Dehydration During Cancer Treatment: The Threat No One Talks About

Feeling tired, dizzy, or just "off" during cancer treatment? It might not just be the meds - dehydration can seriously affect your recovery. Learn what to watch for and what to do about it. https://bit.ly/4nPAOv0

Why Is Dehydration a Threat for Persons with Cancer? 

Dehydration isn’t just about feeling thirsty-it can seriously impact your cancer treatment, increase side effects, and even become life-threatening if left unaddressed. In this episode, we break down why people living with cancer are at higher risk for dehydration, how to recognize early warning signs, and simple but powerful ways to stay safely hydrated. Whether you’re going through treatment or supporting someone who is, this is vital information you can’t afford to miss.

👉 Featuring tips on:

• Spotting subtle signs of dehydration
• When to call your doctor
• What fluids (and foods) really help
• Why staying hydrated is part of your treatment

#CancerAwareness #HydrationMatters #CancerSupport #PodcastClip #Dehydration #OncologyEducation #treatmentsideeffects

In this Episode:

• 01:46 - The Friend: Great New York Scenes, a Great Dane, and Grief
• 05:25 - Scott Simon’s tweets during the last days of his mother's' life
• 10:03 - Recipe of the Week - Mission-Style Carne Asada Burritos
• 11:20 - Dehydration and Cancer - The Threat You Really Need to Know About
• 14:54 - Treatment for Hydration - First, what is the Cause?
• 19:08 - Drinks to Maintain Hydration and Electrolyte Balance 
• 22:19 - Outro

Chapters

• 0:00 Intro
• 1:46 The Friend: Great New York Scenes, a Great Dane, and Grief
• 5:25 Scott Simon’s tweets during the last days of his mother’s’ life
• 10:03 Recipe of the Week – Mission-Style Carne Asada Burritos
• 11:20 Dehydration and Cancer – The Threat You Really Need to Know About
• 14:54 Treatment for Hydration – First, what is the Cause?
• 19:08 Drinks to Maintain Hydration and Electrolyte Balance
• 22:19 Outro

Transcript

Hello and welcome to Everyone Dies. This week, we have a discussion about dehydration. Dehydration is an excessive loss of body fluids and occurs when your body's fluid output exceeds its fluid intake.

A usual part of cancer treatment includes chemo and radiation therapy and both of these treatments can cause nausea, vomiting, loss of appetite, all of which contribute to dehydration. Dehydration is a serious condition and can be life-threatening if left untreated. So relax and settle in for our podcast about serious illness, dying, death, and bereavement.

Our discussion about dehydration is in the second half so you can just fast forward to that chitchat-free zone if you want to get right to it. I'm Marianne Matzo, I'm a nurse practitioner and I use my experience from working as a nurse for 47 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City and here to offer an every person viewpoint to our podcast.

We're both here because we believe that the more you know, the better prepared you are to make difficult decisions. Keep in mind that this podcast does not provide medical or legal advice. Please listen to the complete disclosure at the end of the recording.

In the first half, Charlie has a story about National Public Radio's Scott Simon's tweets during the last days of his mother's life and our recipe of the week. In the second half, as part of our ongoing series, Everything You've Always Wanted to Know About Cancer but Didn't Have Anyone to Ask, we're going to talk about dehydration. And in the third half, Charlie has tips to help manage dehydration.

Charlie, have you seen the film Cambridge last year? I think it's called The Friends, The Friend with Bill Murray. Oh, and Rashid. Yeah, the great composer.

Oh, Quincy Jones, Quincy Jones' daughter, whose name I do not remember. Is that the one? No, this is the one about a dog. Oh, no.

About a great, a Great Dane dog. A Great Dane as opposed to dog as opposed to Great Dane like Hamlet? No. I don't believe so.

You know, it kind of sounds familiar. It's from last year, 2024, and it's from a novel of the same name. And it's Bill Murray is this writer who commits suicide.

And I know that's a difficult topic for a lot of people. And you know, as always, if you're feeling suicidal, be sure that you contact the hotline and get support. But in this film, he just suddenly commits suicide and he has this Great Dane dog.

