Coping with side effects from chemotherapy

Although the side effects are often explained and managed by your medical professionals, it is best to make sure you’re well-informed - by asking questions such as:

• What should you watch out for?
• What can be done to help?
• What’s the best way to manage this?
• What will help you to feel better?

Always report any symptoms or problems you may experience along the way - never suffer in silence, because as with every part of your cancer journey, coping with side effects involves a team effort.

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Chemotherapy referred to as ‘chemo’ is used to treat various types of cancer, very successfully. The side effects of chemo are well established with different chemo drugs resulting in different side effects. How you react to chemo will depend on a number of things such as the type of cancer you have and the treatment you are prescribed.

It’s important to chat with your doctor before starting treatment, to find out about your treatment and the possible side effects you can expect. It’s also critical to make sure your medical team is aware of any symptoms you may be experiencing.

“And remember to always verbalise any physical or emotional concerns about side effects - such as hair loss and nerve damage,” says Oncology Care Physician Dr Inge Kriel. “While these may seem ‘trivial’ in comparison to some of the more serious side-effects of treatment, they nevertheless may impair your quality of life and hamper your ability to move out of the cancer routine once treatment has ended.”

While side effects do vary from drug to drug and from person to person, there are some general guidelines for coping with the most common chemo-related side effects:

Side effects from chemotherapy include:

• Nausea and vomiting: there are a number of medications available that are extremely effective in alleviating symptoms and preventing nausea and vomiting. If you are at any point experiencing nausea and / or vomiting discuss this with your treating team.
• Hair loss or hair thinning: a number of different chemotherapy treatments may result in hair thinning or hair loss. Discuss this with your medical team up front so that you understand whether this may affect you and various options available to you.
• Fatigue: always discuss any problems with fatigue and exhaustion with your medical team to exclude any underlying causes first such as anaemia, thyroid issues, depression or a Vitamin B deficiency.
• Fever: some chemo drugs may cause neutropenia, this is when a person has low levels of neutrophils, a type of white blood cell, which helps the body to fight infections. Neutropenia makes a person vulnerable to infection and is usually diagnosed from a blood test or through specific signs and symptoms such as a fever. Report any signs of a fever to your treating team.
• Chemo brain: is the term used by cancer survivors to describe the mental lapses that often occur after undergoing treatment. Always chat to your medical team if you find you’re all over the show mentally - struggling to concentrate or to multitask or to remember things. Brain training exercises for mental stimulation - such as Sudoku - can be beneficial
• Digestive problems: are extremely common as a result of loss of taste, loss of appetite, vomiting, chronic diarrhoea etc. Consulting with a dietitian can be valuable.
• Peripheral neuropathy: some chemo drugs may cause nerve damage (known as ‘chemotherapy-induced peripheral neuropathy’) which may present during treatment, immediately after treatment, or even months to years after chemotherapy is completed. Your treating team may recommend placing your hands and feet on ice packs during treatment to decrease this risk but take care not to cause frost bite. Report any sensation of burning/numbness/tingling/pins and needles in the fingers and toes to your treating team.
• Potential damage to heart muscle cells: there are specific chemo drugs that put you at risk of potential damage to the heart muscle cells. Your treating doctor may request a cardiac assessment before initiating treatment and possibly during follow up (which is individualised for every patient) to monitor this.

Always immediately report any symptoms, specifically if you are feeling any of the following; overwhelming fatigue; shortness of breath; fever; and swelling of the extremities