July 15, 2021 BY PAMELA
SCHLEMBACH, M.D.
Keeping cool during the summer can be a challenge for
even the healthiest individuals. So, how do you manage it when you’re a cancer
patient? Is there anything special you should do to cope with scorching outdoor
temperatures if you’re in active cancer treatment?
Here are five things I tell my patients.
Don’t underestimate the value of good
hydration
When it comes to dealing with extreme heat, the biggest
challenge for most cancer patients is usually staying hydrated. That’s because
both cancer itself and the side effects of its treatment can cause
people to stop eating or drinking the way they normally would. And whether it’s
caused by an altered taste sensation, nausea from chemotherapy, or diarrhea from either chemotherapy, immunotherapy or radiation therapy, the
result is often the same: dehydration.
Getting enough water is important for many reasons. It
allows the blood to more efficiently transport nutrients and oxygen throughout
the body. It also lubricates joints, keeps mucus membranes moist, and helps
regulate not only body temperature, but also heart rate and blood pressure.
Some chemotherapy drugs get filtered out of the body by the kidneys, too, so
it’s important for those organs to have enough water to function correctly.
Our bodies use sweat to regulate temperature through
evaporation. But by the time you’re feeling thirsty due to water lost from that
and urination, you’re already fairly dehydrated. And the worse it gets, the
longer it will take your body to actually use the liquids you ingest. That’s
why I encourage patients to sip cool drinks throughout the day.
Not everybody likes plain cold water, though. So, I
recommend chilled water infused with celery, cucumber or different types of
fruit. If you don’t want to cut up any produce, just add ¼ cup of your favorite
juice to a large pitcher of water. Or, try an iced, low-sugar sports drink or
low-sugar popsicles to keep cool while increasing your fluid intake.
Above all, avoid beverages that contain alcohol or
caffeine, as those can work against you. And talk to your care team if you’re
struggling with nausea, because once you start feeling that way, you usually
don’t want to drink anything at all. And that can lead to more nausea, which
then becomes a vicious cycle.
Think twice before swimming if you’re
in cancer treatment or immunocompromised
Many people enjoy taking a dip to cool off when it’s hot
outside, but check with your doctor to be sure that swimming is a safe option
for you.
Sometimes radiation therapy can make people more
sensitive to the chemicals used in pool water, such as chlorine. But it might
be OK if the part of your body being treated is not soaking in the water. For
instance, if you have a head and neck cancer,
your doctor might approve sitting in pool water that only comes up to your
chest. But if the pool isn’t being properly maintained, it could be a source of
infection.
That’s why I generally don’t recommend swimming in
natural bodies of water, either, due to the risk of infection. Immunocompromised people
in particular should avoid ponds and lakes — especially if they have a break in
the skin — because bacteria and many other microorganisms thrive in still, warm
waters. But check with your care team to find out what’s best for your
particular situation.
Avoid getting overheated during cancer
treatment
Regulating body temperature is generally not a problem
for most cancer patients. But high humidity makes it harder for your body to
cool off by sweating, so try to avoid really hot places like saunas, steam
rooms, hot yoga classes, or hot tubs.
Also be mindful of your environment while exercising.
Psychologically, it’s great to get outdoors, and mild to moderate exercise can
be healthy for our patients. But during the hottest months of the year,
it’s often better for patients to stay inside, where it’s air-conditioned.
If you absolutely must be outside — and your doctor says
it’s OK — avoid strenuous activity when it’s really hot. Instead, exercise
early in the morning or late in the evening when it’s cooler, and drink lots of
fluid. Consider using insulated bottles to keep iced beverages cold longer,
too, or bring cooling towels with you.
Watch for warning signs of heat stroke
and heat exhaustion
Cancer treatment side effects can cause dehydration, so
doctors do everything they can to prevent it. That’s why one of the first
things I usually ask patients is how much fluid they’ve been drinking. Because
early signs of dehydration can include headaches and nausea, as well as
weakness, dizziness, constipation and fatigue.
Headaches and nausea can be symptoms of heat exhaustion
and heat stroke, too. So, it’s important to be alert for warning signs of those
as well.
Heat exhaustion is usually caused by salt depletion
and/or short-term exposure to high temperatures. It’s more common among the
elderly and obese, and can generally be reversed by moving to an
air-conditioned environment, resting and drinking something cold.
Other signs of heat exhaustion include:
·
muscle cramps
·
pale, clammy
skin
·
decreased
urine output
·
heavy sweating
·
dizziness/weakness
·
Signs of heat
stroke may include one or more of the above symptoms, plus:
·
red, hot skin
·
temperature of
103°F or higher
·
confusion
·
vomiting
·
collapse
·
rapid, strong
pulse
But heat stroke is different. It usually occurs among
people who’ve been exposed to high temperatures for an extended period of time,
like manual laborers or competitive athletes who are practicing outdoors. And
when someone’s core body temperature gets that high, it can be
life-threatening. So, it’s imperative to get them help immediately. Call 9-1-1
for anyone with suspected heat stroke, and while you’re waiting, have the
person stop whatever they’re doing, lie down in a shady area or indoors, and
then wrap them in cold, wet towels and give them cold sports drinks.
Limit sun exposure
Certain forms of chemotherapy and radiation therapy can
make cancer patients more sensitive to sunlight. But your particular risk
depends on the type of cancer you have and the treatments you’re receiving.
Some people assume that if radiation therapy is being applied to their chest
for breast cancer, then they
can’t expose their legs or arms to the sun, either. But that’s not true. While
systemic therapies such as chemotherapy can affect the whole
body, the side effects of radiation are usually limited to a very specific part
of it.
That said, anyone who spends time outdoors should use a
sunscreen of at least SPF 30, and reapply it
frequently. It’s also important to wear a wide-brimmed hat and sunglasses with
UVA and UVB protection, as well as UV protective clothing, such as long-sleeved
swim shirts. Wearing a hat is particularly important for people who have lost their hair or
are receiving radiation therapy for head and neck cancers. Above all, seek
shade or stay indoors between the hours of 10 a.m. and 4 p.m., when the sun’s
rays are the strongest.
By following these tips, you can stay cool — and safe —
as you navigate the hottest months of summer.
Pamela Schlembach, M.D.,
is a radiation oncologist at MD Anderson The Woodlands.
Request an appointment at MD
Anderson online or by calling 1-888-450-0629.
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