And his wife said, oh, he wanted this friend of his to have the dog who lives in a small apartment in New York City that doesn't allow dogs. And she's like, I can't take this dog. I'm not allowed dogs.

And so she agrees to take it for like overnight until she can rehome it. And thus, the story ensues. And it's just, I just thought it was a wonderful story.

And through the whole thing, it was like, oh, my God, don't get rid of the dog. I don't remember that film at all. Oh, you have to watch it.

Let me see. Where was it? I forget where it was, of course. It's called The Friend.

The Friend. But if you look up, I would think it's Bill Murray's most recent film because it was just last year. You will find it.

And it's worth watching. And if you love animals, it gets a little scary sometimes. But I won't tell you how it ends.

Okay. I assume it will be uplifting though. Or is that giving away too much? You should never assume that.

Oh. Hmm. Yes, this is the 21st century.

Yes, you're right. Nice shots of the city and a beautiful dog and well written. It was like a pleasure to listen to.

Well, as soon as you said shots in the city, I bellied up to the bar. I will definitely check. Yeah.

You're into having shots in the city. Yes. All right.

Very good. For our first half, it might seem callous to some, while therapeutic to others, to follow a dying person live on Twitter. In 2013, National Public Radio's Scott Simon tweeted his mother's last days of life.

It began with a tweet. I just want to say that ICU nurses are remarkable people. Thank you for what you do for our loved ones.

Simon then began to grieve in real time from his mother's ICU room to his more than 1.2 million followers. That feed was retweeted by the Today Show, Esquire Magazine, and the AARP, among others. For the next few days, he sent sets of 140 characters about the details of his mother's final days on earth.

Tech writers linked to Simon's Twitter feed to show what Twitter could do. The Gigaohm headline read, NPR hosts live tweeting of his mother's last moments shows the power of 140 characters. At first, he tweeted about her health, but as she deteriorated, he began to write, I love holding my mother's hand.

Haven't held it like this since I was nine. Why did I stop? I thought it unmanly. What crap? As she worsened, mother cries, help me at 2.30. Been holding her like a baby since.

She is asleep now. All I can do is hold on to her. When she died, Simon tweeted, the heavens over Chicago have opened and Patricia Lyon Simon Newman has stepped on stage.

Many of his followers shared their own experiences of grief. The weekly news magazine, The Week, reported a variety of views. Simon should have spent the precious final moments of his mother's life providing love and support.

Instead, he spent them tapping away on his smartphone while she suffered beside him. From Huffingtonpost.com, Simon has set an unsettling precedent. Live death videos and photographs inevitably will follow.

From salon.com, so what? There isn't one right or wrong way to let someone go. Unfortunately, we Americans have let our cultural squeamishness about death dictate how we mourn, preferably privately and quietly. Megan O'Rourke in newyorker.com said, Simon gave us an intense glimpse into an experience usually marked by deep secrecy, using a modern medium to restore something we'd lost.

She pointed out that before the 20th century, mourning was a public act. People would bring casseroles, help to wash the body, sit shiva or attend the wake. Some would even get to the deathbed in time to quote, witness the solemn and ecstatic moment of death itself.

But because most people today die in hospitals, we've lost that old intimacy with death. The extraordinary response to Simon's Twitter feed suggests that many Americans hunger for a fuller sense of mourning. Grief, we come to realize, is the flip side of love.

In the Los Angeles Times, Matt Pierce wrote that before the 20th century, death was much more public than it is today. Funerals often took place in the deceased's home. Stoic Victorians were better at death than we are.

They had cemetery picnics, death portraits, among many ways to express their pain about death. In the nine years since Simon's tweets, the rise in popularity of hospice care services is bringing death back into homes. People prefer to die at home.

Death is accepted more today, but much taboo still exists. In Death, American Style, Larry Samuel states that death has become almost embarrassing, like a mistake of nature that you're going to die instead of the most natural thing in the world. Cemeteries are on the outskirts of town.

