Chemotherapy: other issues

Your emotions during chemotherapy

Being told that chemotherapy is part of your treatment can lead to a range of emotions. Many people feel positive and confident that everything possible is being done for them. Others feel anxious and frightened. This may be because people mistakenly think that chemotherapy is given only when the cancer has spread and is more serious.

In reality, chemotherapy is commonly given in addition to surgery and radiotherapy even when there is no evidence of spread. Fear of the unknown is natural and common, so finding out as much as possible about your treatment may help you to cope better.

If you feel low, tired, irritable or tearful at any point during your treatment, remember that this isn’t unusual and there are people there to help you.

Let other people, particularly your family and friends, know how you’re feeling so that they can be supportive. Talking to children about chemotherapy and any side effects you are experiencing can be difficult. It is usually best to be open and honest as this can help children feel less frightened.

It may also help to discuss any worries that you may have with your specialist, chemotherapy nurse or breast care nurse. Alternatively, a qualified counsellor might be appropriate if you want to talk through your feelings in more depth over a period of time. Your specialist team or GP can usually arrange this.

You may find it easier to share your feelings with someone who has had a similar experience to you. You can do this either one to one or in a support group.

Do I have to pay for my chemotherapy?

Chemotherapy treatment is free to all patients within the NHS. Since 1 April 2009, people in England affected by cancer are entitled to all their prescriptions free of charge. This will also include any additional medication you may need from your GP following chemotherapy, for example, anti-sickness medication.

To show you are eligible for free prescriptions you need to apply for a prescription exemption certificate from your GP. This certificate will mean no charges for any prescriptions for five years. A renewal application can be made after five years if you are still undergoing treatment.

Prescription charges have been completely abolished in Wales (since 2007), Scotland (since April 2011) and Northern Ireland (since April 2010).

Going on holiday

Check with your specialist team before booking a holiday. It’s sometimes possible to plan your treatment around your holiday.

If you plan to go somewhere hot, take care not to stay in the sun for long periods as you may burn more easily when having chemotherapy .

It’s a good idea to avoid the sun during the hottest part of the day (11am-3pm), to use a high-factor sun cream and keep covered with light clothing and a hat.

You may also find that it can be difficult to get travel insurance while you’re still having treatment. However, it is worth shopping around as premiums and terms vary widely.

Vaccinations

It’s important to tell whoever is giving you vaccinations that you are having chemotherapy. You should not have any live vaccines including measles, rubella (German measles), polio, BCG (tuberculosis) and yellow fever while you’re having chemotherapy. It’s safe to have these vaccinations six months after your treatment finishes. If you’re in any doubt, talk to your GP or specialist team.

Inactivated vaccines like diphtheria, tetanus, whooping cough, hepatitis A and B, rabies and cholera can be given once you’ve finished treatment. However, for about six months after the end of your treatment these vaccines may not be as effective as usual, since your blood cell count may still be low. Waiting for six months after treatment before you’re vaccinated may give better protection.

The (seasonal) flu vaccine is also an inactivated vaccine. However, because chemotherapy can lower your immunity (and you may therefore be more at risk of infection), you may be offered the flu vaccine if your chemotherapy occurs during the winter season.

Timing of the flu vaccination is important for cancer patients. It has been suggested that the response to the vaccination might be best between chemotherapy cycles or more than seven days before chemotherapy starts.

If you have any concerns about the flu vaccine, please discuss your concerns with your specialist team.