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Cancer treatment side effects

Common cancer treatment side effects

Cancer treatment causes many side effects. Here are ways to deal with these common side effects.

Fatigue

Fatigue is one of the most common problems cancer patients have to deal with. It is a warning sign that the body needs more rest, so listen to your body.

Hair loss

Hair loss is a common side effect of many chemotherapy drugs and radiation used to treat cancer.

Low platelets

When your platelet count is low you may bruise or bleed easily.

Low red blood cells

Chemotherapy and radiation can affect the bone marrow where all your blood cells are made.

Low white blood cells

The majority of patients receiving chemotherapy and/or radiation will have some low blood counts.

Menopausal symptoms

Your breast cancer treatment may cause you to feel menopausal symptoms.

Mouth sores

It is common for patients being treated with chemotherapy or radiation to have problems in their mouth or throat. These areas may become dry or develop sores as a result of treatment.

Nausea and vomiting

Chemotherapy and radiation may cause nausea and vomiting because they affect the stomach lining and the part of the brain that controls vomiting.

How to deal with fatigue

Fatigue is a feeling of tiredness that can keep you from doing the things you normally do or want to do.

Fatigue is one of the most common problems cancer patients have to deal with. It is a warning sign that the body needs more rest, so listen to your body.

Signs of fatigue

  • feeling weary or exhausted. It may be physical, emotional and/or mental exhaustion.
  • decreased desire to do normal daily activities
  • finding it hard to think clearly and to concentrate
  • feeling very "heavy,” especially arms and legs.

When to call your nurse

You should call your nurse if you:

  • are too tired to get out of bed for the past 24 hours
  • feel confused or cannot think clearly
  • think your fatigue has become worse
  • have severe shortness of breath
  • feel dizzy when you change positions.

How to manage your fatigue

  • Plan your day so that you have time to rest.
  • Take several short naps instead of one, long rest period.
  • Pace your activities around your energy level.
  • Eat a well-balanced diet if possible and drink plenty of fluids.
  • Increase the protein and calories in your diet (such as cheese, yogurt, milk shakes, fish, meat, poultry and supplements).
  • Take short walks or do light exercise once a day if you can.
  • Try easier or shorter versions of activities you enjoy.
  • Try less strenuous activities, like reading or visiting with friends and family.
  • Save your energy for those activities that are most important to you.
  • Try to become comfortable asking friends and family for help.
  • Avoid caffeine and alcohol.
  • If you can, reduce your hours at work or stop working temporarily.
  • Do activities that you enjoy or make you feel good.

Source: Allina Health Patient Education, How To Deal With Fatigue, can-ahc-10737 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007

How to deal with hair loss

Hair loss is a common side effect of many chemotherapy drugs and radiation used to treat cancer. How much hair you lose and how long you will lose it depends on the types of drugs used and the areas of radiation.

For many people, hair loss is one of the most difficult side effects of cancer treatment because it affects their self-image and quality of life. Remember — everyone's experience is different and that hair loss caused by chemotherapy is usually not permanent.

General information

  • Hair loss can start anywhere from seven to 21 days after treatment.
  • Hair will usually fall out gradually or in clumps.
  • Any hair still growing may become dull and dry.
  • Your hair will start to grow back when you are finished with your treatments.
  • It may take up to six to 12 months to grow back completely.
  • Hair may grow back with a different color or texture.
  • You may also have hair loss from other parts of your body, such as eyebrows, eyelashes and genital area.
  • Radiation to the head may cause permanent hair loss.
  • Get a wig or hairpiece before your hair falls out.
  • The purchase of a wig or hairpiece is tax-deductible. Some insurance companies may cover the cost — check your policy.
  • Consider borrowing a wig or hairpiece.
  • Try hats, turbans and scarves for hair coverings.

How to manage hair loss

  • Use mild shampoos.
  • Use soft hairbrushes.
  • Avoid hair dryers or use the lowest heat setting.
  • Cut your hair short. This makes the hair look thicker and fuller and it will also make hair loss easier to manage if it occurs.
  • Avoid permanents or hair coloring at this time.
  • Be sure to cover your head or use sunscreen (SPF 15) when exposed to sunlight.
  • Cover your head in winter to prevent heat loss.

Hair loss from chemotherapy or radiation can be hard to accept. It's common and normal for both women and men to feel angry or depressed about this outward sign of their illness. Remember that preparing yourself in advance can enhance the quality of your life during and after treatment.

Talk with your nurse if you have any other questions about hair loss.

Source: Allina Health Patient Education, How To Deal With Hair Loss, can-ahc-10736 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007

How to deal with low platelets

Chemotherapy and radiation can affect the bone marrow where all your blood cells are made, including platelets, which help your blood to clot. When your platelet count is low you may bruise or bleed easily.

