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Cancer and mental health

Cancer and Mental Health

With cancer, your emotional and physical well-being will be compromised. It is good to ensure you get adequate sleep and exercise in all stages of the disease and have a diverse diet. You should also be mindful of your social well-being. Cancer and well-being go hand in hand. Cancer influences your own image and knowledge of yourself. Changes can be fearsome for physical appearance and the ill-health. Yet it is very important to continue to handle yourself as best as possible in terms of your own best-being and healing. Cancer and Mental Health has been discussed in this blog


Cancer and Mental Health 

Having cancer produces many distinct emotions with it. Not only does the illness affect your health, but also your emotional well-being. It may be difficult to consider the patient’s position. The significant disease leads us to have a wider view of life. The emotions of the crisis triggered by the disease are part and parcel of the process. Everybody deals in their own way about their emotions.


The way to cope with cancer is subjective. There can be ample episodes of mood swings. Negation, rage, fear, frustration, sorrow, disappointment, shame, and isolation are the most common.

Facing your thoughts and resolving them is the most important thing. You should not suppress, but you should confront and learn to cope courageously with your emotions. Only then will the mental recovery begin correctly.

Everybody deals in their own way about their emotions. Others unload them by events, others manage to communicate about them or to learn about them alone.


Ask for help

Cancer may induce multiple intense psychological responses, such as anxiety and depression. It is necessary to obtain clinical assistance if those conditions feel insurmountable and you are unable to handle it. 

It is enough for you to speak to your doctor frequently and especially family or friends about stuff. You can also get help from the Cancer Rounds, where professional oncologist assists people with cancer and their loved ones. 

It is important to speak to your doctor or the nursing staff who will care for you about your well-being.


Ways to improve your state of mind:

  • Fresh outdoor weather helps enhance body and mind activity and exercise.
  • Look after your looks. 
  • Celebrate the accomplishments and milestones – be honoured.
  • A healthy attitude comes from doing nice things.
  • Write down the list of good things to read in sad days.
  • Don’t hanker for the past, consider the happy days instead.
  • It depends on you to act in your life. You have to think about items in a positive or negative way and remember them.

Cancer and a healthy diet

Cancer has a number of effects on a person’s diet and dietary habits. The disorder itself can lead to weight loss, lack of appetite, or other eating disorders.

Surgical therapy may impact swallowing or digestive tract function. The treatment of radiation and chemotherapy can lead to nausea, diarrhoea, loss of appetite, and alteration of taste and smell.

Mood disturbances or stress related to your disease will often affect your appetite, which also leads to weight loss. Any patients with cancer may also face starvation that may hinder recuperation and strength.

The case could be the reverse with certain cancer patients being treated. Medication with hormones or cortisone can induce appetite and increase weight. Treatment doesn’t lead to weight loss, but, by making daily meals chart, consuming nutritious food, and doing more based on your ability, you can look after your weight.

The cancer patients require a diverse diet and a decent quantity of fluid. And if your appetite is often bad, your daily meal requires ample calories and nutrients. High iron levels such as the spinach and chicken cereal, green vegetables, pulses, and foods help us retain capacity. The same happens to food also with small foods. You should snack processed food supplements, which in limited quantities provide lots of nutrients. It’s good to talk to a psychiatrist, nurse, or dietitian about diet.

Cancer and exercise

As we rightly mentioned in the start, Cancer and well-being have a direct relation. Exercise is vital to the well-being and recovery when you have cancer. The stronger and the easier you continue to workout following treatment, recovery begins.

Physical exercise and light training improve the strength of your muscles and give you stamina. You don’t need to workout excessively, since your condition and recovery physically may put pressure on you.

After rehabilitation, it is appropriate to start walking, for example by taking clear walks. To do stuff like housework, shopping and working are appreciated and encouraged.

You note the positive benefits of exercising are attained easily. Your mood is starting to change as exercise raises endorphin levels, particularly in the brain, and circulated in the body. Endorphins ease discomfort and strengthen well-being emotions.


Cancer and Mental Health is directly proportional. The physical and mental well-being of a Cancer patient is very important. It not only helps in a speedy recovery but also makes life worth living. For more information and assistance on psychological, physical, or dietary help, visit Cancer Rounds or call our Customer Care service. 



Posted by, Medical Team, Cancer Rounds
October 20, 2020
cancer second opinion

Cancer Second Opinion-When and Why?

