The word cancer actually refers to many diseases, not one. What these diseases have in common is that the body's cells (tiny units that make up all living things) behave abnormally. In someone who has cancer, cells grow and divide uncontrollably and eventually form tumors.

Many people with cancer (or who know people with cancer) find that learning more about it is a good way to understand and feel more in control of their situations. Knowing more about the disease also allows people to feel knowledgeable enough to ask relevant questions and take charge of their medical options.

Cancer has its own language, and doctors can sometimes forget that non-medical people may not understand its terms and phrases. If there's anything you don't understand, ask for explanations.  People with cancer usually have a specially trained medical team working with them to fight the disease. So if a doctor's not around, an oncology nurse can probably answer any questions.

Another way to make sense of cancer is to read. You can find tons of information and resources in public libraries, bookstores, and on the Internet. Remember, though, that you may come across information (especially on the Internet) that is incorrect or outdated. If you find information in your research that is different from what your doctor is telling you, be sure to ask your doctor about it.

People who are living with cancer and their families often find it helpful and comforting to share their experiences and learn what others have gone through. There are a variety of supportive environments where people can do this - everything from Internet chat areas on cancer sites to local support groups where people meet face to face. Ask your doctor to put you in touch with support resources for people who are dealing with cancer. Although no two patients have the exact same cancer experiences, it can sometimes feel good to know you're not alone.

Feelings and worries can seem overwhelming if they get bottled up inside. It's important to get help in sorting out your emotions.

Above all, remember that although you may have cancer, you are a person first and a patient second. Cancer is not your identity; it is simply an illness you are trying to overcome.

If a friend or relative has cancer, the most important thing you can do is to be yourself! Many people who have cancer say that the people they love suddenly treat them differently or stay away completely.

It's natural to feel frightened, anxious, or even angry when someone you know has cancer, but don't let that keep you from being there for your friend or loved one. You may need help dealing with your strong emotions, and there are many places you can turn: Many hospitals have counseling groups for families and friends of people with cancer. Or you can talk to an adult whom you trust for support and reassurance. You can also visit websites related to cancer.

Most people with cancer like having their friends and family around, even if the visits are short and there may not be much to say. If you're not sure whether to visit, ask. Even if your schedule is very busy, you can keep in touch in other ways, like sending cards, talking on the phone, or using email. It will do a lot to lift the spirits of someone you know who is dealing with cancer.

Keep in mind that the person you care about is simply sick. Despite the cancer, he or she is still the same person you've always known and loved.

Why Do People Need Help in Dealing With Cancer

Most people struggling with a new diagnosis usually feel as if this is the most serious situation they could possibly face. Older adults have learned to cope with difficult situations in their lives. Younger people may not have dealt with problems as frightening as a new diagnosis of cancer. If there are children in the family, the problems may seem even more complicated

A cancer diagnosis means you are bombarded with new information. You might forget that you already have skills that have helped you cope with other problems. You will use these skills as well develop new ones to deal with cancer.

In the first few weeks and months of a cancer diagnosis you will need to make many decisions. In addition to learning and understanding the language of cancer, you’ll need to make decisions about where to be treated, choosing a doctor, choosing treatment options, and managing treatment side effects. In addition to the medical issues, it is useful to learn what you can about emotional responses to cancer so you are in the best position to help yourself and your family. Support from family, friends, and the health care team will also be important.

Dealing With Cancer Therapy Hair Loss

Cancer Information Service
Holden Comprehensive Cancer Center
University of Iowa Hospitals and Clinics

Creation Date: 2003
Last Revision Date: May 2004
Peer Review Status: Internally Peer Reviewed

Hair loss occurs because anticancer drugs (chemotherapy) or radiation can affect normal cells, including the cells responsible for hair growth. This effect, however, is not permanent, and hair grows back normally once the therapy has been completed. The degree of hair loss depends on the chemotherapy drug, the dosage of chemotherapy or radiation, and how it is given. In radiation, only hair that is in the field of radiation will be affected by hair loss. Very rarely with radiation therapy hair loss, there might be an area where the hair is permanently thinner.

Patients often ask if there is anything that can be done to prevent the hair loss of chemotherapy. Generally there is nothing to stop hair loss if the chemotherapy agent is one that causes hair loss. With some chemo drugs hair loss is inevitable.

To avoid hastening hair loss:

• Use mild shampoos and conditioner to lessen pull on hair while combing.
• Permanent hair dye may cause hair to fall out quicker. (hair color rinses are not as hard on the hair and scalp.)
• Brush hair rollers and sleeping in hair curlers can cause pulling on the hair and cause it to fall out quicker.

Managing when the hair is falling out:

• Consider getting a shorter haircut. Shorter hair is easier to manage under a wig. A shorter style will make your hair look thicker and fuller. It may also make your hair loss less traumatic.
• Some people choose to shave their head once hair starts falling out.
• Wear a hairnet, soft cap or turban around your head at night to collect any loose hairs.
• Be aware that during the period of time you lose hair, the scalp may be tender or sensitive. Some people report having a tingling feeling of the scalp during hair loss.

To lessen scalp irritation:

• Use soft hairbrushes to lessen scalp irritation and pull on the hair shaft.
• Permanent wave solution may irritate the scalp and hasten hair falling out.
• Use hair dryer on low heat to lessen dryness and irritation of the scalp.
• Use a satin, polyester, or cotton pillowcase, rather than a nylon pillowcase, which can cause irritation.
• Wear sunscreen on scalp with thinning/no hair. Cover scalp with hat when out in the sun.