When to call your nurse

You should call your nurse if you have:

  • prolonged bleeding from a cut
  • blood in your urine or stool
  • dark brown vomit
  • black, tarry stools
  • frequent nose bleeds
  • tiny pinpoint-sized red or purple spots on your skin
  • unusually heavy menstruation
  • headache
  • bleeding gums.

What to do if your platelet count is low

  • Postpone any surgeries or dental work.
  • Avoid injury, make your home as safe as possible.
  • Avoid using aspirin or aspirin-containing medicines.
  • Use stool softeners to avoid straining on the toilet.
  • Do not use sharp instruments.
  • Shave with an electric razor only.
  • Use a soft bristle toothbrush.
  • Avoid flossing your teeth.
  • Avoid rectal suppositories, enemas, douches and tampons.
  • Blow your nose gently.
  • Report any changes in menstruation, including increased bleeding and bleeding between cycles.
  • Avoid intercourse when your platelets are too low.
  • Avoid contact sports.
  • Wear shoes when you walk.
  • If your platelet count becomes too low, you may need a platelet transfusion.

Your platelet count will get better. Until then, it is important for you to be careful and to try and prevent any bleeding. Please ask your nurse if you have any questions.

Source: Allina Health Patient Education, How To Deal With Low Platelets, can-ahc-10733 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007

How to deal with low red blood cells

Chemotherapy and radiation can affect the bone marrow where all your blood cells are made. The red blood cells are the oxygen-carrying cells in your body. When your red blood cells are low, you may become anemic.

When to call your nurse

You should call your nurse if you:

  • are tired (fatigued)
  • have shortness of breath
  • feel lightheaded
  • are dizzy
  • have a fast heart rate
  • have a headache
  • feel weak
  • have a pale skin color.

What to do if your red blood cell count is low

  • Eat foods rich in iron such as green leafy vegetables.
  • Change your activities to get enough rest.
  • Do light exercises if possible every day.
  • Save your energy for those activities that are most important to you.
  • Pace your activities around your energy level.
  • Change your positions slowly.
  • If your red blood cells become too low, you may need a blood transfusion.

Your red blood cell count will get better. Until then, it is important to follow the advice above and to listen to your body.

Please ask your nurse if you have any questions.

Source: Allina Health Patient Education, How to Deal with Low Red Blood Cells, can-ahc-10731 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007

How to deal with low white blood cells

Chemotherapy and radiation affect the bone marrow where all your blood cells are made. The majority of patients receiving chemotherapy and/or radiation will have some low blood counts. The white blood cells are your infection-fighting cells, so when they are lowered, usually seven to 14 days after treatment, you are at a higher risk for getting an infection.

When to call your nurse or doctor

Please tell your nurse or doctor if you have:

  • a fever of more than 101 degrees Fahrenheit
  • shaking or chills
  • burning or frequent urination
  • a cough or sore throat
  • redness, swelling or drainage in any area.

Ways to help prevent getting an infection

  • Remind all visitors to wash their hands. Hand washing is the most important way to prevent spreading an infection.
  • Do not have more than three visitors at one time. Family or friends should not visit if they have skin, intestinal or respiratory infections. Only children who are family members should visit. Those children should not have come in contact with exposure to an illness that can be spread within the last three weeks.
  • Wear a special filter mask (N95) if you leave your room.
  • Keep your hospital room door closed at all times. Leave your bathroom door open. (This helps the air circulation work to protect you.)
  • Do not have fresh plants, flowers or dried moss in your room.
  • Do not let anyone bring you food made outside the hospital unless your doctor says it's OK. If it is OK, eat the food right away.
  • Be sure to wash all fresh fruits and vegetables.
  • Brush your teeth with a soft bristled toothbrush or a sponge brush.
  • Rinse your mouth with a salt solution four times a day to keep your mouth moist and clean.
  • If you are a woman of child-bearing age, do not use tampons.
  • Practice proper skin care. Pat, don't rub, your skin. Do not use a straight edge razor only use an electric razor.
  • Do not keep any water pitchers at your bedside. Bacteria can form in stale water.

Your white blood cell count will get better. Until then, it is important to take these extra precautions to prevent infections. Please ask your nurse if you have any questions about low white blood cell counts and infection precautions.

Source: Allina Health Patient Education, How To Deal With Low White Blood Cells, can-ahc-10732 (9/08)
Reviewed by: Allina Health Patient Education experts
First Published: 09/15/2008
Last Reviewed: 09/15/2008

How to deal with menopausal symptoms

Your breast cancer treatment may cause you to feel menopausal symptoms. This is because:

  • you were taken off hormone replacement therapy or
  • your chemotherapy drugs (such as cytoxan) or hormone blocking medicines (such as tamoxifen) brought on menopause.