The second opinion is nothing but a reassurance or another judgment from any person for a particular problem or a situation. Similarly, sometimes cancer second opinion are considered as decision-makers in getting right aid of treatment with team of highly expert cancer specialist. Patient-initiated second opinions are increasing tremendously for every simple or complicated disease or disorder. The popularity of such a trend is not known.

The need for the cancer second opinion is greater than any other cases. The situation when the patient is diagnosed with cancer is the most difficult one for them as well as for the family. In one go it becomes hard for the patient to believe that he or she is diagnosed with cancer and just to reassure or reconfirm, they go for a cancer second opinion through which they get some clarity of the diagnosis, prognosis and the treatment.


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Reasons why patients seek cancer second opinion after first diagnosis:

  1. First and foremost, to confirm the cancer diagnosis.
  2. Lack of trust in the original physician.
  3. Need for more information about the disease.
  4. Psychological satisfaction.
  5. For better treatment options.
  6. If diagnosed with a rare type of cancer.
  7. The treating doctor does not have expertise in treating this type of rare cancer.
  8. When test results are unclear for a particular type and location of cancer.
  9. Several treatment options are available but unsure of which one to opt for.
  10. Last but not the least unsure of the diagnosis and the treatment option and want to confirm whether the planned treatment is the best preference or no.
  11. In case your doctor has suggested chemotherapy treatment and you are not sure if that is the right choice for you.


These are some common reasons for which patients seek the second opinion. It’s not always patient-initiated; sometimes the original physician may also advise the patient for a cancer second opinion that can be; an advice from a more experienced or a specialist in oncology discipline.

Seeking second opinions may sometimes benefit the patient resulting in better treatment and perfect diagnosis but sometimes they may not yield any robust medical benefit for them.

As the cancer second opinion has advantages likewise they do have some disadvantages as well. 

The following can be the adverse impacts of the cancer second opinion while choosing any treatment option for cancer;

  1. Sometimes seeking the second opinion in cancer treatment may result in disappointment and can be distressing for the patient.
  2. Going for a cancer second opinion can take time as the patient won’t be a priority as he or she has already seen a specialist. Like in case of leukemia treatment the patient needs to act as fast as he can to curtail the disease and start treatment
  3. The disappointment of the patient can result in increased uncertainty and can also affect the relationship of the patient with its initial physician.
  4. Going for a second opinion in cancer treatment can sometimes also delay the patient’s existing or suggested treatment.
  5. It can also increase the workload of the physicians and can signal a lack of trust in the physician.
  6. Second opinion in cancer treatment can be a costly affair as the other oncologists can recommend some additional diagnostic tests and consultations.
  7. There can be a difference of opinions between the two consultants or physicians.
  8. It can also lead to more confusion and can put the reasoning ability of the patient at stake.
  9. The disease can progress which in turn can make the initial treatment more intricate or sometimes unworkable.
  10. The timelines of opinions can also differ depending upon the availability of specialists to review the patient’s case.

Cancer Rounds team helps the patient takes a cancer second opinion in 24-48 hours. Call us and discuss your case now.

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Posted by, Medical Team, Cancer Rounds
August 3, 2019

Know About Chemotherapy

What is chemotherapy?

When we hear the word chemotherapy, it is instantly associated with hair loss, cancer and misery. To make the most of chemo, a thorough understanding of what it is and how it works is necessary.

Normal cells follow the life cycle of birth, maturation, function and death. In cancer cells, to put it in simple terms, they do not follow any specific cycle. They do not perform proper function but more importantly, they do not die.

Natural cell death is called apoptosis. It is very important as it maintains the number of cells that are limited at a certain region and allows new cells to be born in its place.

But, in case of cancer cells, apoptosis is absent, which leads to invasion of cells into local structures and also, far off structure. This obstructs the normal functioning of cells.

Chemotherapy is a chemical treatment which involves destruction of cancer calls. But, along with cancer cells, normal healthy cells get destroyed as well. This is what causes the side effects.

How does chemotherapy work?

Chemotherapeutic drugs work on multiple principles:

  • Impair mitosis: mitosis is a type of cell division that occurs in normal cells. A single cell splits into two with two separate pairs of DNA’s and genetic material. Chemo drugs can affect dividing cells at the stage of splitting or DNA synthesis. The impaired cells are destroyed and formation of cancer cell is stopped. But along with these normal, rapidly dividing cells, like the blood cells are also affected.
  • Nutrition deprivation: chemo drugs can deprive the cancer cells of their nutritional source, which are through blood vessels, enzymes and hormones.
  • Trigger apoptosis: apoptosis is the programmed cell death that is required for removing old cells and making space for healthy new cells. This can be triggered by some chemicals which are released by the chemo drugs.