Bodies are whisked away. Food is associated with waits. From my trip to California this week, I brought back the recipe for Mission Burritos.

Which came first? Swaddling a newborn baby in a blanket and calling them a burrito baby? Or saying your Mission-style burrito is the size of a human baby? We don't know. But we know you will love bringing Mission Burritos to your next funeral lunch. Bueno appetite! And I wonder why my mother would say I speak Spanish like a gringo.

Please go to our webpage for this week's recipe for Mission Burritos and additional resources for this program. This is the part where we ask you for financial support. Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone.

You can donate at www.everyonedies.org. That's every, the number one dies.org. Or at our site on Patreon under Everyone Dies. Marianne? Thanks, Charlie. Dehydration, the loss of body water and salt, occurs when your body loses more fluid than what you take in.

Fluid can be lost from your body through sweating, crying, vomiting, having diarrhea, and through your urine. Our bodies are 66% water, so water is vital to our existence. Being well hydrated will help to balance minerals and electrolytes in your bodies, which can affect how your organs work, lubricate your joints and eyes so they can move and work more easily, keep your body at a healthy temperature, digest the food you eat, remove wastes and toxins from your body, and help skin look and stay healthy.

Whether or not you have a cancer diagnosis, dehydration can lead to severe complications. But for those living with cancer and undergoing treatment, dehydration can intensify treatment side effects, reduce the usefulness of medications, and increase the risk of kidney problems and urinary tract infections. And for some people, severe dehydration can be life-threatening.

Dehydration can cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up. This is called orthostatic hypotension. You may be at a higher risk of dehydration if you take medicine to lower your blood pressure, including water pills called diuretics, are older than age 65, and are on a low-salt diet and have kidney problems.

So what is it about cancer therapies that place a person at risk for dehydration? Both chemotherapy and radiation increase the risk for dehydration because of side effects like loss of appetite, changes in how you swallow, nausea and vomiting, diarrhea, fever, or fatigue. The symptoms of dehydration that you should be aware of includes feeling of thirst, dry mouth, feeling lightheaded, headache, feeling more tired than normal, dark-colored and or bad-smelling urine, dry skin, and urinating less often than normal. Signs of more serious dehydration that you need to tell your oncology practitioner right away about are feeling confused or excessively sleepy, fainting or feeling dizzy, low blood pressure, not urinating at all, breathing faster than normal, and having a fast heart rate.

Please be sure to call your practitioner if you have these symptoms. You might not realize how serious this is, but people do die from dehydration. When you call, your practitioner will ask you questions about your recent symptoms, activity level, and how much fluid you are taking in.

They may ask you to do a skin-turgor test where you pinch your skin on your hand or another part of your body over bony areas, which is why we usually use the hand. If your skin takes longer than it should to return to normal, it could mean you're dehydrated. This is called tenting, where your skin sticks up like a tent instead of returning to its place.

They may also test your blood and urine to check for dehydration. Treatment for dehydration depends on what is causing it and how severe it is. For example, if you're vomiting a lot, getting that under control will be important, and then managing the vomiting unless they have you come in for IV fluids, and sometimes they will because this is important.

Talk to your practitioner about how much fluid you should drink in a day because this is different for each person. If you are able, drink plenty of fluids, and water is always best. Try to drink less caffeinated or sugary drinks.

Any foods that melt at room temperature can be considered fluids, so ice cream is a fluid and popsicles are a fluid. Isn't this great information to have? Fruits and vegetables can also contain water. In some cases, you may need fluids that have electrolytes.

Ask your practitioner what is best for you. Loss of appetite can make it hard to get enough fluids. You can try flavoring water with a splash of fruit juice or lemon.

Eat foods that are mostly liquid like soup and ice. You could add fresh fruit to ice cubes to freshen up your glass of water. If you're having trouble swallowing, your practitioner can order swallow studies with a speech and language pathologist to see how you are swallowing and can give you ways to manage these issues to prevent choking on fluids and dehydrations.

Medication and diet changes can also be used to help manage diarrhea. It can be helpful to track what foods make your side effects worse. Taking small frequent sips of water can be helpful.

