Managing Treatment Side Effects

Side effects, like treatment programs, vary from person to person. They can be unpleasant, but most often they are temporary, and most are treatable. Typical side effects for the most common cancer treatments include:

Surgery: During surgery, complications may include bleeding, organ damage and organ dysfunction. After surgery, side effects include pain and infection.

Radiation therapy: Fatigue, nausea and eating problems, mouth sores, localized hair loss in the area of radiation, skin irritation, and dryness.

Chemotherapy: Nausea and vomiting, hair and nail loss, fatigue, eating problems, mouth sores, infection, bleeding or easy bruising, low white blood cell count, and anemia (low red blood cell count).

Coping with Common Treatment Side Effects

• Fatigue
• Hair, Nail and Skin Issues
• Infections
• Lymphedema
• Mouth Sores
• Nausea and Vomiting, and Eating Problems
• Neuropathy
• Neutropenia
• Pain

As with all drug treatment, the risks must be weighed against the benefits. In most patients with cancer, the potentially toxic effects of chemotherapy are justified in order to get the cancer into remission. This is not always the case, and you should tell your doctor whether you’ve ever had any type of heart condition, including high blood pressure. You should also inform him/her about any radiation treatment to the chest area that you might have received in the past.

Fatigue

• To avoid fatigue, plan your days so you have time to rest, especially around treatment times. Save your energy for activities that are most important to you and ask for help with the rest.
• Report symptoms of fatigue to your doctor because fatigue caused by anemia should be diagnosed and treated promptly, so it won't interfere with your treatment schedule.
• Fatigue can also be a sign of depression, a not uncommon response to the stress of cancer diagnosis and treatment. If your doctor rules out other causes of fatigue, ask for a referral to a psychotherapist who specializes in treating people with cancer.

Hair, Nail and Skin Issues

• Be especially careful with your skin in areas where you're receiving radiation therapy. While you're being treated, don't rub your treated skin, wear tight clothing over it, use hot pads or cold packs on the area of treatment, or expose your skin to the sun.
• Use only skin care products that your doctor or nurse has approved. Ask your medical team for recommendations. 
• Cancer-related hair loss can be especially distressing. Many people plan ahead by buying a wig that matches their hair color before starting treatment. Some insurance plans cover the cost of wigs, and there are organizations that specifically help cancer patients cope with hair loss, including the American Cancer Society sponsored sites, Look Good, Feel Better and Look Good Feel Better for Men.
• Before using makeup or false eyelashes to compensate for loss of hair around the eyes, check with your doctor because your skin might temporarily be too sensitive to handle such enhancements.
• If you lose your head hair, wear sunscreen on your scalp, and cover your head when you go outside in the sunlight or cold.
• When hair begins to grow back, treat it gently, and don't color your hair for at least six months after treatment has ended.
• Research has shown limited success in preventing hair loss during cancer treatment using two methods: scalp hypothermia (basically, icing the scalp during chemo treatments) and applying Rogaine (minoxidil). Neither has proven more than mildly successful.

Infections

• Tell your doctor if you have any signs or symptoms might indicate infection, such as pain, fever or swelling.
• If an infection is diagnosed, take the full course of medication that's prescribed for you.

Lymphedema
If you have a mastectomy with axillary dissection (removal of the breast and lymph tissue under the arm), you may develop swelling, or lymphedema. This is a symptom that should be reported to your doctor right away.

Lymphedema can be treated with:

• compression bandages or pneumatic compression pumps
• specific exercises prescribed by a physical therapist
• a massage procedure called manual lymph drainage that pushes fluid and waste to drain properly
• surgery in some cases

Mouth Sores
As a result of some cancer treatments, red sores or ulcers can form on the mucous membrane inside the mouth or on the lips. These sores can make it difficult to talk, eat, breathe comfortably and swallow, so it's important to let your doctor know about any mouth symptoms such as pain or sensitivity to heat or cold.

To prevent mouth sores:

• Visit a dentist before you begin treatment to take care of existing issues such as cavities or gum infections.
• Brush and floss your teeth after each meal to keep your mouth in good health; use a soft brush or ask your doctor about nonirritating teeth cleaning.
• Stop smoking because smoking decreases the ability of mouth tissue to heal itself if sores develop.
• Drink lots of water, so your tissues will stay hydrated and fight infection better.
• During chemotherapy treatments, munch on ice chips; this limits the amount of the drug that reaches mouth tissue and thus helps prevent sores.

Treatments for mouth sores:

• Coating agents are medications that coat the mouth lining and form a protective film that can lessen the pain of eating or drinking.
• There are also topical pain relievers that you can apply directly to mouth sores. Because they cause numbness, be careful not to injure your mouth when eating or brushing your teeth.
• Ask your doctor about a medication called Kepivance (palifermin), which is approved to stimulate the growth of cells in the mouth in people with some cancers. Some cancer centers may offer low-energy laser therapy to stimulate cell growth after chemotherapy and during and after radiation therapy.
• Avoid acidic, spicy or irritating foods (such as chips or pretzels), as well as caffeine and alcohol. Also avoid excessively hot or cold food and drinks.
• Use a straw for drinking liquids to keep the liquids away from mouth sores.
• If you use a mouthwash, make sure it doesn't contain alcohol. You can also use slightly salted plain water to rinse out your mouth. Use the softest brush possible to clean your teeth, or use foam swabs made for sensitive mouths.

Adapted from Everyday Health By HealthTalk Staff