5 Side Effects of Chemotherapy and How to Deal with Them

Story submitted by Sue Weber, RN, MEd, OCN, TriHealth Cancer & Blood Institute

Chemotherapy affects any fast-growing cells in the body, like the ones that line your mouth and intestines, as well as the cells that make up your bone marrow and hair follicles, With chemo, normal, healthy cells should bounce back and, ideally, the cancer cells don’t. Chemo may be used to:

• Cure the cancer
• Shrink the cancer
• Prevent the cancer from spreading
• Relieve symptoms the cancer may be causing

Sue Weber, RN, MEd, OCN, of the TriHealth Cancer & Blood Institute, explains common side effects of chemo and ways to deal with each.

Common Side Effects include:

#1: Decrease in Blood Cell Counts:

Why it happens: Red blood cells carry oxygen throughout your body, white blood cells help fight infection, and platelets help stop bleeding. These normal, healthy cells divide rapidly, just like the cancer cells, which is why chemo often affects these benign (good) cells in addition to the cancer cells.

How to handle anemia (low red blood cell count):

• Get at least eight hours of sleep each night
• Take short naps (less than one hour) during the day
• Limit your activities by setting priorities of what you need to get completed for the day
• Accept help when your family and friends offer
• Eat a well-balanced diet that contains all the calories and protein your body needs to keep your weight up and repair tissues that have been harmed by the chemo

How to handle infections (caused by a low white blood count):

• Wash your hands with soap and water
• Carry hand sanitizer
• Use sanitizing wipes to clean surfaces and items that you touch
• Be gentle and thorough when you wipe after a bowel movement
• Take good care of your skin and clean cuts right away
• Stay away from people who are sick or crowds
• Wash raw vegetables and fruits before eating them
• Do not eat raw or undercooked fish, seafood, meat, chicken, or eggs
• If you are a pet owner, have someone else clean up animal waste
• Do not get a flu shot or other vaccine without first checking with your cancer doctor or nurse.

How to handle a low platelet count:

• Brush your teeth with a soft toothbrush
• Blow your nose gently
• Be careful when using scissors, knives or other sharp objects, and use an electric shaver instead of a razor
• Avoid using dental floss or tooth picks, tampons, enemas, suppositories, or rectal thermometers
• Do not play sports or do other activities where you could get hurt.
• Do not wear tight-fitting clothes, especially with tight collars, wrists or waistbands 

Your doctor or nurse will order blood tests to find out your blood counts throughout your chemo treatment.

#2: Nausea and Vomiting

Why it happens: Chemo can irritate the gastrointestinal (GI) tract, or stimulate the chemoreceptor trigger zone in the brain, or it can affect the nervous system – all of which can lead to nausea and vomiting.

How to handle:  

#3: Hair Loss

Why it happens: Hair follicles are made of rapidly dividing cells, so some types of chemo damage these cells. Hair loss can happen anywhere on your body, including your head, face, under arms, legs, or pubic hair. It usually starts two to three weeks after chemo begins.

Your scalp may be tender at first and you might lose hair slowly thoughout your treatment or all at once. Many people prefer to shave their heads or cut their hair very short.

Hair regrowth usually starts two to three months after chemotherapy has stopped.

How to handle: If you plan to buy a wig, it is best to do so before you lose your hair. Many insurance companies cover the cost of a wig so ask your doctor or nurse to write a prescription. Additionally: 

• Be gentle when you wash your hair
• Protect your scalp from the weather by wearing a hat and using sunscreen
• Try sleeping on a satin pillowcase since it causes less friction
• Avoid items that might hurt your scalp, like hair dyes, products that perm, relax or straighten hair, etc... (talk to your cancer doctor or nurse about any questionable hair products or tools)

#4: Mouth and Throat Changes

Why it happens: Since chemo affects fast-growing cells, like the cells that line your entire GI tract (your mouth, throat, lips, teeth, gums and the glands that make saliva), you may experience changes in these parts of your body.

Problems may include:

• Dry mouth
• Changes in taste and smell
• Infections in your gums, teeth or tongue
• Increased sensitivity to hot or cold foods
• Mouth sores

How to handle:  

• Visit a dentist at least two weeks before starting chemo (if that is not possible, ask your cancer doctor or nurse when you should visit)
• Check your mouth and tongue every day, especially if you wear dentures or a partial plate
• Keep your mouth moist by sipping water all day (check with your cancer doctor or nurse if you are having problems producing saliva, because there are medications that can help)
• Brush your teeth with a soft toothbrush after every meal and at bedtime
• Do not use mouthwash that contains alcohol (ask you cancer doctor or nurse what mouth rinse they recommend)
• Take small bites of food
• Soften food with gravy, broth or other liquids
• Suck on popsicles or ice chips.

You cancer doctor or nurse may refer you to a dietitian who can provide further education.

• TriHealth Cancer & Blood Institute: Patient Care Essentials >>

#5: Pain

Why it happens: Chemotherapy may cause painful side effects like burning, numbness and tingling or shooting pains in your hands and feet, as well as mouth sores, headaches, muscle and stomach pain.

Pain can be caused by the cancer itself or by the chemo. It is very important to talk candidly with your cancer doctor or nurse about your pain. 

How to handle: When discussing pain with your nurse or doctor, here are some suggested talking points:

• Location - Is your pain in one spot or all over your body?
• Description - What does your pain feel like? Is it sharp, dull, nagging or throbbing? Does it come and go or is it all the time? How long does it last?
• Pain strength - Rate your pain on a scale of 1-10.
• Pain relief - What makes your pain better or worse?
• Medications for pain - Be sure you have an updated list of all your medicines. Do your pain medicines work? How long do they last and how often do you take them?

It's important to let your family and friends know about your pain so they can help you effectively manage it.

Also, practice pain control by taking your pain medicine on a regular schedule, even when you are not in pain (pain is harder to control when you are playing catch up).

Other methods of pain control include yoga, deep breathing or other activities you find relaxing.

Sources

Chemotherapy and You, created by National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services 

Image source: https://www.haikudeck.com