Common menopause symptoms -- and ways to deal with them -- include:

hot flashes
vaginal dryness
depression
insomnia
headaches

Source: Allina Health Patient Education, How To Deal With Menopausal Symptoms Caused By Cancer Treatments, can-ahc-10579 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2010
Last Reviewed: 04/15/2010

How to deal with mouth sores

It is common for patients being treated with chemotherapy or radiation to have problems in their mouth or throat. These areas may become dry or develop sores as a result of treatment. And since the lining of your mouth provides the first line of defense against infection, these sores can lead to a more serious infection if not treated.

Signs of mouth sores

  • pain or burning
  • taste changes
  • sore throat
  • difficulty swallowing
  • mild redness and swelling along the gumline
  • white patches in your mouth

When to call your nurse

You should call your nurse if you have:

  • ulcers or white patches
  • difficulty eating or drinking due to pain
  • a fever.

How to help prevent mouth sores

  • Use a soft bristle toothbrush.
  • Wear dentures only when needed. You may need to keep your dentures out if they do not fit right, to avoid irritation.
  • Drink lots of liquids.
  • Keep your lips and mouth moist.
  • Avoid commercial mouthwashes.
  • Rinse your mouth after every meal and at bedtime with a non-irritating mouth wash:
    • Mix 1 teaspoon baking soda with 1 cup warm water.
    • Do not add hydrogen peroxide to mouth rinses.
  • Clean your dentures every day and soak them every night in fresh solution.

How to manage mouth sores

  • Keep your mouth and gums clean to help prevent infections.
  • Avoid foods and juices that are highly acidic.
  • Avoid hot, spicy or sugary foods.
  • Cold, soft, bland foods, such as ice cream, yogurt, or Popsicles are more soothing and usually better tolerated.
  • Use a straw to make drinking easier.
  • Avoid cigarettes and alcohol.
  • Avoid using floss and toothpicks if your blood counts are low.
  • If dry mouth is a problem:
    • sip water often
    • suck on ice chips
    • chew sugarless gum or suck on hard candy
    • use artificial saliva (over-the-counter product).
  • Use prescription oral anesthetics as directed.
  • Use pain medicines as directed.

Because eating well and drinking fluids play a vital role in your body's healing process, it is important to take good care of your mouth and throat. Call your doctor or nurse if you begin to have problems. Please ask your nurse if you have any more questions about mouth care or mouth sores.

Source: Allina Health Patient Education, How to deal with mouth sores, can-ahc-10734 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007

How to deal with nausea and vomiting

Chemotherapy and radiation may cause nausea and vomiting because they affect the stomach lining and the part of the brain that controls vomiting. The amount of nausea and vomiting a patient has varies from person to person. Nausea and vomiting can usually be controlled with medicine.

When to call your nurse

You should call your nurse if:

  • vomiting occurs more than three times in one hour for three or more hours
  • you are unable to keep liquids down for 12 or more hours
  • you are unable to eat for more than two days
  • you have any blood in the vomit or if the vomit looks like coffee grounds
  • you are unable to keep medicines down.

How to manage nausea and vomiting

  • Take anti-nausea medicine as prescribed.
  • Eat small, frequent meals during the day.
  • Eat foods cold or at room temperature to decrease strong smells.
  • Avoid fried, fatty, greasy or spicy foods.
  • Try eating bland, starchy foods such as toast, crackers or cereal.
  • Avoid foods that are hard to digest like red meat.
  • Avoid your favorite foods during episodes of nausea and vomiting. You may develop a dislike for those foods.
  • Drink more liquids:
    • clear liquids such as water, ginger ale, fruit juices
    • try Popsicles®, Jell-O®, ice chips and sport drinks.
  • Drink liquids one hour before or after meals. Avoid drinking during meals.
  • Rest after meals. Do not lie flat. Instead rest in a chair for one to two hours after meals.
  • Avoid unnecessary stimulation or excitement during meals. Try a cool, well ventilated environment with less noise and light.
  • Avoid odors that bother you, such as smoke, perfume or cooking odors.
  • Avoid eating for a few hours before treatment if nausea usually occurs during chemotherapy.
  • Keep crackers or bread within reach.
  • Try distractions such as music, watching TV, or visiting with friends or family.
  • Do not force foods or fluids if you are vomiting.
  • Do not lie flat on your back to avoid inhaling vomit into your lungs. Try resting on your side or stomach.

Because eating well and drinking fluids play a vital role in your body's healing process, it is important to try and control or minimize nausea and vomiting during your treatments. Be sure to let your doctor or nurse know if your nausea is not being controlled.

Talk with your nurse if you have any concerns or questions about nausea and vomiting.

Source: Allina Health Patient Education, How to Deal With Nausea and Vomiting, can-ahc-10735 (4/07)
Reviewed by: Allina Health Patient Education experts
First Published: 04/15/2007
Last Reviewed: 04/15/2007