Tests performed before chemotherapy:

Before chemotherapy, the physician evaluates if the patient is fit enough to handle the side effects of the therapy.

  • Liver function tests: liver undergoes a lot of stress whenever a new chemical is added to the body as it metabolizes the drug. If the liver is already in a weak condition, chemotherapy is not advised.
  • Complete blood picture: if the total number of red blood cells, white blood cells and platelets are already low, chemotherapy will only make it lower.

Blood tests are continued during the treatment as well to know any adverse conditions.

How are chemotherapeutic drugs administered?

Routes of administration of chemotherapeutic drugs vary greatly on the patient’s cooperation, type of cancer, location of cancer, physical health status, age, capacity to withstand the selected route.

Some of the most common routes of administration are:

  1. Oral route: if the patient is fit enough, the drug can be taken as a tablet, pills, capsules or liquid form. This can be administered from home, but the patient will require regular check-ups to ensure its proper functioning. Some capsules with protective coating helps in slow release of the drug. This allows to maintain a longer duration between the doses.
  2. Sub lingual tablets: are those which can be placed under the tongue for absorption. This allows rapid absorption through the blood stream and has a quick effect. It is especially useful for anti-nausea medications.

Not all medications can be given this way. This is because sometimes the drug gets destroyed by the stomach acids and turn out to be ineffective. The released drug may also not be absorbable by the stomach and intestinal lining which ends up excreted without being metabolized. Sometimes, the drug may damage the intestinal walls if released in the stomach. Few other forms are as follows-

  • Subcutaneous injections: the drugs that are injected between the skin and muscle layer are called subcutaneous injections. They do not go to the level of muscles. They are mostly used as chemotherapy support drugs. They are less likely to bleed when compared to intramuscular injections and hence are used in patients who have platelet deficiency.
  • Intramuscular injections: the drug is injected into the muscle past the skin. This method causes bleeding within the muscle. Most chemo drugs cannot be administered in this manner as they may cause damage to the tissue wall.
  • Intravenous injections: the chemo drugs are directly infused into the patient’s veins and is carried to the blood stream. It is the quickest source of administration with modifiable dosage time and duration. Various methods of intravenous injections are given:
  • Angio-catheter: a temporary catheter until drug is administered.
  • PICC lines: these are long plastic catheters that may be placed for a longer duration. It could be used for in-patient treatment or at-home infusions. Fluoroscopy X-rays are done to confirm if the catheter is placed in the right position.
  • Tunneled catheters: these are catheters placed sub-cutaneous, at the chest, and inserted into the superior vena cava. They have multiple lumen or entry points. They can be left in the patient’s body for months to years with low risk of infection. Regular changing of dressings is necessary. It is used in extensive therapies like bone marrow transplants.
  •  Non-tunneled catheters: these are directly entered into the jugular or subclavian vein to reach the superior vena cava. They are done for emergency or short-term treatments. Infections can spread faster and regular dressings are needed.
  • Port-a-cath: this is a more permanent device. It can be left unchanged for 3-5 years. It is inserted directly to the superior vena cava in the right atrium of the heart.
  • Intraventricular or intrathecal methods: this is when the medication is to be injected into the cerebro-spinal fluid. There are two methods, lumbar tap and ommaya reservoir.
  • Intraperitoneal methods: the drug is directly injected into the abdominal cavity and does not go through the stomach or intestines. This is said to reduce the body’s overall exposure to the drug.
  • Intra-arterial methods: in this method, the drug is directly infused to the artery that is feeding the tumour.
  • Intravesicular chemotherapy: the chemo drugs are infused to the urinary bladder through a catheter.
  • Intrapleural chemotherapy:  the chemo drug is injected into the lung cavity or the pleura. It is primarily used in treatment of lung cancers.
  • Implantable chemotherapy treatments: implantable structures are placed into the cavity after surgery for slow release of the drug.
  • Topical chemotherapy treatments: the chemotherapy drugs can sometimes be applied on the skin like a cream. It is used in cases of skin cancers.


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What are the side effects of chemotherapy?

Chemotherapy destroys not only the cancer cells but also the normal, healthy viable cells.

Some of the common side effects are:

  1. Hair loss: this is one of the first things noticed by the patient. Hair loss is not only on the scalp, it is throughout the body. Hair loss is a temporary side effect. Hair grows back normally once the treatment is completed. It can be reduced by wearing a cold cap (except in cases of leukaemia). This does not cause any physical health issues but has an adverse effect on the psychology of the patient.

