How to Manage the Side Effects of Cancer Treatment
Cancer treatment commonly causes side effects that can range from uncomfortable to interfering with your ability to go about your daily life. Fortunately, your cancer care team at WVCI can help you prevent, treat, or manage many of the side effects associated with cancer treatment.
Side effects could be experienced at varying levels and at different times throughout cancer treatment. Side effects can vary between the types of treatment, so the side effects of chemo may be different from those associated with radiation, for example.
Managing Common Cancer Treatment Side Effects
Some cancer treatment side effects are preventable and many side effects are treatable. Specific side effects and their severity can vary from person to person, depending largely on the type of treatment. Fortunately, there are ways to manage these side effects.
Anemia is a condition characterized by the lack of red blood cells, which carry oxygen from your lungs to the cells and tissues in our body. Some types of chemotherapy cause your body to make fewer red blood cells, which can cause you to feel tired, dizzy, or short of breath; you may notice that your heart beats faster or harder.
Your doctor will order blood work throughout your course of treatment to monitor your red blood cell count. If you develop anemia, your doctor may recommend a blood transfusion or medications that trigger the production of red blood cells.
Tips for managing anemia
- Get plenty of rest - try to sleep 8 hours each night and take short naps as necessary throughout the day
- Limit your activities to what are most important to you
- Let family or friends help with cooking, cleaning, driving to appointments or other things you feel too tired to do
- Eat a well-balanced diet that provides your body with the nutrients it needs
- Stand up slowly to avoid feeling dizzy when you rise from a chair. Sit up for a minute before standing when rising from bed or recliner.
Chemotherapy can affect your appetite. The treatment can cause nausea; it can also cause you to lose your taste for food. Depression and fatigue that often accompany chemotherapy can change your appetite too. Appetite changes may persist for days or even longer.
It is important to keep eating, even if you are not hungry. Your body needs the vitamins and minerals in food to heal, stay strong, and function well throughout the course of your treatment. Willamette Valley Cancer Institute and Research Center has an on-site dietician to help you maintain proper nutrition.
Tips for managing appetite changes:
- Eat 5 to 6 small meals or snacks each day instead of eating three large ones. Opt for foods and drinks that are high in calories and protein
- Eat your meals according to a schedule rather than when you feel hungry
- Drink milkshakes, smoothies, soup or juice when solid foods do not appeal to you
- Use plastic utensils and glass pots and pans instead of metal ones, as chemotherapy can sometimes cause a metal taste in your mouth
- Increase your appetite by engaging in physical activity before meals
- Avoid drinking beverages immediately before or during meals, as fluids can fill up your stomach
- Apply herbs and seasonings liberally to improve flavor of food
- Keep food and snacks that are easy to eat close by
Chemotherapy can affect your platelets, which are the cells that help your blood clot when you cut yourself. Specifically, chemotherapy can cause your body to make fewer platelets, which means your blood does not clot as it should. This can cause you to bruise easily, and to bleed from your nose or gums.
Tips for managing bleeding:
- Use a very soft toothbrush; run hot water over the bristles to soften them even further before you brush your teeth
- Blow your nose gently
- Be careful when using knives or scissors, or handling sharp objects
- Use an electric shaver rather than a razor with a blade
- Never use aspirin or ibuprofen unless your doctor specifically says you can
- Protect your feet, especially when you are outdoors
- If you do cut yourself, apply firm but gentle pressure to the cut until the bleeding stops
- Avoid using tampons if your platelet count is low
- Use toothpicks and dental floss with caution if your platelets are low
Contact your cancer care team immediately if you have bruising but have not bumped into anything, or if you see tiny red dots on your skin. Notify your doctor immediately if you see blood in the toilet after you urinate or have a bowel movement. Women on chemotherapy should call their doctor right away if their periods are heavier or longer than usual.
Chemotherapy can decrease hormones, which play an important role in maintaining bones. Low levels of certain hormones, particularly estrogen, can weaken bones and increase the risk of fractures.
