side effects chemotherapy

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Managing chemotherapy side efects

http://www.cancercouncil.com.au/58066/b1000/chemotherapy-

!/chemotherapy-tips-"or-managing-side-efects/#tired

http://www.cancer.go$/about-cancer/treatment/side-efects

While chemotherapy can kill cancer cells, it can also afect normal cells that grow or

divide rapidly, such as those in the bone marrow, digestive tract, skin, hair and

reproductive organs. When the normal cells are damaged, this causes side efects.

Feeling tired and lacking energy

Appetite changes, nausea or vomiting

Hair loss

Skin and nail changes

Mouth sores

Memory and concentration changes

fects on the blood and immune system

!hange in hearing

!onstipation and diarrhoea

Se" and #ertility

$erve and muscle efects

%eeling tired and lac&ing energy

Feeling tired and lacking energy %#atigue& is the most common and o#ten,debilitating side efect o# chemotherapy. Fatigue can include #eeling e"hausted,

drowsy, con#used or impatient. 'ou may have a heavy #eeling in your limbs, or (nd

it di)cult to do daily activities.

Fatigue can appear suddenly and rest may not relieve it. 'ou might still #eel tired #or

weeks or months a#ter a treatment cycle ends.

Save your energy. Help your body recover by doing only the things you really need

to do and resting more.

*et people help you. Family, #riends and neighbours o#ten want to assist but may#eel unsure about what to do. +hey could help with shopping, driving, housework or

gardening.

# you have children, ask #or help looking a#ter them during chemotherapy and a #ew

days a#terwards.

-lan activities #or the time o# day when you tend to #eel most energetic.

http://www.cancercouncil.com.au/58066/b1000/chemotherapy-37/chemotherapy-tips-for-managing-side-effects/#tiredhttp://www.cancercouncil.com.au/58066/b1000/chemotherapy-37/chemotherapy-tips-for-managing-side-effects/#tiredhttp://www.cancercouncil.com.au/58066/b1000/chemotherapy-37/chemotherapy-tips-for-managing-side-effects/#tiredhttp://www.cancercouncil.com.au/58066/b1000/chemotherapy-37/chemotherapy-tips-for-managing-side-effects/#tired


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o light e"ercise, such as walking, and/or keep up with your normal e"ercise

routine. 0egular e"ercise can help reduce #atigue and increase appetite. +alk to your

health care team about suitable activities #or you.

+ry to eat a well1balanced diet with plenty o# #ruits and vegetables.

o rela"ation or meditation e"ercises to see i# they improve your sleep or give you

more energy. For a copy o# !ancer !ouncil2s 0ela"ation and Meditation !s, call 34

33 56.

!heck with your doctor whether your #atigue is related to low red blood cells

%anaemia& so that this can be treated.

iscuss the impact o# your treatment with your employer. Some workplaces may

allow you to work 7e"ibly during or a#ter chemotherapy. 8ptions include taking a

#ew weeks of work, reducing your hours or working #rom home.

'ppetite changes( nausea or $omiting

t is common #or your appetite to change when you are going through

chemotherapy, and some drugs temporarily change the taste o# #oods. Sometimes

you may not #eel hungry, or you may not en9oy the #oods you used to like or crave

#oods you don2t usually eat.

!hemotherapy can make you #eel sick %nauseated& or cause you to vomit. 'our

medical oncologist will tell you i# the drugs you are given are likely to cause nausea

and vomiting. $ot everyone #eels sick during or a#ter chemotherapy but, i# nausea

afects you, it usually starts a #ew hours a#ter treatment. $ausea may last #or many

hours and be accompanied by vomiting or retching. Sometimes nausea lasts #ordays a#ter treatment.

Anti1nausea %anti1emetic& medication helps most people avoid chemotherapy

related nausea or vomiting. +his medicine can be taken be#ore, during or a#ter

treatment. t may be available as:

in9ections ; usually given be#ore chemotherapy

tablets ; can be taken regularly at home

li


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=eing unable to keep li>y drinks such as soda water or dry ginger

ale.

# you wake up #eeling sick, eat a dry biscuit or a slice o# toast rather than skipping

#ood altogether or #orcing yoursel# to have a #ull meal.

=reathe deeply and gently through your mouth i# you #eel like you2re going to vomit.

Avoid strong odours and cooking smells.

at and drink slowly. !hew your #ood well to make it easier to digest.

-repare meals between treatments and #ree>e them #or the days you don2t #eel like

cooking.

at what you #eel like, when you #eel like it. For e"ample, have cereal at dinner time

and a main meal at lunch.

Have small, #re


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Whether or not you lose your hair depends on the drugs you receive. Some drugs

don2t cause this side efect. Ask your doctor i# hair loss is a possibility and how you

can prepare.