Make sure you have water close by always to drink. Now, I've had patients tell me that they don't like the taste of water. In this case, I would suggest that you not think about drinking water as an option but as an important part of your treatment and just do it.

Make a game of it or reward yourself each time you drink a whole glass of water. Honestly, if you start doing it, it will become just something you do and your body and your mind will get used to it. Fatigue can affect your ability to do everyday tasks.

Try to have someone help you with these until you feel better. Having help with these tasks will save energy for things like making sure you're taking in enough fluids. It may seem like a job, but honestly, treatment for cancer is in its own way a part-time job.

So, consider drinking water as other duties as assigned in this new job description. If your dehydration is affecting the way your body works or if you're unable to take in enough fluids, you might need intravenous, you know, IV into the vein fluids. Your practitioner will figure out the amount of fluids you may need and IV fluids can be given in the outpatient or inpatient setting.

Bottom line, stay hydrated. Call your healthcare practitioner right away if you reduce the amount of food or fluid you drink. If you experience nausea or vomiting or diarrhea that doesn't slow down when you take your medication to manage these side effects or if your temperature is above 100.4 degrees Fahrenheit.

And I've seen patients who, you know, we give them the medicine for, you know, in the event that they have nausea and vomiting or in the event that they have diarrhea and they call and I'll say, so did you take your medicine? And they'll say no. And I gotta know, like why not? That's why it's there. So, if they've given you medicine for nausea, vomiting and you're nauseous and vomiting, take your medicine and call your practitioner and let them know.

Now, Charlie has been doing research all week to give you insights into other types of fluids that you could be drinking. Charlie? Marianne asked me to focus today's third half on the topic of the best electrolyte drinks to have during chemo and radiation therapy to prevent dehydration. I want you to know I take these assignments very seriously.

So, I have spent the last week consulting with my favorite bartenders around New York City. Surprisingly, their advice was not particularly helpful, but not surprisingly, I had a good time doing the research. After adjusting my methods, the following drinks can help maintain hydration and electrolyte balancing during treatment.

Always consult with a healthcare practitioner for personalized recommendations. Let's start with coconut water, a natural alternative that provides electrolytes without added sugars. You can put the rum in the coconut and drink it, oh wait, no, just the coconut water, no rum.

Let me make a note of that. Next, electrolyte beverages without added sugars. Avoid drinks with sucrose, fructose, or high fructose corn syrup.

Opt for those sweetened with stevia or lohan guo. Next, juices and slightly sweetened beverages such as lemonade or iced tea can also be beneficial. Two products that people may tell you to drink during chemotherapy, Gatorade and Pedialyte, are in fact not a good choice.

Gatorade contains 34 grams of sugar and dextrose per 20 ounce serving, sodium, and potassium, but omits all the other electrolytes. Sugar depletes minerals, can lower immunity, spur cancer growth, and has been found to increase strains of bad bacteria like C. diff and Clostridium berfringens, food poisoning strain. Chemotherapy severely affects the microbiome, causing a dramatic shift in good and bad bacteria.

Up to 80% of your immune system is in your digestive tract, making chemotherapy extremely immunosuppressive. Which brings me to Pedialyte, which contains dextrose, citric acid, natural and artificial flavors, sodium, potassium, sucralose, asulfamic potassium, zinc gluconate, and depending on the flavor, yellow six, blue one, and of course red 40. Sucralose is a synthetic organochlorine that has been found in studies to reduce the total number of bifidobacteria, lactobacilli, and other good bacteria, which you do not want, especially during treatment for cancer.

Not for nothing, you can make your own natural electrolyte drink. Check out the link in the show notes, and please stay tuned for the continuing saga of Everyone Dies, and thank you for listening. This is Charlie Navarrete, and from J.D. Salinger, author of The Catcher in the Rye, Who Wants Flowers When You're Dead? Nobody.

And I'm Marian Matzo, and we'll see you next week. Remember, every day is a gift. qualified health providers with any questions that you may have regarding your health.

Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast. If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast.

Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies, or by other members is solely at your own risk.