Feel Like You Want to Avoid Chemotherapy?

Chemotherapy is not as unpleasant as it used to be.

avoid chemotherapyAre you feeling like you want to avoid chemotherapy? You are not alone. Chemo has never been on anyone’s bucket list, but it is more pleasant than it used to be. New developments have helped to lessen or eliminate many of the common side effects. Dr. Kelly Shimabukuro is a medical oncologist. She has seen many patients undergo chemotherapy. In this video, she talks about the new developments in chemotherapy and how they are helping patients.

To learn more watch “How Will My Life Change after Chemotherapy for Colorectal Cancer?” with Dr. Christopher Lieu.

Video Transcripts

Kelly A. Shimabukuro: That is something that I encounter a lot in my practice. People have experiences with family members, who had a particular unpleasant or in some cases, a pleasant experience with chemotherapy and I have a lot of patients who tell me why would I put, you know, poison in my body. So, if I encounter somebody who has had that experience especially if they have a high risk for recurrence that is seen from the pathology reporting might be the stage of their cancer then I talk a little bit more about their experience with chemotherapy because it may not necessarily mean that that is going to be the experience that they have. So, I spend myself and with my nurse and also, we have a social worker, who is part of our care team. We spend a lot of time with patients talking about what their experience has been and try and draw differences because a lot of times, those differences make the situation that the patient is in completely different from what that family member may have experienced.

You know, a particular example might be a patient that I have who would be undergoing treatment for colon cancer, but yet they had an uncle who died of lung cancer and they talked about how they did not tolerate chemo very well and I explain to patients that chemo is a blanket term for different drugs and the side effects are different for different people and the use of different drugs and I also explain that if you were treated several decades ago, the experience may be completely different than now because we have a lot of really good supportive drugs that help with symptoms like nausea, diarrhea and other things that can happen with chemotherapy. So that is one thing I tell patients when they tell me about a bad experience that a family member may have had.

The other part I talk about is trying to really give them may be a concrete idea of what the benefits of chemotherapy would be, especially if you have a high risk for recurrence and that is where I might use other tools to help them better quantify what the benefits would be, so that they can really make an educated decision, but I find that when people have these concerns about chemotherapy, they are spending time talking about what their fears are and investigating whether those are valid fears because there are certain genetic, particularly some of the chemos I use, genetic predispositions to making people now metabolize them well that if say they had a family member, who had a particular bad reaction to a drug that I would want to be using, I may send additional testing, so really getting to the bottom of what are their fears, what was their experience and see if it is something that could potentially happen to them, that if it seems like it is, than I further the investigation, if it is not then I explain to them why that experience would not be likely to happen and a lot of times I think that helps people a lot and I always tell people that you can try doing the chemotherapy and if side effects happen, we can do dose adjustments, but I always tell people that I never want the treatment to be worse than the disease and that is what I think in terms of the big picture.

Kelly Shimabukuro
Dr. Kelly Shimabukuro is currently the Assistant Clinical Professor of Medicine at the University of California, San Diego department of medicine. She specializes in the management of gastrointestinal cancers including colorectal cancer, pancreatic cancer, esophageal cancer, hepatobiliary cancer and anal cancer. She has a particular interest in hepatocellular cancer and is working closely with our multidisciplinary hepatology team in the management of these patients. She has specialized training in clinical trial design and implementation and is integrating this into her practice.

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