Coping with Side Effects

Unfortunately, while chemotherapy and radiation kill the bad cancer cells in your body, they also can attack some of the normal ones, which you need for strength. This results in a variety of unwanted side effects which vary from person to person and one treatment to the next.

Because chemotherapy can be hard on your body, it’s important to manage your side effects in order to maintain your physical and emotional strength.

Don’t be surprised during your treatment if you are not as interested in sex as you usually are. This is understandable given the emotional and physical stresses you are facing. Treatment side effects such as nausea, fatigue and pain, and changes in your body and appearance (e.g. hair and weight loss) also can reduce your libido.

Although you may not be interested in sex and feel tempted to withdraw, it is important that you and your partner communicate, address each other’s fears and stay connected. Be patient with yourself, only do what you are comfortable with and trust that in time, as you feel better, you will feel sexual again.

Communicate - Talk to your partner about your needs and limits and address each other’s fears.

Explore Non-Sexual Intimacy - Hugging, cuddling, kissing and holding hands can be a satisfying addition or alternative to sex.

Rest and Plan - Rest before and after sexual activity and plan sexual activity during times when you think you have the most energy.

Use Lubricants - Hormonal changes can result in your vagina being drier than usual. Water-soluble lubricants can help.

Talk to Someone - In some cases, it’s helpful for couples to speak to a counselor or therapist to help deal with emotional issues and sexual problems associated with your cancer treatment and recovery.

Fatigue (extreme tiredness) is one of the most common side effects of cancer and cancer treatment. You may be suffering from fatigue if you feel physically, emotionally or mentally exhausted and have difficulty concentrating or thinking clearly.

One of the most common causes of fatigue in a person with cancer is anemia, a condition in which a person’s body does not have enough red blood cells. Anemia happens when chemotherapy decreases the bone marrow’s ability to make red blood cells, resulting in a reduced amount of oxygen transported to all parts of the body. This causes chemotherapy patients to feel the symptoms of anemia –including extreme tiredness, headaches, shortness of breath and difficulty sleeping.

A key signal of anemia in a person undergoing chemotherapy is when she feels so tired, that she can’t do the activities she normally would do, such as taking a shower, making the bed, cooking or climbing stairs.

Chemotherapy-related anemia can be treated with medications, such as erythropoietic agents, which increase red blood cell production.

Talk to Your Doctor About Anemia - If you are feeling extremely tired, tell your doctor. He/she can do a simple blood test to determine if your fatigue is caused by anemia. If it is anemia, it can be treated, and you can get back the energy and strength you need to fight your cancer.

Adjust Your Schedule - Adapt your activities based on your energy levels. Save energy for activities that are most important to you.

Eat Well and Stay Hydrated - Good nutrition will provide you with important fuel that your body needs.

Allow Time to Sleep - Go to sleep early and take naps to allow your body to get the rest it needs to recuperate from your cancer treatment.

Conserve Energy - When possible, practice efficiency in all daily activities (e.g. using the dishwasher instead of washing dishes by hand).

Ask for Help - Your family and friends want to help and are waiting for you to allow them to.

Pain is a common side effect of cancer and can be caused by a tumor pressing on nerves, bones or organs and sometimes even by your treatments. You should speak to your doctor to determine your personalized pain management strategy.

Treat Pain Early - Talk to your doctor early – don’t wait until your pain is unbearable to treat it.

Stay on Schedule - Follow your doctor’s guidelines for taking medication. Don’t "wait it out" until the pain gets worse.

Try Complementary Therapies - Meditation, aromatherapy, acupuncture and other methods may help alleviate your pain.

Talk to Your Doctor - Make sure to let the doctor know if your pain is worsening, so he/she can help you.

For many women, losing their hair (alopecia) is one of the most devastating side effects of cancer treatment, because the loss is so visible and directly linked with identity and style.

Chemotherapy can cause hair loss all over the body, including the eyebrows, eyelashes, arms and legs, but fortunately, the hair almost always grows back. Radiation, however, can cause permanent hair loss, but only in the area where the treatment is directed.

Cut it Off - Many women get a short "crew" cut in advance of treatment to minimize trauma when hair loss happens and to assert their power.

