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Dealing with Cancer Therapy Side Effects

April 2015 Vol 1 No 2
Evan C. Naylor, MD
Meridian Cancer Care Hematology/Oncology Attending Physician;
Chief of Palliative Care,
Southern Ocean Medical Center
Manahawkin, NJ

Cancer therapy varies according to the type and stage of one’s cancer. Cancer treatment may include surgery, radiation therapy, or medications, such as “traditional” (older) chemotherapy or newer drugs known as “biologic” or “targeted” medications. All cancer drugs provide a benefit, including preventing the cancer from recurring, shrinking the tumor, or slowing the growth of the cancer. However, many drugs are also associated with negative side effects. The effects differ among the many cancer drugs, but most of them are considered a “normal” consequence of using these drugs. Some of the most common side effects of cancer therapies and how to deal with them are described here.

Fatigue is perhaps the most common and universal side effect of cancer drugs. It may last a few days after treatment or persist throughout the entire treatment period and beyond. Strategies for combating fatigue include conservation of energy, self-monitoring of fatigue patterns, distraction (playing games, socializing, and similar activities), optimizing sleep patterns, and referral to an appropriate specialist (a palliative care physician or a psychologist). Some supplements, such as American Ginseng, have shown a benefit in clinical trials; prescribed stimulant medications may also be beneficial.

Nausea and/or Vomiting are typical side effects of many traditional chemotherapy drugs, and they often last up to 1 week after chemotherapy is over. Your oncologist will provide specific medications to prevent or treat any nausea or vomiting when it occurs. Other useful interventions include eating small meals frequently (instead of a few large meals), eating healthy food, and consuming ginger.

Skin Changes including acne-like rash, are common with many of the newer biologic cancer drugs. The use of mild moisturizing creams, corticosteroid cream, or topical or oral antibiotics may be helpful for such a rash. Hand and foot swelling, pain, and redness may be seen with several cancer drugs. This may require stopping the medication and using moisturizers, such as Udder Cream, to prevent or treat this problem.

Diarrhea associated with cancer therapy can often be managed by eating nondairy, low-fiber healthy foods, drinking fluids with electrolytes (soup broths are typically high in electrolytes), avoiding caffeine and alcohol, and taking medications, such as loperamide tablets. Diarrhea should be discussed with your care provider to make sure there is no infection involved, which would require the use of antibiotics.

Hair Loss & Nail Changes are common side effects. Partial or complete hair loss is common with many of the traditional chemotherapy drugs. The hair often recovers several months after the treatment is completed, although the hair may change in texture or character (straight, wavy, or curly). Pain, color changes, or loss of fingernails and toenails may also develop often, which will typically resolve after treatment.

Other Side Effects

One common chemotherapy drug—cisplatin—may cause hearing loss or ringing in the ears that may be permanent, so notifying your physician about this early is important. Some drugs can also cause damage to the heart, lungs, kidneys, liver, gastrointestinal tract, or the brain, and early diagnosis by a physician through a medical history, physical examination, and laboratory and other testing may prevent more serious and long-term harm.

All cancer drugs provide a benefit, including preventing the cancer from recurring, shrinking the tumor, or slowing the growth of the cancer. However, many drugs are also associated with negative side effects. Ask your doctor if any of the interventions discussed here are appropriate for you.

Peripheral Neuropathy affects the hands or feet and is described as numbness, tingling, “shocklike” pain, “bunching of the socks within shoes,” or “sand in the shoes.” Neuropathy may impair regular daily activities, such as buttoning shirts and picking up small objects, which will necessitate stopping the offending drug. Neuropathy may improve even weeks or months after treatment is over, or it may be a permanent effect. Prescription medications may be necessary to reduce the pain and discomfort.

Low Blood Counts can occur with cancer therapy and may require injected medications to prevent infections or to maintain appropriate levels of red blood cells. In some cases, blood transfusion may be necessary.

Mouth Sores may be painless or painful ulcers or redness of the lining of the mouth. These sores may be prevented with salt water and baking soda rinses. If the sores are painful or hinder eating, they may be alleviated with topical (cream or gel) numbing rinses or with steroid rinses, depending on the drug that caused the mouth sores.

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