from this side-effect.
Patients simply take a deep breath and hold it for around 20 seconds just before each radiotherapy dose. As the lungs expand, they push the heart back and down out of danger.
More people than ever are living with cancer — as many as 2.5 million in the UK, according to Macmillan Cancer Support. But therapies to keep the disease under control can be gruelling, with side-effects including sickness, nerve damage and hair loss [File photo]
A study of 50 patients, published in the journal Practical Radiation Oncology in 2014, found it reduced the radiation dose to the heart by 75 per cent compared with those who breathed normally. It can also help in lung cancer or cancer of the lymphatic system.
A similar approach is also being introduced for tumours in the liver and pancreas, although here patients hold a deep exhaled breath before each radiotherapy dose to ‘immobilise’ the organ.
With the right guidance this technique can be used without needing expensive machines.
Dr Andy Gaya, a consultant oncologist based in London, says: ‘Deep inhalation is used now to protect the heart in breast cancer and lymphoma radiotherapy, and expiration breath hold is increasingly used for liver and pancreas radiotherapy.’
Availability: At some NHS units and privately.
Milk supplement can save taste
A metallic taste and altered sense of smell are common during chemotherapy.
Exactly why is not well understood, but these taste and smell abnormalities can last for weeks and lead to loss of appetite, weight loss, depression and poor nutrition, which can slow recovery.
But U.S. research, published in the journal Food & Function last year, suggests a protein found in milk, saliva and tears called lactoferrin — already available as a nutritional supplement on the High Street — could help.
Researchers from Virginia Tech College of Agriculture and Life Sciences in the U.S. asked 19 patients with taste and smell disturbances to take 250mg of lactoferrin three times a day for 30 days.
But U.S. research, published in the journal Food & Function last year, suggests a protein found in milk, saliva and tears called lactoferrin — already available as a nutritional supplement on the High Street — could help [File photo]
They found cancer patients’ saliva contained significantly reduced levels of some proteins known to play a role in immunity and taste. However, lactoferrin boosted these levels and, at the same time, reduced the iron content of saliva.
Professor Susan Duncan, who carried out the study, said: ‘By suggesting lactoferrin as a dietary supplement, cancer patients and their family and friends may again find comfort in enjoying a meal together.’
Dr Gaya says: ‘Metallic taste is a huge problem, leading to reduced appetite and weight loss. If proven, this is a welcome, easy and cheap way to overcome a debilitating issue.’
Availability: On the High Street, but seek medical advice first.
Icy socks stop nerve damage
Peripheral neuropathy or nerve damage causes pain and numbness in hands and feet, affecting three-quarters of patients given paclitaxel, used for ovarian, breast and lung cancers.
It occurs because this chemotherapy drug can destroy nerves as well as cancer cells.
But wearing gloves and socks stored at minus 30c can help, according to researchers from Kyoto University in Japan.
Peripheral neuropathy or nerve damage causes pain and numbness in hands and feet, affecting three-quarters of patients given paclitaxel, used for ovarian, breast and lung cancers [File photo]
Reducing the temperature in hands and feet lowers blood flow to these areas and as a result the amount of chemotherapy reaching them.
Patients wear the gloves and socks 15 minutes before, throughout treatment and for 15 minutes afterwards (90 minutes in total).
A small study of 36 breast cancer patients undergoing 12 weekly cycles of chemotherapy, published in the Journal of the National Cancer Institute in 2017, found just 28 per cent of hands wearing the gloves lost sensitivity to touch (81 per cent without); and 25 per cent of feet lost some sensitivity when wearing the socks (64 per cent without).
‘Frozen gloves and socks are under-utilised in the UK to reduce the risk of chemotherapy induced peripheral neuropathy,’ says Kefah Mokbel, a breast cancer surgeon at The Princess Grace Hospital, and St George’s Hospital, in London. ‘They should be considered to improve patients’ quality of life.’
Availability: Available online.
