Women have harsher cancer treatment symptoms. Here’s what you can do to help
MDlinx Apr 15, 2022
A body of evidence has long established that women are subject to greater adverse effects due to chemotherapy when compared with men. Some women even report symptoms that feel like “going to hell and back,” as one patient described in a recent article.
Banks M. Women see more adverse events with chemotherapy and newer cancer treatments, study finds. StatNews.com. March 7, 2022.
Women also deal with more severe symptoms related to immunotherapies and targeted therapies than men do, even though such therapies are supposed to be less toxic than chemotherapies. Clinicians can help their female patients find ways to mitigate the harsh effects from cancer therapies.
Sex-based AEs
According to a 2022 study published in the Journal of Clinical Oncology, women are 34% more likely to have adverse experiences from standard cancer treatments than men are. When immunotherapies are involved, that number jumps to 49%.
Unger JM, Vaidya R, Albain KS, et al. Sex differences in risk of severe adverse events in patients receiving immunotherapy, targeted therapy, or chemotherapy in cancer clinical trials. Journal of Clinical Oncology. 2022:JCO.21.02377.
Researchers discovered this sex-based discrepancy after looking at clinical trial data from 1980 to 2019 regarding adverse effects due to targeted therapies in 23,296 patients. Chemotherapy, immunotherapy, and targeted therapies were administered in each case study.
About 38% of patients were women, and 62% were men. Of all participants, 9% were Black, and 34.7% were 65 or older. More than 64% of all patients reported at least one severe adverse effect. Women, however, were more likely to experience harsher symptoms across the board. Those receiving chemotherapy or immunotherapy in particular reported severe hematologic symptoms.
One contributor to this dynamic is the reality that most current single-cell cancer studies mainly use male-derived cells, creating a representation gap in the research.
Narjust Duma, MD, who advocates for more inclusive cancer research and treats patients with lung cancer at the Dana-Farber Cancer Institute in Boston, is well aware of this discrepancy. As she explained in a recent article, men account for at least 70% of participants in Phase 1 trials. In addition, cells with XY chromosomes are more often the type used in preclinical studies of investigational cancer drugs.
Banks M. Women see more adverse events with chemotherapy and newer cancer treatments, study finds. StatNews.com. March 7, 2022.
While immunotherapy is generally “well-tolerated,” that’s mainly true for the subjects of the Phase 1 studies: men. Women tend to be excluded from the research that cancer treatments are based on, leaving plenty of room for side effects like nausea, constant vomiting, and general debilitation to go unwitnessed during the study period.
CAM healing methods
The good news is that there are multiple complementary and alternative medicine (CAM) routes that female patients with cancer can take to ease their cancer treatment symptoms until more inclusive research on cancer treatments comes to bear.
CAM can mitigate pain, nausea, fatigue, and stress associated with cancer and standard cancer treatments.
Some patients turn to CAM because it makes them feel that they are doing something themselves to help treat or cure their cancer.
A wide variety of treatment options come under the CAM umbrella, although it is important to note the dearth of evidence-based data for some of the modalities. Here are a few outlined by the National Cancer Institute:
NIH. Complementary and Alternative Medicine. National Cancer Institute. March 21, 2022.
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Mind-body therapies. These treatments consist of meditation to decrease stress and calm the mind, biofeedback to increase awareness of one’s body functions, and hypnosis to induce a calm and focused state for healing. Other options include yoga, tai chi, imagery practices, and creative outlets like music and art to bring the mind and body to a state of relaxation.
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Biologically based practices. Vitamins and dietary supplements, such as minerals and herbs, may help the body to function at its best. Botanicals, including cannabis, and also spices, such as turmeric and cinnamon, offer potential healing properties for patients with cancer. Some patients may choose to eat special foods or stick to a diet that best serves them.
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Manipulative and body-based practices. This area of treatment centers on body work. Massage therapy is one option, as is chiropractic therapy, in which the spine, joints, and musculoskeletal system are manipulated. Another is reflexology, the application of pressure to different points of the hands and feet believed to correspond to other body parts.
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Energy healing. This approach relies on the philosophy that the body has different energy centers. Through practices like reiki and therapeutic touch, patients are said to be able to balance their natural energy centers. Research on the legitimacy of energy healing is lacking, but there is no harm in implementing these practices into one’s care plan if the patient is willing.
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Whole medical systems. Finally, patients can lean on long-held healing traditions from around the world. Ayurvedic medicine is an Indian practice that features herbal medicines, meditation, exercise, physical therapy, and breathing to heal the body, mind, and spirit. Traditional Chinese medicine, on the other hand, seeks to restore the body’s natural yin and yang energies by means of practices like acupuncture. Naturopathic medicine—the use of natural elements like air, water, massage, and heat—is also said to help the body in natural healing processes without the use of surgery.
What this means for you
Female patients with cancer often live with more severe symptoms from chemotherapy, immunotherapy, and targeted therapy than men do. This is largely because biological sex is omitted in the development of cancer treatments, which are based on studies that tend to use male cells more frequently than female cells.
Your female patients who are suffering unbearable symptoms from standard cancer treatment may find alternative healing methods useful. Meditation, yoga, herbal supplements and vitamins, reflexology, Ayurveda, and naturopathic medicine could help your female patients with cancer to manage their symptoms.
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