Tips for managing and preventing bone loss:
- Do weight bearing exercises, which keeps bones strong; these exercises include dancing, aerobics, hiking, jogging or running, jumping rope, using an elliptical, treadmill or stair-step machine, or even taking a fast walk outside
- Reduce or stop smoking – smoking can make hormone therapies less effective
- Talk to your doctor about taking vitamin D and calcium supplements to find out if taking them could prevent bone loss
Chemotherapy, pain medications, and other drugs associated with cancer treatment can cause constipation. Inactivity and reduced food and fluid intake can also cause constipation.
Tips for managing constipation:
- Drink 8 cups of water or more every day; warm or hot liquids can stimulate the bowel, as can prune juice
- Exercise as tolerated
- Eat a high fiber diet and increase fluid intake
- Take a stool softer or laxative as needed
- Call your cancer care team if you have not had a bowel movement in more than two days
Chemotherapy, medications, and infections can cause diarrhea; loose watery stools can cause dehydration.
Tips for managing diarrhea:
- Drink 8 to 12 cups of clear liquids each day to avoid dehydration
- Eat low fiber foods
- Avoid alcohol and caffeine
- Avoid milk and milk products
- Avoid spicy, greasy foods
Immunotherapy can cause inflammation of the colon, a condition known as colitis (Inflammation of the colon), which can cause mucus or blood in the stool, dark or tarry stool, stomach pain or tenderness, diarrhea with fever, and even tears or holes in your intestine. Do not manage colitis with over-the-counter medications without consulting with your doctor.
Chemotherapy can cause feelings of tiredness; radiation coupled with chemotherapy can make fatigue worse.
Tips for managing fatigue:
- Eat a well-balanced diet and drink 8 cups of fluids each day to maintain energy levels and proper hydration
- Take short 10-15 minute “cat naps” that are long enough to boost energy by short enough to let you sleep at night
- Go for a 15-minute walk, ride a bike, or engage in other gentle exercise that gets your blood moving; plan to be active at those times of day when you have the most energy
- Engage in the activities that are most important to you and let someone else handle the rest – ask a friend or family member to do the laundry, for example, or buy groceries
- Adjust your work schedule to lessen fatigue
- Talk with your doctor to rule out other causes of fatigue, such as anemia
Chemotherapy can cause some or all your hair to fall out on your head and elsewhere on your body, usually starting 2 to 3 weeks after you begin treatment.
Tips for managing hair loss:
- Consider a wig; choose your wig before hair loss starts to make matching the color and style of your hair easier
- Cut your hair short or shave your head; while drastic, this step may help you feel more in control
- Wear a hat or scarf when outside and avoid very hot or very cold places
- Consider a cold-cap, which is a system that cools your scalp to prevent or reduce hair loss
Hot Flashes / Night Sweats
Some cancer treatments can lead to hot flashes in both men and women.
Tips for managing hot flashes:
- Eat a low-fat diet
- Drink something cold during a hot flash
- Avoid alcohol, caffeine, and nicotine
- Dress in layers of loose clothing made of natural fibers
- Use cotton sheets and sleepwear
- Exercise regularly
- Keep rooms at a constant temperature and use fans to keep air moving
- Slowly inhale for a count of seven then exhale for a count of nine during a hot flash
Chemotherapy can reduce your body’s ability to make white blood cells, which means you may be more vulnerable to infection. In fact, your oncologist may recommend a drug to help stimulate the growth of white blood cells so that your body doesn't become too depleted.
Tips for managing your risk of infection:
- Wash your hands often
- Keep surfaces clean
- Avoid people who are sick
- Avoid crowds
- Take care to avoid cuts and nicks
- Watch for redness, swelling, drainage or soreness that could indicate infection
- Brush your teeth after meals and before bed
- Avoid cleaning up after pets; wear a mask and wash your hands thoroughly if you must deal with pet waste
- Contact your doctor if you have a fever over 100 degrees or notice other signs of infection
Some types of chemotherapy can cause infertility by damaging the ovaries or sperm, or by lowering hormone levels.
