Cancer treatments: 6 things you might not expect

You expect your hair to fall out. But no one tells you what it's like to lose your eyelashes or battle depression. Here are some things you may not know about the effects of cancer treatment -- and how to deal.

1. You might lose your eyelashes, eyebrows and pubic hair, in addition to the hair on your head. And, it might grow back in a new style, color or texture.

"Hair loss is the biggest one for women," says Robin Brugger, a registered nurse and triage nurse at Cape Medical Oncology. "It does grow back, and you know that it will, but it is kind of humbling to look in the mirror and see a stranger looking back at you."

Brugger is also a breast cancer survivor. She was diagnosed in November 2012, finished chemotherapy in April and finished radiation in June. Her hair is growing back now, she says, but while it was always straight before cancer, it's growing back in tight curls. This is very common, says Dr. Andrew Moore of Southeast Hematology/Oncology, but no one's quite sure why it happens.

Cancer patients may "feel like they have a blank face" after their eyelashes and eyebrows fall out, says Brugger. These will grow back, too, but there are ways to cope in the meantime.

"You can use an eyebrow pencil and eyeliner to make your eyes stand out more, and a bit more makeup than you normally wore to make up for not having eyelashes," she says. "But I always thought that when patients didn't have hair, their eyes were more beautiful. Their eyes stood out."

2. You'll have to take extra-special care of your skin and nails.

Cancer treatments make the nails soft or brittle, so that they tear or break easily. They'll also change colors. There's not much you can do but wait until your nails grow out, but Brugger does recommend keeping them trimmed short and wearing nail polish to help protect them.

You'll probably also have dry skin -- find a good lotion and use it several times a day, says Brugger.

3. There will be changes in your appetite, metabolism, weight -- even menopause.

Moore says many patients have loss of appetite for two or three days in each cycle of treatment.

"As long as patients are drinking fluids, this usually is not a problem," he says. "If patients begin to lose weight and become malnourished, there are medications that can be used to help support the appetite."

Brugger experienced changes in her appetite and her sense of taste. She recommends trying a different variety of foods, and perhaps stronger seasonings than you've used in the past. Try to eat small, frequent meals, even if you don't have much of an appetite.

"What I always found most helpful was that I ate what craved," says Brugger. "Even if it was not the healthiest thing, I ate what I craved."

Chemotherapy can also affect metabolism, especially in younger women.

"At times, chemotherapy may induce menopause in younger patients undergoing treatment," Moore explains. "With a change in metabolism, this can lead to unhealthy weight gain, which, in turn, can lead to unwanted, adverse cardiovascular effects. This chemotherapy-induced menopause can lead to hot flashes, mood swings and changes in sexual health."

4. You might feel nauseous.

Many patients fear nausea as a side effect from cancer treatment, but Moore says nausea is becoming less of an issue, thanks to medical advancements.

"We are very aggressive at trying to prevent nausea by giving (anti-emetic) medications before chemotherapy, and fortunately, in most cases, nausea is not an issue."

5. You might feel depressed.

If you have cancer, you're going through a lot, both physically and emotionally. It's completely normal to feel depressed.

"The best thing for that is to stay busy, stay focused on yourself and try to exercise," says Brugger. "That helps a lot -- at least a small amount of daily exercise."

Both Brugger and Moore say it's very important to have a good support system in place, whether through friends and family or a support group and church members.

"The biggest thing I found was that sharing with other breast cancer survivors was really helpful," says Brugger. "We would exchange stories and helpful hints and support each other. We could relate to what others were going through because we had all been there."

Try to stay upbeat and make light of your situation, Brugger suggests -- for example, she and her family called her wig "the helmet" and made little jokes about it, along with other "cancer humor."

"Take it one day at a time. Set small goals for yourself and try to have a little humor about those situations," she says. "You have to keep yourself from going crazy, so try to laugh about it."

Your doctors and nurses are there for you, too, says Moore -- don't be afraid to share what you're going through and ask for help or advice.

6. It's OK to exercise when you have cancer -- and you should.

Once again, Moore says exercise has many physical and psychological benefits, and he encourages all breast cancer patients to stay active.

"Keeping yourself physically and mentally strong is important for all patients undergoing treatment, as well as throughout survivorship," he says. "Studies have shown that patients who are more physically active tend to tolerate treatments better and with fewer side effects than those who are feebler."