Navigating Chemo
- “Top Chef” alum Shirley Chung is undergoing treatment for stage four tongue cancer, a type of oral cancer that is also referred to as a head and neck cancer, with courage and hope. As she embarks on her chemotherapy journey, she took to social media this week to show off her stylish “armor,” as doctors allowed her to wear her regular clothing instead of a hospital gown.
- Tongue cancer is more commonly found in people older than 40. In addition, tongue cancer is twice as common in men, and smokers are five times more likely to develop tongue cancer than nonsmokers.
- Chemotherapy stops cancerous cells from growing, dividing, and spreading to other organs. It works by traveling through the bloodstream, killing cancerous cells. However, the process also impacts healthy cells, leading to side effects.
- Your doctor will help you manage the side effects by either adjusting your medication or offering recommendations to help you cope, such as pressure bracelets and breathing exercises for nausea or cryotherapy, which minimizes hair loss.
- For more on how to manage chemotherapy side effects, check out SurvivorNet’s digital guide.
The Chinese-American chef, who has “endless love and gratitude” during this new chapter of her life, recently started chemotherapy treatment amid closing up her and her husband Jimmy Lee’s Chinese restaurant Ms. Chi Cafe” to focus on her health.
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Additionally, she shared a photo of her forearm with an IV in it, alongside the hashtag “#cancerwarrior.”
Chung added, “My arms used to be filled with burn marks/oven kisses from cooking. Now is different kind of battle wounds, bruises, and hardening veins from chemo/IV.”
The star chef, who previously displayed her cooking skills and placed as a finalist in “Top Chef: Charleston” and “Top Chef: New Orleans,” decided to update her fans just five days after putting on her Dumpling apron in Ms. Chi Cafe “one last time.”
In her farewell post, featuring a video of Chung in the restaurant’s kitchen, she wrote “Our hearts are full as we say goodbye (for now!) while I take the time to rest and recover. To our staff, our regulars, our Goldbelly customers, and our Culver City neighborhood, thank you for supporting us over the past six years.
“The overwhelming love you’ve shown us in these final weeks means more than words can express. Our last day of service was truly beautiful, filled with so much love.”
She concluded, “We are especially grateful to our incredible team—many of whom have been with us since day one. In these last two weeks, you’ve worked tirelessly, showing up every day, exhausted but driven, working with all your heart to keep us serving our community. You are the heart of Ms Chi.”
“To everyone we couldn’t include in this caption (you know who you are!), from the bottom of our hearts, thank you, thank you, thank you. We couldn’t have done it without all of you. With endless love and gratitude. [love] Chef Shirley, Jimmy, and the Ms Chi.”
The restaurant closure and Chung’s busy week of testing comes about one month after Chung announced the news of her cancer diagnosis with a video of herself shaving her head.
During her tell-all post, Chung said her cancer journey began after experiencing a “series of dental issues” in December, explaining, “I bit my tongue severely; I fractured my tooth and had to extract it and get an implant… we thought it was because I am a heavy teeth grinder.
“And I was too busy to see a EMT specialist. The end of May, ulcers erupted in my mouth and my oral surgeon discovered a hidden tumor under my tongue. A few days later, I was diagnosed, stage 4 tongue cancer, as cancer cells also spread into my lymph nodes.”
She spoke with her doctor, her lead oncologist at at Cedar Sinai on June 2 to talk about her treatment plans, and they ultimately decided she would go through radiation and chemotherapy, instead of having surgery to remove “100 percent” of her tongue.
In her June 26th Instagram post, she explained, “I just finished 6 weeks of Chemo (and have many more to go), going to the hospital 4 times a week for injections, it’s like a full time job.
“My tumor is shrinking, my speech is much better and I can eat most normal food now. I am learning to lean on others, to let go, to be more vulnerable ….. it took me 2 weeks of contemplating to decide to tell my parents about my cancer, only my close circle of friends and my sister have known until now. I am learning, I can be strong 98% of the time, it’s ok to be not ok.”
She finished with, “I have a tough long road to recovery in front of me. Your love and support will carry me through. Cheer me on, Shirley Chung 2.0 will be reborn in 2025!”
Managing Chemotherapy and Its Side Effects
Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, healthy cells are also impacted in the process, leading to side effects.
Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle, previously told SurvivorNet.
“Neuropathy is probably one of the most challenging side effects,” says Dr. Urban.
Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the lining of the stomach, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications,” Dr. Urban explains. “We also ensure that patients have medications at home that they can use should they develop nausea after treatment.”
Hair loss is another side effect of chemotherapy.
WATCH: Coping with hair loss.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after chemotherapy and continues throughout treatment.
It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.
Most patients can expect regrowth four to six weeks after treatment. However, it is possible when your hair grows back, you may notice some changes in its color and texture.
Tips to Navigating Chemo Side Effects
When dealing with fatigue, doctors don’t have an arsenal of weapons to combat fatigue in terms of prescription medications. However, you can do several things to help minimize the hit and restore your energy.