Tips for caring for new hair:

• Shampoo twice a week.
• Thoroughly massage scalp to remove any scaling.
• Avoid high heat from hair dryers.
• Keep hairstyling to a minimum, as new hair is prone to breaking.
• Avoid vigorous brushing, hair pins, curlers, curling irons. Use wide tooth combs.
• Mousse, gels, sprays may be used in moderation. Use products with normal to light holding abilities, as the high holding products may not be completely removed with mild shampoos. (Some hair styling aids can build up on the hair shaft resulting in dullness and possibly scalp irritation).
• Chemical curling is best avoided until hair is 3 inches long. Many patients cannot tolerate permanent wave solution on their scalp for possibly up to a year following chemotherapy/radiation.
• Hair coloring can also be irritating to the scalp. Permanent hair coloring is the most damaging to the hair shaft. Semi-permanent hair coloring products, which wash away, may be less harsh to the hair shaft. Most experts recommend waiting at least three months after the last treatment before using any type of hair coloring products.

Wigs

Many people say buy a wig before you lose your hair. However, the wig may not fit as well when your hair is completely gone, if fitted while hair is still present. Shop for the wig while you still have hair, but have it fitted after the hair has been lost.

• There are full service wig salons that fit and style wigs.
• Wig salons also sell turbans and scarves that come in a variety of colors and fabrics so that you can look good even when you are lounging at home or at bedtime.
• The lining of a wig can sometimes irritate the scalp. It may be helpful to wear a thin cotton scarf or skull cap under the wig. These are usually available from wig suppliers.
• If you can not afford a wig contact the American Cancer Society's Look Good/Feel Better Program at 800-227-2345 or Cancer Care at 800-813-4673
• Some insurance plans cover the cost of wigs. Check with your particular insurance company.
• If you buy a wig, save the receipt. It can be a medical tax deduction.

Drugs that usually cause hair loss

• Adriamycin
• Daunorubicin
• Etoposide (VP-16)
• Irinotecan
• Cyclophosphamide (Cytoxan)
• Epirubicin
• Docetaxel (Doxil)
• Paclitaxel (Taxol)
• Ifosphamide
• Vincristine
• Vindesine

Drugs that sometimes cause hair loss or thinning

• Amasacrine
• Cytarabine (ARA-C)
• Bleomycin
• Busulphan
• 5-Fluorouracil (5-FU)
• Melphalan
• Vinblastine (Velban)
• Lomustine (CCNU)
• Thiotepa
• Methotrexate
• Mitoxantrone
• Mitomycin C

Drugs that usually do not cause hair loss

• Carmustine (BCNU)
• Carboplatin
• Cisplatin
• Procarbazine
• 6-Mercaptopurine
• Streptozotocin
• Fludarabine

• BE REALISTIC: Settle it in your mind that the cancer is a serious thing but it shouldn't consume your life thinking about the possibility of death. Think of the life still left to live and try to make that as pleasant as possible for the person diagnosed with cancer. Ignoring the cancer doesn't help anything. Recognize and turn the negative into a positive.
• POSITIVE OUTLOOK: Maintain a positive outlook. Yes, cancer can be overcome (my mother is an example of that - she's beaten it over 15 years ago now!) But it is important to live life as normally as possible and to have the cancer victim have something to hold on to in life. My mother always says that she fought the cancer because she wanted to see her children grow up. She didn't give up!
• BE PREPARED: While death may be the outcome of the cancer, remember that death is a natural part of our lives and we'll all have to experience loved ones passing at least once within our own lifetimes. They will be in a better place so don't look at death as losing someone. Focus on the great times and experience you gained from the person while they were on this earth.
• SADNESS: Yes, it is okay to be sad.
• NOT CONTAGIOUS: Cancer has not been proven to be contagious. Don't treat a cancer victim as a leper. Avoiding the person doesn't help the person deal with it any better. Be as supportive as you can and try to learn and understand the condition.
• LAUGH: Laughter is, in my opinion, one of the ways our bodies heals itself. It presents positive energy into our bodies and I think most people would probably agree that a happy person who laughs a lot has a better outlook on life.

Being told that you have cancer can be devastating. A thousand frightening thoughts race through your mind. "Am I going to die?" "How bad will the pain be?" "What about my family? "How will they handle the news?"

In addition to the anxiety surrounding the illness itself, living with cancer exposes patients to physical and emotional stress from painful and sometimes emotionally difficult treatments and their side effects.

If you or someone you love has cancer and you're feeling depressed, hopeless or anxious, talking to a mental health professional can help.

Some people may consider asking for help a weakness. But reaching out and recognizing you may need help requires a great deal of courage.

Psychological therapy is best provided as part of a coordinated treatment plan. You may want to see a psychologist who has experience working with cancer patients or others with serious illnesses.

For example, some may feel hesitant to talk to their physician about sexual problems that occur after treatment for cancer or serious illness, and many physicians may lack specific expertise in such areas. However, a couple can encounter problems if their sexual relationship is overwhelmed by physical discomfort, fear, anxiety or feelings of unattractiveness in the aftermath of cancer.

Treatment for cancer can be extremely difficult and painful — patients often develop anticipatory anxiety and nausea. Sometimes relaxation strategies can help patients tolerate it better.

A technique called "systematic desensitization" uses relaxation methods to help the patient confront fears related to treatment. At first, the patient and psychologist discuss and rank the various aspects of treatment. Then the patient uses a relaxation technique to induce a tranquil state.

When relaxed, he or she imagines various aspects of treatment as vividly as possible, beginning with the least frightening. Once the patient is relaxed imagining that particular procedure he or she moves to the next most frightening procedure. A patient does this until he or she is comfortable imagining the most painful or frightening procedure. Studies show that patients who use this method experience shorter and much less severe bouts of anticipatory nausea.

Copyright © 1997 by the American Psychological Association. All rights reserved.