Half treatment with same result
Halving the time breast cancer patients spend on the drug Herceptin significantly reduces side-effects — and is just as effective, suggests a major new trial.
Herceptin targets a protein called human epidermal growth factor receptor 2 (HER2) on the surface of cancer cells, stopping them growing and dividing.
However, it can affect the heart’s pumping ability (because there are HER2 receptors in heart muscle, too), causing breathlessness and palpitations.
In the new study, involving more than 4,000 women with early-stage HER2 positive breast cancer, six months of treatment was as effective as the standard 12-month course, The Lancet reported earlier this month.
It was also associated with significantly fewer side-effects.
But if you take Herceptin, don’t change anything without your doctor’s advice. ‘Other studies have not shown the same result, so standard duration of Herceptin should remain 12 months,’ says Professor Mokbel.
Availability: Herceptin is widely available, but more research is needed into this new approach.
Rose geranium oil for nasal pain
A spray of rose geranium oil may ease nasal vestibulitis, which causes the lining of the nostrils to become excessively tender, bleed and form scabs.
It can be caused by a class of cancer drugs called taxanes, which stifle tumour growth by stunting formation of new blood vessels.
A small study published in the journal BMJ Supportive & Palliative Care last year suggested rose geranium oil may help alleviate the pain. Doctors gave rose geranium oil spray to 40 women who had nasal vestibulitis and were having chemotherapy.
Those who responded to a survey afterwards said it had eased symptoms and, in two cases, cleared completely. Results of a further trial are expected next year.
Availability: On the High Street, but ask your doctor first.
Anti-poison drug prevents deafness
Eighty per cent of children who develop liver cancer can be cured, however two-thirds will be left with hearing loss from the treatment that saves them.
It’s because cisplatin, the drug used to treat it, also permanently kills sensory cells in the ear.
Research led by Great Ormond Street Hospital has shown that adding sodium thiosulphate, better known as an antidote for cyanide, to treatment with cisplatin can reduce the chance of hearing loss by 50 per cent, reported the New England Journal of Medicine last year.
Dr Penelope Brock, a paediatric consultant who led the research, says: ‘With sodium thiosulphate, we have a real chance to reduce the incidence of hearing loss, preventing children needing a hearing aid for the rest of their lives.’
Dr Gaya says: ‘Hearing loss is a major problem with some chemotherapy drugs, leading to doctors having to reduce the dose and stop chemo early, so further results are eagerly awaited.’
Availability: Next year on the NHS and privately. Some patients can get it via their doctor for free on ‘compassionate grounds’.
Sponge to mop up toxic chemo drugs
Hair loss, nausea, fatigue and infection are common side-effects caused by chemotherapy drugs affecting healthy tissue.
Researchers at the University of California, San Francisco, have designed a ‘sponge’ to catch chemotherapy drugs as they leak out of the treated organ, before they reach healthy tissue.
It has an absorbent mesh-like centre to soak excess toxic drugs, but lets blood flow unhindered. Made using a 3D printer, surgeons place it in the vein leading from the organ being treated, leave it in during chemotherapy (normally an hour or two) and remove it afterwards.
Results published in the journal ACS Central Science showed it intercepted 64 per cent of the drug. So far it has only been tested on pigs for liver cancer, but trials are due on kidney and brain cancer.
Steve Rannard, a professor of chemistry at the University of Liverpool, says: ‘This is an exciting new approach. We now need to build a greater body of evidence to ensure it is safe.’
Availability: Trials on patients will begin in the next few years.
…and the experts pick the latest High Street products that could help
We asked leading doctors for their recommendations for products to help ease the side-effects of cancer treatment.
Post-surgery tote
Drain Dollies, £9.50, draindollies.co.uk
A pretty tote bag (right) to store a wound drain discreetly and securely while out and about, it was developed by Charley Wood, who had a double mastectomy aged 26.