Nails ca become brittle and flaky as well.

  • Nausea and vomiting: almost 65 to 70 %of patients face this problem. Anti-emetics (drugs which prevent vomiting) help to reduce and prevent its re-occurrence when the chemotherapy is completed.
  •  Low white blood cell count: due to chemotherapy drugs, the number of white blood cells are depleted. This condition is called neutropenia. This makes the patient more susceptible to infections. The patient must take utmost care to protect himself from infections by maintaining proper hygiene and cleanliness.
  • Low platelet count: this condition is known as thrombocytopenia. It is a condition in which the patient has reduced platelets due to destruction by the chemotherapeutic agents. This leads to easy bleeding and bruising. This is especially seen when the patient has bleeding gums and small cuts even by razors. Patient needs to take care to not cause any open wounds that might bleed.
  • Low red blood cell count: this is known as anaemia.  Red blood cells carry oxygen to the body. They are rapidly destroyed in the presence of chemo drugs. This reduces the overall oxygen supply to the body and makes the patient dizzy, tired and breathless. Patient is usually advised to take foods rich in iron along with iron supplements and erythropoietin.
  • Mucositis: this is the inflammation of mucous membranes. It could affect the mucous membrane of any part of the body. It usually manifests orally as a burning sensation with blisters, redness, and ulcerations. Drugs may be prescribed for the reduction of inflammation.
  • Appetite loss: chemotherapy and cancer itself can reduce one’s appetite and metabolism. Patients are asked to eat smaller frequent meals and drink fluids through a straw. Patients who are incapable to physically feed on their own are fed through nasogastric tube to maintain nutrition supply.
  • Effect on pregnancy and fertility: patient temporarily loses libido. Many chemotherapy drugs cause deformities in the foetus. Patients are advised to avoid pregnancy during chemotherapy. It can also reduce the fertility in both men and women. 
  • Cognitive and mental health problems: patients have previously reported short term memory, reduced attention span, reduced capacity to multitask, depression and mood swings.

What are the types of chemotherapeutic drugs available?

The drugs used for chemo are derived from many natural and synthetic sources. There are four main groups:

  1. ALKYLATING AGENTS: these are drugs which have a direct impact on the DNA synthesis and disrupts cell cycle at various stages. Ex: chlorambucil, busulfan.
  2. ANTIMETABOLITES: these are chemical substances that have structures similar to that of proteins required for the survival of cancer cells. When the cancer cells absorb them, they do not receive any nutritional value and are made to starve. Ex: purine and pyrimidine antagonist.
  3. PLANT ALKALOIDS: substances that block the ability of cells to grow and multiply. Ex: actinomycin, mitomycin.
  4. ANTITUMOUR ANTIBIOTICS: these are substances which bind to the DNA and stops synthesis of RNA which further deactivates the reproductive capacity of cells. This will reduce the size of tumours and prevent further growth of tumours. Ex: doxorubicin.



When is chemotherapy given for breast cancer?

 It can be given either before or after surgery.

  • Before surgery: chemotherapy is given to reduce the size of the tumour before surgery to have a conservative surgery instead of a complete mastectomy.

It can also be given to patients who have triple negative breast cancer which will not respond to hormone therapy.

  • Post – surgery: chemotherapy can be given after surgical excision to prevent reoccurrence of cancer and to destroy the remnant cancer cells which may be left behind after surgery.
  • Secondary breast cancer: chemotherapy can be given before surgery of cancer which has attacked for the second time and may have spread to other parts.

Commonly used drugs for chemotherapy of the breast:

  • Anthracyclines, such as doxorubicin (Adriamycin) and epirubicin (Ellence)
  • Taxanes, such as paclitaxel (Taxol) and docetaxel (Taxotere)
  • 5-fluorouracil (5-FU)
  • Cyclophosphamide (Cytoxan)
  • Carboplatin (Paraplatin)

How is the chemotherapy given?

Chemotherapy is given in the form of:

  • Intravenous injections
  • Central venous catheters
  • Central venous access devices

Other symptoms in breast cancer chemotherapy:

  • Menstrual changes: the patient, if of a younger age group may have changes in the menstrual cycle and may even reach menopause at an early age. This may be permanent. It could also lead to loss of fertility.
  • Heart damage: when chemo drugs like doxorubicin is used for prolonged duration or at high doses, it could lead to damage to heart tissue damage. Drugs which are to target HER2 are also to be taken with caution.
  • Nerve damage: drugs like vinorelbine, eribulin, and taxanes are known to affect the neural system outside the spinal cord and brain (peripheral nervous system). This can lead to numbness, tingling sensation, burning, or sensitivity to heat and cold. This usually vanishes once the treatment is stopped.
  • Hand-foot syndrome: drugs like capecitabine and liposomal doxorubicine cause burning, numbness, redness and tingling of skin. It could progress to blistering or swelling which may turn extremely uncomfortable or even painful. Only steroidal creams can be used for symptomatic treatment.
  • Risk of leukaemia: very rarely, chemo drugs may cause bone marrow diseases which might lead to myodysplastic syndrome or even acute myeloid leukaemia. But the benefit from chemotherapy is much higher than the risk of leukaemia.

