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Neuroendocrine Cancer Community

Staying Safe in the Heat – Is there anything you should do to cope with scorching outdoor temperatures if you’re in active cancer treatment? 

Jul 18, 2022

 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? 

The hot weather can trigger side effects like hot flashes for some men and women and make wigs feel uncomfortable and itchy. 

Here are some ideas to help you keep your cool through the hot days predicted:

  • Be aware of medication side effects. Some medications may make you more sensitive to the sun. These include specific types of antibiotics, anti-inflammatories, antifungals, blood pressure medications, and some types of chemotherapy. 
  • Limit sun exposure. The sun’s rays are the most intense between 10:00 AM and 4:00 PM. Practice the shadow rule: if your shadow is shorter than you, you should find shade. Always keep babies younger than 6 months old completely covered and in the shade.
  • Pay attention to the UV index. This numbered scale measures how damaging exposure to the sun will be on any particular day. It is often included in the weather report. When the index is 10 or higher, people should try to stay indoors. Avoid recreational sunbathing.
  • If you have to go out in the heat, walk in the shade, apply sunscreen and wear protective clothing including a hat and/or sunglasses.Make sure you have a long-sleeved shirt, long pants, and a hat that shades the face, neck, and ears. For additional protection, look for clothing made with special sun-protective materials. Make sure your sunglasses have 99% to 100% UV absorption. Be careful around reflective surfaces. Water, snow, and sand reflect the damaging rays of the sun and increase your risk of getting sunburned. Don’t leave anyone in a parked car. 

 

  • Avoid extreme physical exertion. Consider swimming – but check with your doctor to be sure that swimming is a safe option for you and make sure to follow local safety advice if you are going into the water to cool down

   nb Immunocompromised people, in particular, should avoid ponds and lakes (open water 

   swimming)— especially if they have a break in the skin

  • Keep your environment cool:  Place a thermometer in your main living room and bedroom to keep a check on the temperature. Keep windows that are exposed to the sun closed during the day, and open. Care should be taken with metal blinds and dark curtains, as these can absorb heat – consider replacing or putting reflective material in-between them and the window space. Turn off non-essential lights and electrical equipment – they generate heat.  Keep indoor plants and bowls of water in the house as evaporation helps cool the air.  If possible, move into a cooler room, especially for sleeping. Lower the thermostat, if possible.
  • Wear breathable fabrics that allow sweat to evaporate. If you have lost your hair because of chemotherapy or radiation therapy, think about wearing a cotton head scarf or turban rather than a wig.
  • If you decide to wear a wig, you may want to cut your hair short or shave your head while your hair is falling out to keep cool and for a better wig fit. Also, consider wearing a synthetic wig during the hot summer months. Lightweight, synthetic wigs are cooler to wear than natural wigs because their open-cap construction allows air in and heat to escape 

  • Take a cool shower before bed to manage hot flashes during hot summer nights. Wear lightweight clothing to bed. 
  • Drink cold water, low-sugar juices, or sports drinks or eat popsicles or frozen juice pops to quench your thirst and cool down. Keep iced beverages on hand throughout the day. However, make sure to avoid drinks that contain alcohol or caffeine, as they may trigger hot flashes and promote dehydration.  

TOP TIP : 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 favourite 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.

Be aware of the signs and symptoms of both heat exhaustion and heat stroke – headaches and nausea can be symptoms of both, alongside weakness, dizziness, constipation and fatigue. If they’re not quickly treated, they can both be very serious.

There are specific heat-related illnesses including:

  • Heat cramps – caused by dehydration and loss of electrolytes, often following exercise. 
  • Heat rash – small, red, itchy papules (a small pimple or swelling on the skin, often forming part of a rash)
  • Heat oedema – mainly in the ankles, due to vasodilation and retention of fluid. 
  • Heat syncope – dizziness and fainting, due to dehydration, vasodilation, cardiovascular disease and certain medications. 
  • Heat exhaustion – is more common. It occurs as a result of water or sodium depletion, with non-specific features of malaise, vomiting and circulatory collapse, and is present when the core temperature is between 37ºC and 40ºC.                                                             Left untreated, heat exhaustion may evolve into heatstroke. 

Heat exhaustion is usually caused by salt depletion and/or short-term exposure to high temperatures.Heat exhaustion can occur when the temperature inside the body (the core temperature) rises to anything between the normal 37°C (98.6°F) up to 40°C (104°F).

At this temperature, the levels of water and salt in the body begin to fall, which can cause a person to feel sick, feel faint and sweat heavily. 

It’s more common among the elderly (>75yrs) , the very young (children and babies < 2yrs), those with diabetes (particularly the insulin dependent), people  with heart conditions, respiratory or renal insufficiency, Parkinson’s disease, severe mental illness or those less able to look after themselves eg. bedbound.

Specific populations are at increased risk of exposure to heat due to the context in which they live include: homeless people whether sleeping rough or in shelters, people resident in specific institutional setting e.g. care homes, prisons, inpatient psychiatric units and some occupations, workplaces and schools particularly those involving significant manual exertional and/or heat generation (e.g. cooking, some manufacturing roles)

Apart from the above symptoms, other signs of H.E. include muscle cramps, pale, clammy skin, decreased urine output and heavy sweating. 

If a person with heat exhaustion is taken quickly to a cool place, is given water to drink and has their excess clothing removed, they should begin to feel better within half an hour and have no long-term complications.

Without treatment, they could develop heatstroke.

  • Heatstroke – can become a point of no return whereby the body’s thermoregulation mechanism fails. This leads to a medical emergency, with symptoms of confusion; disorientation; convulsions; unconsciousness; hot dry skin; and core body temperature exceeding 40ºC for between 45 minutes and eight hours. It can result in cell death, organ failure, brain damage or death. Heatstroke can be either classical or exertional (e.g. in athletes).

Heat stroke is far more serious than heat exhaustion. It occurs when the body can no longer cool itself and starts to overheat. When the core temperature rises above 40°C (104°F) the cells inside the body begin to break down and important parts of the body stop working.

It usually occurs among people who’ve been exposed to high temperatures for an extended period of time, like manual labourers or athletes who are practicing outdoors. 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 and/or rapid, strong pulse. 

Heatstroke is a medical emergency and should be treated immediately. 

Dial 999 to request an ambulance if you suspect heatstroke. 

While you’re waiting for an ambulance to arrive, make sure that the person is as cool as possible. Move them to a cool area as quickly as possible, remove excess clothing and try to cool them by fanning them. If they’re conscious, give them cool, not cold, water to drink.