Some proceeds go to charity Prevent Breast Cancer. After a mastectomy and reconstructive breast surgery, patients wear ‘drains’ to remove excess fluid that collects in the wound as it repairs, explains Lester Barr, a breast cancer surgeon at the Christie Hospital, Manchester.
‘But they need to be carried around and many hospitals don’t routinely supply drain bags. This is a useful product for this.’
Heart-shaped cushion
Zara faux fur heart shaped cushion, £9.99, zara.com
A heart-shaped cushion (right) can be helpful after breast surgery for keeping the arm away from the armpit.
Steven Thrush, a consultant breast cancer surgeon at Worcestershire Royal Hospital, says: ‘Most breast surgery discomfort comes from removing lymph nodes under the armpit to see if breast cancer has spread. A heart-shaped cushion fits under the arm, providing comfort when sitting, in bed or wearing a seatbelt.’
No-spill cup
HandSteady No Spill Cup and Lid, £15.99, cancer.livebetterwith.com
Chemotherapy can cause damage to nerves in hands, resulting in numbness. This cup (right) can help counter the effects of an unsteady hand.
Cancer drugs such as oxaliplatin used for colon cancer can damage nerves in hands and feet, explains Professor David Lloyd, consultant liver and laparoscopic surgeon at University Hospitals, Leicester.
‘This is lightweight and has a rotatable handle for up to four fingers to give greater stability and prevent spills.’
White noise machine
X-sense Sound White Noise Machine, £25.99, amazon.co.uk
This radio-sized machine plays a selection of 30 soothing sounds including six types of white or ‘background’ noise.
Professor Christopher Eden, a consultant urologist at The Royal Surrey County Hospital, Guildford, says many cancer patients have difficulty sleeping due to pain, weakness or nausea brought on by chemotherapy.
‘White noise masks distracting sounds and may help a good night’s sleep.’
Wig liner
Wig Liner, £5.99, cancer.livebetterwith.com
This 95 per cent bamboo and 5 per cent Lycra cap should keep the scalp cool and dry if you wear a wig due to chemo-induced hair loss.
Trichologist Iain Sallis, of Hairmedic Clinics, says: ‘This liner — which is like a soft swimming cap — can help stop a wig becoming itchy. Bamboo is non-irritating, moisture-wicking, anti-bacterial and anti-fungal, all helpful if the scalp is sensitive after chemo or radiotherapy.’
Natural moisturiser
Sylk Vaginal Lubricant & Moisturiser, £9.99, sylk.co.uk
The first natural vaginal lubricant available on NHS prescription, this plant-based product is water soluble, non-hormonal and pH-balanced so it won’t irritate sensitive tissues.
Many women with ovarian cancer have surgery to remove the womb and go into menopause, as will many women being treated for other cancers, explains Professor Gordon Jayson, an oncologist specialising in ovarian cancer at Manchester’s Christie Hospital.
‘This can cause vaginal dryness, discomfort and sexual dysfunction. Many nurses I work with recommend a product like this to help with these problems.’
Could fasting protect healthy cells?
It’s controversial, but fasting from 36 hours before chemotherapy until 24 hours after may reduce side-effects of the treatment.
German researchers asked 34 women having chemotherapy for breast or ovarian cancer to fast for a 60-hour period starting before their treatment and finishing after it (during the fast they could drink water, herbal tea and vegetable broth but consume no more than 350 calories).
Eight days later, those who’d fasted tolerated chemotherapy better, had better quality of life and reduced fatigue.
It’s thought fasting may protect healthy cells against chemotherapy (by inducing changes in gene expression and cell metabolism which makes them more resistant to stress) while making tumour cells more vulnerable. More research is needed.
Julia Frater, cancer information nurse at Cancer Research UK, warns patients should ‘always check with their doctor before making any significant changes to their diet or lifestyle during treatment’.
Dr Andy Gaya, a consultant clinical oncologist based in London, says: ‘While this is gaining popularity, it is potentially dangerous in an often malnourished group. The risks outweigh possible benefits.’
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