Tips for managing infertility:
- Consider egg and sperm banking before you start treatment if you want to have children in the future
- Call the clinic if you think you or your partner might be pregnant
Some cancer treatments can cause joint aches and stiffness.
Tips for managing joint pain:
- Engage in muscle strengthening exercise and moderate aerobic activity at least twice a week
- Use over-the counter pain relievers
- Contact your doctor if exercise and analgesics do not alleviate joint pain
Kidney and Bladder Changes
Some chemotherapy drugs can cause burning or pain with urinating, trouble urinating, or being unable to control the flow of urine. Some medications can cause urine to look dark yellow, orange or pink in color; blood may appear in the urine.
Tips for managing kidney and bladder changes:
- Drink 8 to 12 cups of water each day
- Limit beverages containing caffeine
- Talk to your doctor if you notice blood in the urine for more than one day after chemotherapy
Mouth and Throat Changes
Chemotherapy can affect the cells of your lips, teeth, gums and salivary glands to cause dry mouth, taste changes, infections of the mouth, sensitivity to hot or cold foods, or mouth sores.
Tips for managing mouth and throat changes:
- Brush your teeth and tongue with a soft toothbrush after each meal and at bedtime
- Gently floss every day, but avoid any areas that hurt or bleed
- Rinse your mouth with ¼ teaspoon each of salt and baking soda mixed in 8 ounces of warm water several times daily; do not use mouthwash that contains alcohol
- Sip water and use sugar-free candy or gum to keep your mouth moist
- Opt for soft or pureed foods; soften foods with sauces or gravy
- Apply water-based lip balm to dry lips
Nausea and Vomiting
Nausea and vomiting may occur during or after chemotherapy sessions. Your chemotherapy team will administer anti-nausea medications prior to treatment, and provide prescriptions for anti-nausea medication for use at home.
Tips for managing nausea and vomiting:
- Choose bland, easy-to-digest foods and avoid greasy, fatty fried foods
- Let hot food and drinks cool down and allow cold foods to warm up before you eat them
- Eat small meals and snacks
- Do not lie down immediately after eating
- Avoid strong-smelling foods
- Avoid smelling food as it cooks
- Suck on ice chips, sugar-free mints or tart candy
- Take slow, deep breaths and get fresh air if you feel nauseated
Nervous System Changes
Some chemotherapy drugs can damage the nerves far away from your brain and spinal cord, such as in your hands and feed. This condition, known as peripheral neuropathy can cause changes in feeling or sensation, numbness, tingling or pain, especially in your hands and feet.
Tips for managing peripheral neuropathy:
- Eat a diet high in B vitamins
- Report any nervous system changes to your doctor or nurse
- Be careful when handling knives or other sharp objects, as you may not realize it if you hurt yourself
- Wear shoes with rubber soles, even indoors, to protect your feet
- Wear gloves while working in the garden or washing dishes
- Use a cane or other walking assistance device to improve balance
Lymphedema is common for those who have had lymph nodes removed. The lymph fluid can't flow through the body as easily, causing swelling, especially in the area where the lymph nodes were removed.
Tips for managing lymphedema:
- Use compression garments to help keep the swelling down
- Light exercise can encourage the lymph fluid to drain
- Massage or manual lymph drainage
Side effects associated with immunotherapy
Immunotherapy is a type of cancer treatment that uses the body’s own immune system to fight cancer. Because immunotherapies work by boosting the immune system, immunotherapies have a different set of potential side effects than do other cancer treatments – immunotherapies can actually boost the immune system too much to trigger a variety of side effects, such as skin rash, fatigue, colitis, and bone and joint pain.
Tips for managing side effects associated with immunotherapy
Depending on the severity of side effects associated with immunotherapy, your doctor may pause treatment or prescribe a corticosteroid.
If you experience side effects from your cancer treatment and are unable to manage them, consult with your cancer doctor. Your oncology team may be able to share other management tips, prescribe medications to ease side effects, or change your cancer treatment medications.