Consider a Wig - Before you begin treatment, shop for a wig that matches your hair color and style. Sometimes, insurance will cover wig costs as do some organizations such as "Look Good… Feel Better."

Treat Your Hair Gently - During your treatment your hair may become fragile and dry. Use mild shampoos, a soft hairbrush and avoid dyes, rollers, hair sprays and permanents.

Explore Other Head Coverings - Hats, scarves and turbans also can be good solutions to camouflage your hair loss while expressing your sense of style.

During your treatment you may experience difficulty passing stool (constipation) or loose stools (diarrhea). These changes in your bowel habits can be caused by your cancer treatment, changes in your diet, pain medication (constipation) and inactivity.

If you experience severe stomach pain, cramping or diarrhea for more than a day, call your doctor.

Drink Plenty of Fluids - Mix grape, apple or cranberry juice with water for better tolerability.

Don’t Eat Insoluble Fiber - This includes high-fat foods, whole wheat and whole grain breads, popcorn, seeds and nuts, raw vegetables, fruit with skin.

Add Soluble Food to Your Diet - This includes oatmeal, potatoes, apricots, bananas, white rice, peeled apples, pears and peaches.

Eat Small Meals, Often

Use Reduced-Lactose Products

Avoid Caffeine

Call Your Doctor - Check with your doctor before you take antidiarrheal medications or if you have a fever, bloody stools or severe cramps.

Drink Plenty of Fluids - Non-caffeinated and warm fluids can be more helpful.

Eat High-Fiber Foods - Plant-based foods such as vegetables, fruits and beans and certain grains add fiber to your diet.

Move Around As Much As Possible - Take a walk or exercise (if your doctor approves) to stimulate bowel movements.

Add a Fiber Laxative to Your Diet

Talk to Your Doctor Before Using Suppositories (laxatives other than fiber, stool softeners or enemas) Taking the wrong treatment can make your condition worse. Some of these treatments should not be used when your white blood counts are low.

Not every person treated for cancer experiences nausea and vomiting, but for those who do, the level of discomfort varies from person to person, drug to drug, and can last from hours, to a day or sometimes longer.

Relax Before Treatments - Sometimes nerves or the thought of the treatment can trigger an upset stomach.

Avoid Greasy High-Fat Foods - Stay away from fried foods, potato chips, hamburgers, etc.

Eat and Drink Slowly - Chew food well and take small sips of fluids.

Rest After Eating - Stay upright – do not lie flat for at least one hour after eating.

Stay Hydrated - After vomiting, sip clear, cool beverages or suck on ice cubes or popsicles.

Talk to Your Doctor - Medications called antiemetics may be able to reduce or even eliminate nausea and vomiting.

Chemotherapy drugs can affect the healthy lining of your mouth, throat and tongue and can cause you to have difficulty swallowing. In addition, the tissue in your mouth can be irritated and dry, which can cause you to lose your appetite, develop mouth sores and infection.

Keep Your Mouth Moist - Keep an ice cube or popsicle in your mouth during chemo and sip often from a bottle of water.

Rinse Your Mouth Frequently - Gargle with mild salt water to remove loose debris, especially after meals.

Avoid Irritating Food and Drink - Don’t consume oranges and other citrus foods, spicy or acidic foods.

Did You Know?

Cancer drugs can change the way food tastes to you. Many people on chemotherapy

have a constant metallic taste in their mouth. To some, foods taste bitter and quite different than they once did. Remember, changes in taste are temporary – so try to continue eating to keep up your weight and energy level.

Many chemotherapy drugs can cause a reduction in the number of white blood cells in your body - making you more likely to develop an infection. During your treatment, even minor infections can become a problem, which is why it is important during this period of vulnerability to take special precautions to protect yourself.

Avoid Cuts and Scrapes - Be careful when using knives, scissors, needles and shavers. If you accidentally cut yourself, clean the wound immediately.

Wash Hands Often - You and your family should wash hands before eating and after using the toilet and touching things in public places.

Avoid Crowds - Go shopping or do other activities at lesscrowded times of day.

Trim Your Nails Carefully - Avoid nail biting or tearing your cuticles.