When hair loss does occur, it usually starts 5;4 weeks a#ter the (rst treatment and

grows back when chemotherapy is completed. =e#ore, and while your hair is #allingout, your scalp may #eel hot, itchy, tender or tingly. Some people (nd that the skin

on their head is e"tra sensitive, and they may develop pimples on their scalp.

Although losing head hair is most common, you may also lose hair #rom your

eyebrows, eyelashes, arms, legs, chest and pubic region.

t takes ?;35 months to grow back a #ull head o# hair. When your hair (rst grows

back, it may be a diferent colour or curly %even i# you have always had straight

hair&. n time your hair usually returns to its normal condition.

Many people (nd losing their hair very di)cult. 'ou may #eel that your hair is part o#

your overall image and its loss can make you #eel physically unattractive, vulnerable

or sad. t2s natural to #eel this way. +alking to your medical team may be help#ul.

@eep your hair and scalp very clean.

se a mild shampoo like baby shampoo. # you want to use lotion on your head, use

sorbolene. !heck with your nurse be#ore using any other hair or skin care products.

!omb or brush your hair gently using a large comb or hairbrush with so#t bristles.

!ut your hair, especially i# long, be#ore it #alls out. +his can be less upsetting.

Wear a light cotton turban or beanie to bed i# you are cold at night, or to collect hair.

se a cotton, polyester or satin pillowcase, as nylon can irritate your scalp. # you

pre#er to leave your head bare, protect it against sunburn and the cold.

*imit the use o# hair dryers, rollers and harsh products.

+alk to your hairdresser about making your hair look as good as possible even i# it is

thin or patchy. # you want to dye your hair, use vegetable1 based dyes or those low

in chemicals. +est a small area o# hair #or a reaction be#ore colouring your whole

head.

# your eyelashes #all out, wear glasses or sunglasses to protect your eyes #rom the

dust and sun while outside.

+ell your nurse or doctor i# the skin on your scalp is very sensitive, or i# you have a

lot o# discom#ort and itchiness.

Wear a wig, toupee, hat, scar# or turban. o whatever #eels the most com#ortable

and gives you the most con(dence.


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A #act sheet with more in#ormation about how to cope with and manage hair loss as

a side efect o# cancer treatment is available to download online.

*&in and nail changes

Some chemotherapy drugs can afect your skin. t can darken, peel or become dry

and itchy. t is also likely to be more sensitive to the sun, during and a#ter treatment.

Some people (nd their nails also change and become brittle and dry, develop

ridges, or have white lines across them.

se a moisturising soap or sorbolene cream as a soap replacement.

A#ter showering, gently pat your skin dry with a towel. +ry not to rub your skin too

hard.

se a moisturising lotion or cream containing the ingredient urea to stop the

dryness.

Wear loose, non1restricting clothing. !hoose cotton #abric instead o# rough wool or

synthetic (bres.

Wash your clothing in mild detergent #or people with sensitive skin.

Stop shaving or wa"ing until your skin is completely healed.

-rotect your skin #rom the sun ; especially between 36am and 4pm ; by wearing

high1protection sunscreen %S-F B6C&, a hat and protective clothing. +his advice

applies to everyone, but is especially important #or people having chemotherapy.

# your skin becomes red or sore in the area where the intravenous device went in,

tell your doctor or nurse immediately.

Avoid chlorinated swimming pools as the water can make skin changes worse.

!onsider choosing a wig be#ore chemotherapy starts. 'ou can borrow a wig #rom

hospitals or treatment centres with a wig library. # you want to buy a wig and you

have private health insurance, check with your #und i# you are eligible #or a rebate.

!all !ancer !ouncil Helpline 34 33 56 #or assistance in (nding a wig library or shop.

Mouth sores

Some chemotherapy drugs can cause mouth sores such as ulcers or in#ections. +his

is more likely i# you have had or are having radiation to the head, neck or chest, or i#

you have dental or gum problems.

# you notice any change in your mouth or throat, such as sores, ulcers or thickened

saliva, or i# you (nd it di)cult to swallow, contact your doctor.


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iscuss any dental problems with your doctor be#ore seeing the dentist. # you need

any dental work, tell your dentist you are having chemotherapy.

se a so#t toothbrush to clean your teeth twice a day.

Soothe tender gums and mouth sores with plain yoghurt.

@eep your mouth clean and use a mouthwash to help heal mouth sores. on2t use

commercial mouthwashes containing alcohol as they may dry out or irritate your

mouth. +ry a homemade mouthwash %3 tsp bicarbonate o# soda or salt in a glass o#

warm water& at least #our times a day. Start when treatment commences to prevent

mouth ulcers occurring.

