Understanding Chemotherapy: Side Effects And Care Tips
Chemotherapy ranks as one of the most common treatments to combat cancer. Chemo drugs eliminate fast-growing cancer cells. However, chemo cannot differentiate between fast-growing cancer cells and fast-growing healthy cells, hence it affects the healthy cells as well. When normal cells are damaged, it triggers side effects.
Normal cells that are typically damaged during chemo comprise blood-forming cells inside the bone marrow; cells in the mouth, digestive and reproductive systems; and hair follicles. Some chemo drugs could also hurt cells in the lungs, heart, kidneys, bladder and nervous system.
Occasionally, alongside chemo, the oncologists prescribe medications to patients to safeguard the body’s healthy cells and help relieve side effects. Besides, chemo could be given at levels that are high enough to treat cancerous cells while curbing side effects. Oncologists (doctors treating cancer) avoid using different drugs that have the same side effects.
Note that one cannot predict the side effects each chemo patient will experience or how severe these will be. Yet, knowing about the likely side effects and ways to manage them makes it easier to cope with chemotherapy more efficiently.
Common Side Effects
Side effects depend on the chemo drugs being given and their dosage. The common ones include:
- Fatigue: This remains the most common side effect. The strain on the body in battling cancer and recovering from its treatment leaves one drained of energy. Chemotherapy can also cause anaemia (low blood count), making a person feel tired.
- Hair loss: Generally, hair fall begins within the first few weeks of chemo. While this may be permanent, hair regrowth could start within a couple of months once the treatment stops. However, the colour and texture may now be different.
- Changes in the skin: Skin irritation during chemo can cause rashes. An individual can become sensitive to sunlight, raising sunburn risk.
- Nausea, vomiting and bowel habit changes: Up to 80% of patients are affected by chemo-induced nausea and vomiting. While constipation and diarrhoea may result after chemo, some become lactose intolerant.
- Loss of appetite and difficulty in eating: Since chemotherapy could affect the sense of taste one may not feel like eating. While bitter foods could taste especially bitter, all foods will seem to have a metallic taste. Moreover, a sore throat and mouth sores will make eating painful.
- Bladder and kidney issues: Some chemo drugs will make urination difficult. Pain or burning sensation while urinating and urinary incontinence are other issues.
- Weakened immune system: The white blood cell count can drop with chemo, increasing the chances of falling sick. Chemo patients are particularly at risk of neutropenia – a condition wherein there are a low number of neutrophils (or white blood cells) that maintain immunity and fight infection.
- Bruising and bleeding: Chemo lowers the platelet count, making wounds bleed more. Bruises develop easily too.
- Peripheral neuropathy: Chemo-induced peripheral neuropathy can make parts of the body (e.g., the hands and feet) turn painful, numb or prickly (a pins-and-needles sensation). Muscle coordination becomes difficult.
- Chemo brain: In this condition, people find it difficult to think and remember things clearly like before. Short-term memory could be affected.
- Sex and fertility problems: As oestrogen and testosterone levels decrease, the sex drive and ability to have children are affected. Early menopause could also occur. Pregnancy during chemo treatment is not advised since some drugs can affect the foetus.
How should one Manage Chemo Side Effects?
While the oncologist will advise the patient on how to manage side effects, one should be aware of some general strategies:
- Fatigue: Track energy levels and plan your activities. Balance daily activities (like walking or work) with regular rest breaks. A power nap in the afternoon could be refreshing. Consume nutritious meals, get adequate exercise and avoid stress.
- Hair loss: Use a good wig, hat or scarf. Shampoo, dry and comb hair gently but avoid hair dryers and styling products as well as frequent shampooing, which can damage hair. Protect the head and scalp from the elements when outside.
- Skin changes: Avoid perfumes, powders, strong scented creams and cosmetics that irritate the skin. Only use lukewarm water and mild soap for cleansing the skin and then pat dry with a towel instead of rubbing. Avoid direct heat (heating pads) or cold (ice packs) application to the skin. Avoid tapes or bandages on the affected skin unless advised so by your oncologist. Use sun protection creams – SPF 30 or higher. Reapply periodically when outdoors. Use large hats and protective clothing outside but wear loose garments with natural fibres that allow the skin to breathe.
- Nausea, vomiting and bowel habit changes: To minimise digestive problems, meals should be timed as per chemo treatments. Meals just before or after chemo can raise the chances of nausea. Ensure there is time for meals between treatments. Consume small but frequent meals during the day. Chew and eat food slowly to aid digestion. Avoid spicy, high fat or fried foods and dairy products that can cause gas or diarrhoea. Don’t drink water or liquids during meals. Consume cool beverages that suit you. Rest and relax after meals and take prescribed medications that ease your symptoms.
- Loss of appetite and eating difficulties: If your tastes have been dulled, use new seasonings and eat sour fruits or foods. Keep the mouth moist by sipping liquids when eating. Eat room temperature food so mouth sores are not irritated. Avoid crunchy, acidic foods, carbonated beverages, alcohol, coffee and chocolate. A soft diet may be recommended for some people.
- Bladder and kidney problems: Consume six to eight glasses of water daily but skip coffee and alcohol, which increase urination. Prevent urinary tract infections by avoiding tight trousers and using cotton underwear. Plan your bathroom breaks and urinate before exercise and bedtime.
- Weakened immune system: Take recommended vaccines on time. Wash your hands frequently and bandage wounds, if any, immediately to curb the threat of infections. Avoid sick people and wear a mask whenever required. Only eat well-cooked food to avoid food poisoning. Take prescribed shots to boost white blood cells. If an infection is suspected, contact the oncologist immediately since this could be serious or life-threatening.
- Bruising and bleeding: Take preventive steps inside and outside the home to avoid falls and cuts. While brushing, a soft toothbrush is best to avoid bleeding gums. Use electric shavers with mild, unscented moisturisers. Prevent chapped lips with lip balm. Avoid OTC medications (aspirin and ibuprofen) that enhance the risk of bleeding.
- Peripheral neuropathy: If you have symptoms related to neuropathy such as tingling or numbness in hands or feet, inform your oncologist. The dosage of chemo medications could be revised to stop nerve damage.
- Mental health and sleep issues: Get adequate sleep. Read regularly, complete puzzles and engage in activities that challenge the mind. To limit memory strain, take notes and organise items so these are found easily.
- Sex and fertility problems: Your doctor could recommend medicines to ease symptoms of erectile dysfunction or vaginal discomfort. Consult a fertility specialist and plan a pregnancy, if necessary.
Concluding Points
Most side effects may subside within months after chemotherapy has ended, although some could linger for years. Within six months or a year, most patients will regain earlier energy levels. Always adhere to follow-up schedules so the oncologist can guide you on how to manage lingering symptoms, making life more manageable.