When is chemotherapy given for lung cancer?

Chemotherapy for lung cancer is given either on it’s own or as an adjuvant. This means that chemo drugs are given along with other modes of treatments like radiation therapy. Surgery is not always recommended especially in extensive cases as it is difficult to excise the tumour without causing significant damage to vital cells.

  • Neo-adjuvant chemotherapy: this is when chemotherapy is given prior to radiation therapy or surgery. It is done to reduce the size of the tumour.
  • Post-surgery chemotherapy: it is done to destroy the remnant cancer cells which may cause remission if left out and could not be excised through surgery.
  •  Chemotherapy with radiation therapy: in cases of stage III lung cancer where surgery is not possible, the doctor may recommend chemotherapy with high dose radiation therapy.
  • Chemotherapy alone: in stage IV lung cancer, chemotherapy is the main mode of treatment. It is also given for palliative therapy in cases of advanced cases.

Chemotherapy is mainly prescribed in non-small cell lung cancers. The drugs used are:

  • Cisplatin
  • Carboplatin
  • Paclitaxel
  • Albumin-bound paclitaxel
  • Docetaxel
  • Gemcitabine
  • Vinorelbine
  • Irinotecan
  • Etoposide
  • Vinblastine
  • Pemetrexed

Most of the times, a combination of two or three drugs are used.

Some of the common side effects are hair loss, fatigue, mouth sores, loss of appetite, nausea, vomiting, diarrhoea or constipation, increased risk of infections and easy bruising and bleeding.


In case of bone cancers, chemotherapy is not very useful. They do not usually respond to chemotherapeutic drugs. Nevertheless, chemotherapy is used as an adjuvant for osteosarcomas and Ewing sarcoma.

 Common drugs used in treatment of bone cancers:

  • Doxorubicin
  • Cisplatin
  • Etoposide
  • Ifosfamide
  • Cyclophosphamide
  • Methotrexate
  • Vincristine

The doctor may prescribe a combination of two or three drugs for the treatment.

Specific side effects:

  • Cisplatin: this drug may cause peripheral neuropathy. This leads to numbness, tingling sensations, pain and burning sensations. It may cause ototoxicity which results in deafness.
  • Ifosfamide and cyclophosphamide: these drugs may damage the urinary bladder lining and cause bloody urine. This is called haemorrhagic cystitis.
  • Doxorubicin: this drug is known to cause damage to the heart.

Chemotherapy for ovarian cancer is mostly an adjuvant therapy with surgery or radiation therapy. It is given as intravenous or intraperitoneal route.

Epithelial ovarian cancer in its initial stage is treated with chemotherapy only.

Some of the chemo drugs used in ovarian cancer treatment are:

  • Albumin bound paclitaxel
  • Altretamine
  • Capecitabine
  • Cyclophosphamide
  • Etoposide
  • Gemcitabine
  • Ifosfamide
  • Irinotecan
  • Liposomal doxorubicin
  • Melphalan
  • Pemetrexed
  • Topotecan

Some of the common side effects of these drugs are hair loss, weight loss, fatigue, hand-foot syndrome, nausea, vomiting, mouth sores.


When is chemotherapy used in prostate cancer?

Chemotherapy is usually used when:

  • Hormone therapy does not have effective results.
  • Adjuvant to hormone therapy
  • Adjuvant to surgical or radiotherapy

Chemotherapeutic drugs used for prostate cancers:

  • Docetaxel
  • Cabazitaxel
  • Mitoxantrone
  • Estramustine

Specific side effects of chemo drugs for prostate cancer:

  • Docetaxel and cabazitaxel: these drugs are known to have adverse allergic reactions and peripheral neuropathy.
  • Mitroxatrone: this drug, in high doses and rare conditions, is said to cause leukaemia.
  • Estramustine: this drug carries an increased risk of clot formation.

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Posted by, Medical Team, Cancer Rounds
April 1, 2019

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