Sip 7uids, especially water, and eat moist #oods such as casseroles or soups i# you

have a dry mouth. Moisten #oods with butter and sauces.

+ry sucking on ice while you2re having intravenous chemotherapy to reduce mouth

ulcers.

=lend #oods to make them easier to eat.

Avoid very hot #oods, and spicy, acidic or coarse #oods, %e.g. nuts or grains&, as

these can aggravate mouth sores.

on2t smoke or drink alcohol, as this irritates the mouth.

Memory and concentration changes

Some people say they have trouble thinking clearly #ollowing chemotherapy. +his is

called cognitive impairment or, sometimes,Dchemo brain2. 'ou may (nd that it takesyou more time to process in#ormation, or you may e"perience short1term memory

loss or have trouble concentrating #or long periods.

+here is some evidence that sel#1help techniines with

short articles instead o# books with several characters or comple" storylines.

*earn something new, take up a new hobby, or do crosswords or number pu>>les.


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-lan activities so you do things that re>y or breathless. 'ou may need a blood trans#usion to build up your red blood

cells and treat the anaemia.

ating a nourishing diet with #oods rich in iron and = vitamins is also important i#

you are anaemic. Eood sources include wholegrain breads and cereals, lean meat

and green lea#y vegetables.

,n"ections

# white blood cell numbers drop during chemotherapy, it can make you more prone

to in#ections. Sometimes doctors recommend taking antibiotics as a precaution

against in#ection.

# the number o# neutrophils %a type o# white blood cell that help protect against

in#ection& drop during chemotherapy, you may be given an in9ection o# granulocyte1

colony stimulating #actor %E1!SF& a#ter chemotherapy. 'our doctor or nurse will


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speak to you about possible side efects. Some people may e"perience bone pain or

tenderness at the in9ection site, or show signs o# an allergic reaction.

When to contact your doctor

!ontact your doctor or treatment centre urgently i# any o# the #ollowing occur:

chills or sweats

a temperature o# 4G! or more

persistent or severe vomiting

severe abdominal pain, constipation or diarrhoea

unusual bleeding

redness or swelling around the site o# the intravenous chemotherapy device

any serious une"pected side efects or sudden deterioration in health.

Also, contact your E- or treating specialist i# you e"perience other symptoms that

may be due to an in#ection. For e"ample, sweating, especially at night sore throat

mouth ulcers burning or stinging on passing urine or easy bruising.

Managing the risk o# in#ections when your immunity is low

!heck your temperature every day.

See your doctor i# you are unwell, even i# you 9ust have a cold.

Wash your hands with soap and water be#ore preparing #ood and eating, and a#ter

using the toilet.

+ry to eat #reshly cooked or prepared #oods. Avoid pre1made sandwiches, salads and

takeaway so#t cheeses raw or rare (sh, meat and eggs unpasteurised dairy

products and so#t1serve ice1creams.

se separate chopping boards and utensils #or raw and cooked #oods, and clean

thoroughly with hot, soapy water.

Wash #ruits and vegetables well, or peel where possible.

Store raw and cooked #oods separately.

-ut le#tover #ood in airtight containers in the #ridge as soon as possible.

!ook #ood thoroughly to reduce the risk o# bacteria developing.

on2t eat #ood or drinks past their use1by or best be#ore dates.


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Avoid people who are unwell, especially i# they have the 7u, con9unctivitis, measles,

mumps, a cold sore or chickenpo".

Avoid crowded places such as public transport during rush hour, shopping centres or

public pools to reduce the risk o# picking up an in#ection. +his is not always

practical, so use your commonsense.

!heck with your doctor about having the 7u vaccine i# you are having

chemotherapy in winter.

*et your doctor know i# you think you have been in close contact to someone with

chicken po".

=leeding problems

A decrease in platelets can cause you to bleed #or longer than normal a#ter minor

cuts or scrapes, or to bruise more easily. 'ou may need a platelet trans#usion i# they

are low.

=e care#ul when using scissors, needles, knives or ra>ors. Small cuts or nicks can

harbour germs where an in#ection can start.

se an electric ra>or when shaving to reduce the chance o# nicking yoursel#.

Wear thick gloves when gardening to avoid in9ury, and to prevent in#ection #rom soil,

which contains bacteria.

se a so#t toothbrush to avoid irritating your gums.

# you bleed, apply pressure #or about 36 minutes and bandage, i# appropriate.

# you have problems with bleeding, talk to your doctor

hange in hearing

Some chemotherapy drugs can afect your hearing. 'our doctor may recommend

that you have a hearing test be#ore you start treatment.