Take a Warm Bath or Shower Daily - Pat your skin dry and use moisturizer to avoid dry skin.

Stay Away from Sick People - Try to avoid people with colds, coughs, flu or other illnesses you can catch.

Drink Plenty of Fluids - This may help you avoid getting a urinary tract infection.

Many women with ovarian cancer experience some form of anxiety and depression during the course of their treatment.

Given the seriousness of the diagnosis and abrupt change to your life, these feelings are completely understandable. Learning that you have cancer can cause you to feel a wide range of emotions – from anger to extreme sadness. Sometimes, depression can be a side effect of medications you are taking and can be caused by pain or your chemotherapy treatment.

Common signs of depression include loss of appetite, difficulty sleeping, inability to communicate, loss of concentration, prolonged feelings of sadness and grief, wide mood swings, loss of sex drive and thoughts of suicide.

Contact a Professional - If you experience any of these symptoms for longer than a two-week period you should tell your healthcare team right away. They can refer you to a professional who can provide counseling, and in some cases, medication, to alleviate your symptoms and help you regain your spirit.

Chemotherapy sometimes can affect the muscles and nerves causing you to experience tingling, burning or numbness in the hands and feet (peripheral neuropathy), or loss of balance and clumsiness. It can make it difficult to pick things up and to use your hands for things like buttoning a shirt.

If you experience these symptoms, talk to your doctor. He or she may decide to alter your chemotherapy drug or dosage to help these symptoms get better.

Wear Sturdy, Non-Slip Shoes - To prevent falls, do not walk in socks without shoes.

Be Careful When Bathing - Use bathmats in the shower and consider temporarily installing a shower chair.

Grab Items Slowly - Be careful when handling sharp, hot, heavy or other potentially-dangerous items.

Soak Your Hands and Feet - Try to relieve burning by soaking your hands or feet in warm or cool (not icy) water depending on what feels best to you.

Move Carefully - Don’t step too quickly and remember to use handrails on stairs for balance.

Chemotherapy drugs can cause rashes, itching and peeling skin and can cause your skin to be more sensitive to the sun. Cracked and irritated skin can be more prone to infection, so it is important to take care of your skin during your treatment.

Protect The Skin - Avoid very dry, chapped or sunburned skin. Use hypoallergenic moisturizer and sunscreen with SPF 15 or above, and avoid excessive scratching. Do not use lotions, powder, deodorants and perfumes as they can increase the potential for irritation.

Let Skin Breathe - Wear loose-fitting clothes to avoid chaffing and clothing made from soft, natural fibers, like cotton.

Stay Clean and Dry - Use mild soap when bathing, rinse and pat dry. Avoid using hot water when bathing to prevent skin irritation.

As you undergo cancer treatment, you may lose your appetite or interest in eating. Proper nutrition is always important, but is especially necessary when you are fighting cancer. Eating nourishing food that is high in protein is very important. During the course of your treatment, your doctor may refer you to a nutritionist experienced with cancer patients. This specialist can help design a good nutrition plan that you can follow easily.

Maintain a Well-Balanced Diet - Eat high-nutrient foods like cheese, lean meats, cereal, milk and eggs. If you feel nauseated, eat plain, complex carbohydrate foods like white rice, crackers, toast, pretzels and pasta.

Eat at Regular Times - Set a routine in which you eat smaller portions, more often, throughout the day.

Snack Between Meals - Have a high-protein diet supplement or milkshake to add calories and nutrients.

Plan Meals - Decide your menus in advance and freeze extra meals to simplify your cooking schedule.

Make Eating Enjoyable - Dine with family, play music or get a mood with candles.

While it might be the last thing on your mind when you have cancer, exercise (if approved by your doctor) can help you gain energy, build and maintain strength, boost the immune system and relax your mind. Even a small amount of exercise can be beneficial.

Action Steps

Clear all Exercise with Your Doctor Before Starting - Discuss what type/level of exercise is appropriate for you.

Consider Low-Impact Activities - Walking, stretching and yoga are gentle ways to get back into exercise, raise your heart rate and regain strength.

Do not begin any exercise routine until you have spoken with your doctor and received his/her consent.