Managing Side Effects and Looking After Yourself On & Off Treatment Jane Tinsley Clinical Nurse Specialist Linda Boyne Haematology Nurse Counsellor

Managing Side Effects Treatment as directed. Supportive medicines as directed. Plenty of fluids (2-3L) – day before, day of and day after treatment. Seek advice quickly. Do not suffer. Pace yourself. Small meals on chemo – healthy diet with enough roughage, but not too much fibre. Reasonable precautions against infection. Experience of side effects relative to how you are at the start of treatment. No stupid questions.

Looking After Yourself – On & Off Treatment IgG Deficiency. Probiotics – After antibiotics + on holiday. Need supportive others. Diet and exercise. Keeping busy – Carrying on with life and routines. Making plans – Meeting friends to holidays. Staying well – Optimum health for if/when you need CLL treatment. As much knowledge as you need to be in control. Regular blood tests + check-ups flexible to suit you – in discussion with your specialist. Complimentary therapies. Support organisations – Local and National. Second opinions. Staying positive.

Diet Supplements Vitamin C From diet, not stored in the body. Keeps cells healthy and helps with iron absorption. Antioxidant – Protects against free radicals. May have some benefit in decreasing risk of colds, wrinkles and gout. We need 40mg daily; average UK person takes 80mg daily. Only low if diet is poor and you smoke. Excess is excreted from the body and too much can cause diarrhoea, stomach ache, flatulence and kidney stones. No need to increase your normal intake.

Vitamin D Necessary for healthy bones – helps absorb calcium. Required for cell growth, immune function and decreased inflammation. Implicated in decreased blood pressure. Thought to play a role in preventative colon, prostate and breast cancers. We need 10 micrograms daily and should take a supplement in Autumn and Winter. Present in few foods, mostly produced when UV rays strike our skin and trigger synthesis. Levels can be checked with a blood test. Too much can cause calcium to build up in the body weakening bones and damaging the heart and kidneys. Not overwhelming evidence to support vitamin D reducing all cancers, but you should maintain healthy levels.

Beta Glucan Therapy Found in bacterial and fungal cell walls. Implicated in initiation of immune response. Used as an injection to attempt to extend life in advanced cancer. No clear evidence it works.

Green Tea Richer in anti-oxidants than other teas. Alleged to prevent cancer and help with headaches, depression, weight loss, cholesterol, tooth decay and Alzheimer’s. 2015 study using a green tea compound with Herceptin for stomach and breast cancers – planned human trials. Not harmful.

Turmeric Used in Chinese and Indian Ayurvedic medicine for thousands of years for heartburn, diarrhoea, bloating, depression, wound healing and ringworm. 2009 study found it killed oesophageal cancer cells in the lab. Further studies required. May help with Liver damage, diabetes prevention, Alzheimer’s prevention and arthritis.

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