'ou may be at risk o# losing the ability to hear high1pitched sounds. !hemotherapy

can also cause a continuous ringing noise in the ears known as tinnitus. While these

changes are usually temporary, let your doctor know i# you notice any change in

your hearing.

onstipation or diarrhoea

Some chemotherapy drugs, pain relie# medicines and anti1nausea drugs can cause

constipation or diarrhoea. +ell your doctor or nurse i# your bowel habits have

changed.


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!onstipation

at more high1(bre #oods, such as wholegrain bread and pasta, bran, #ruit and

vegetables, nuts and legumes %For e"ample, baked beans or lentils&.

ase constipation by drinking #ruit 9uice. +ry prune, apple or pear 9uice.

rink plenty o# other 7uids, both warm and cold, to help loosen the bowels.

o some light e"ercise, such as walking.

on2t use enemas or suppositories. +hey are not recommended #or people having

chemotherapy.

*et your doctor or nurse know i# you have constipation #or more than a couple o#

days. +hey may change your medication or give you other medication to relieve it.

iarrhoea

!hoose bland #oods such as clear broth or boiled rice. Avoid spicy #oods, wholegrain

products, #atty or #ried #oods, rich gravies and sauces, and raw #ruits or vegetables

with skins or seeds.

*imit alcohol, #ruit 9uice, so#t drinks, strong tea or cofee and dairy products, as

these may #urther stimulate the bowel.

rink water to help replace the 7uids lost through diarrhoea.

+alk to your pharmacist #or advice about using over1the1counter medications to treat

diarrhoea at home.

# the diarrhoea becomes severe, it can cause dehydration and you may need to be

admitted to hospital.

*e and "ertility

!hemotherapy may impact on your desire or ability to have se". t may also afect

se"ual organs and #unctioning in both women and men. +his can lead to a

temporary or permanent efect on your ability to have children %your #ertility&.

!hanges in se"uality

Many people have a range o# worries that cause them to lose interest in se" while

they2re having treatment. Aside #rom #eeling tired and unwell, you may #eel less

con(dent about who you are and what you can do, or there may be a physical

reason #or not being able or ready to have se". For e"ample, vaginal dryness or

erection di)culties are common issues a#ter treatment.


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-artners may also #eel concerned about having se" ; they might #ear in9uring the

person with cancer or #eel uncom#ortable with the changes in their partner. # you

have se" a#ter receiving chemotherapy, you should take sa#ety precautions.

Se"ual intercourse may not always be possible, but closeness and sharing can still

be a part o# your relationship. +alk about how you2re #eeling with your partner, andtake time to adapt to any changes. +ry to see yoursel# as a whole person %body,

mind and personality& instead o# #ocusing only on what has changed.

!hanges in #ertility

# you want to have children in the #uture, talk to your doctor about how

chemotherapy might afect you and what options are available. Women may be able

to store eggs %ova& or embryos and men may be able to store sperm #or use at a

later date. +his needs to be done be#ore chemotherapy starts.

fects on women

For some women, periods become irregular during chemotherapy but return to

normal a#ter treatment. For others, chemotherapy may cause periods to stop

completely %menopause&.

A#ter menopause, women can2t have children. Signs o# menopause include hot

7ushes, sweating ; especially at night ; and dry skin.

Menopause ; particularly i# be#ore age ?6 ; may, in the long term, cause bones to

become weaker and break more easily. +his is called osteoporosis.

+alk to your doctor about ways to manage menopausal symptoms.

fects on men

!hemotherapy drugs may lower the number o# sperm produced and reduce their

ability to move. +his can sometimes cause in#ertility, which may be temporary or

permanent.

+he ability to get and keep an erection may also be afected but this is usually

temporary. # the problem is ongoing, seek medical advice.

!ontraception

Although chemotherapy reduces #ertility, it is still possible #or some women to

become pregnant while having chemotherapy, and a man having chemotherapy

could still make his partner pregnant.

!hemotherapy drugs can harm an unborn baby, so women should not become

pregnant during the course o# chemotherapy, and men should not #ather a child.


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Should you or your partner become pregnant, talk to your treating doctor

immediately.

+he type o# birth control you choose will depend on what you and your partner are

com#ortable using. Some people use barrier contraception %e.g. condoms&, which

provide protection against any cytoto"ic drug by1products that may be secreted inbody # luids. 'oung women may be prescribed the -ill as a contraceptive and to help

protect the ovaries #rom the efects o# chemotherapy.

$erve and muscle efects

Some drugs can cause tingling and loss o# sensation in your (ngers and/or toes, and

muscle weakness in your legs. # this happens, tell your doctor or nurse be#ore your

ne"t treatment. 'our treatment may need to be changed or the problem care#ully

monitored.

side effects chemotherapy

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