Expert Resources On Coping With a Diagnosis
- ‘Be Patient With Your Emotions’: A Social Worker’s Insights Into Handling a Cancer Diagnosis
- Fear, Anger, Anxiety: You’re Entitled To Your Emotions
- Responding to Stress: How to Cope With Complex & Changing Emotions
- SN & You Presents Mental Health: Coping With Emotions
- Mental Health: Understanding the Three Wellsprings of Vitality
- Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer that have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
- Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
- Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.
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Treating Neuropathy Symptoms
Doctors have several strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to make sure it doesn’t get worse. Before each chemotherapy infusion, the attending oncologist will assess whether the symptoms have progressed. If the symptoms worsen, they may adjust the dose or delay treatment. They may also try switching to another chemotherapy drug.
How to Get a Handle on Nausea
Most of these anti-nausea medications last for more than eight hours. One of the infusions commonly used reduces the degree of nausea for up to three days.
Complementary approaches may also be helpful. A few favorites:
- Ginger: Studies consistently show that ginger helps alleviate chemotherapy-induced nausea. The powerful herb appears to have an anti-spasmodic effect on the gut. Not a fan of raw ginger? Suck on ginger candy, sip ginger ale, or make a steaming cup of ginger tea.
- Pressure bracelets: at your local pharmacy, these bracelets provide consistent pressure on a particular acupressure point on the wrist to reduce nausea.
- Deep breathing: Moving air in and out of your lungs with a few deep breaths can help relieve nausea, particularly if you pair deep breathing exercises with meditation. It can also help you relax and release stress and anxiety.
Coping with Hair Loss
Meanwhile, if losing your hair is something you’re worrying about before or during cancer treatment, know you have options like wigs, hats, wraps, and scarves, among other things.
Another option that can minimize hair loss is cryotherapy, “just a fancy way for saying cold therapy,” says Dr. Renata Urban, gynecologic oncologist at the University of Washington in Seattle.
Cryotherapy involves wearing cold caps or special cooling caps before, during, and after each chemotherapy treatment.
Tongue Cancer: Understanding the Cause of Head & Neck Cancers
According to Cedars-Sinai, several types of cancer develop in the tongue, with the most common being squamous cell carcinoma. The two types of tongue cancer are:
- Cancer of the oral tongue, which consists of the front two-thirds of the tongue that you can stick.
- Cancer of the base of the tongue, the area which is the back one-third of the tongue that extends down the throat.
Although some people may be diagnosed with tongue cancer and have no risk factors, Cedars-Sinai says this type of cancer is most commonly found in adults 40 years old and up. Men are also twice as likely to be diagnosed with tongue cancer.
Other risk factors, as per Cedars-Sinai include:
- Smoking and drinking alcohol [smokers are 5x more likely to develop tongue cancer than nonsmokers]
- Human papillomavirus (HPV)
- African-American men have a greater risk than caucasians
It’s unclear what led to Shirley Chung’s diagnosis, but it’s important to understand that symptoms of tongue cancer can include:
- An unusual lump on the side of the tongue
- An ulcer-like lump, of a grayish-pink to red color
- A lump that bleeds easily when touched
Tongue cancer may be hard to spot in its early stages, however, when the cancer develops, patients may experience trouble with swallowing, voice changes, pain in the ear, pain in the throat, or a feeling of fullness in the throat.
HPV and Cancer Risk: The Basics
As for how throat cancer is diagnosed, it’s usually done through X-rays, CT scans, and PET scans. A diagnosis often requires a biopsy.
For tongue cancer treatment, surgery, chemotherapy and radiation therapy are usually done.
It’s much more common to know someone who has a head or neck cancer, like tongue cancer, now-a-days than it was several decades ago. And that’s because of its strong connection to the human papillomavirus, also known as HPV, which is the most common sexually transmitted infection in the United States.
“From the 1980s to the 2010s, the rate of HPV-related head and neck cancers has gone up by 300 percent,” Dr. Ted Teknos, a head and neck cancer specialist, and president and scientific director of University Hospitals Seidman Cancer Center in Cleveland, Ohio, told SurvivorNet during a previous interview.
The vast majority of humans in the United States both men and women will eventually get infected with HPV, according to Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai.
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” he told SurvivorNet.
“Probably less than 1 percent of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years it develops from a viral infection into a tumor, and a cancer.”
It’s unclear whether HPV alone is enough to trigger the changes in your cells that lead to head and neck cancers, or whether this happens in combination with other risk factors like smoking.
Of course, some people who develop head and/or neck cancers have no known risk factors for the condition. Genetics can play a role in this cancer, too.
Why the HPV Vaccine is so Important in Preventing Cancer
Head and neck cancers are unique in that they’re usually preventable with the HPV vaccine. And that’s why those eligible should get vaccinated against HPV, SurvivorNet experts have told us.
The vaccine is typically given to children before they are sexually active, as HPV is transmitted through sexual contact.
And contrary to some detrimental misinformation circulated online, the HPV vaccine is entirely safe.
There are virtually no side effects with this vaccine, Dr. Jonathan Berek, director of the Women’s Cancer Center at Stanford Medical Center, previously told SurvivorNet.
Contributing: SurvivorNet Staff
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