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Cancer was responsible for 8.8 million deaths in 2015. Globally, nearly 1 in 6 deaths is due to cancer, reports the World Health Organization.
Treatment options for most types of cancer include chemotherapy, radiation therapy and surgery. While treatment varies depending on the type and stage of the cancer, chemotherapy is widely used and often in combination with other treatment methods.
Chemotherapy destroys cancer cells by targeting rapidly dividing cells. But during the process, normal cells that divide rapidly also get damaged, which can cause a lot of side effects.
The normal cells most likely to be damaged by chemotherapy include blood-forming cells in the bone marrow, hair follicles, and cells in the mouth, digestive tract and reproductive system. Certain chemo drugs can also damage cells in the heart, kidneys, bladder, lungs and nervous system.
Side effects of chemotherapy reduce over time, as the body repairs the damage to normal cells. Fortunately, cancer cells can’t repair themselves very well.
Cancer patients will experience different side effects, depending on the type of chemotherapy, the amount of medicine, the length of treatment and overall general health.
Most side effects go away shortly after the chemotherapy. However, some may take several months to go away completely.
Note: Always tell your doctor and oncology nurse about any side effects that you may be experiencing due to chemotherapy.
Here are some of the common side effects of chemotherapy and how to manage them.
Once chemotherapy starts, most patients complain of fatigue and general weakness.
A 2012 study published in the Indian Journal of Palliative Care found that severe fatigue was more prevalent in patients receiving chemotherapy or concurrent chemo-radiation treatment as compared to radiotherapy.
The persistent exhaustion and weakness can make it hard to do everyday activities. In some patients, chemotherapy can lead to anemia and low red blood cell counts, which can worsen the fatigue.
Also, the emotional aspects of coping with cancer and related pain can contribute to the fatigue.
To deal with fatigue:
- Allow yourself to rest and even take several short naps during the day, if needed.
- Don’t waste energy on unimportant things.
- Be ready to ask for help from family, friends and neighbors.
- Make an effort to do a little exercise like a short walk or light yoga to boost your energy level.
- Follow the diet recommended by your doctor. Healthy amounts of proteins, vitamins, minerals and calories can help fight fatigue.
- Be sure to only use treatments and other suggestions that are prescribed or recommended by your doctor.
2. Nausea and Vomiting
Another common side effect is nausea and vomiting. This mainly occurs as a result of the damage to healthy cells in the stomach and intestinal lining.
A 2016 study published in the Journal of Multidisciplinary Healthcare found that chemotherapy-induced nausea and vomiting continues to be a problem that adversely affects patients’ daily lives.
Antinausea medications are often given in conjunction with chemotherapy drugs to help alleviate this symptom.
Ginger supplements as well as acupressure can also help.
A 2011 study published in Oncology & Hematology Review reports that ginger is the most abundantly used supplement for the prevention and/or reduction of chemotherapy-induced nausea and vomiting. Also, acupuncture and acupressure can be used to treat these side effects.
Another study published in Support Care Cancer in 2012 reports that ginger supplementation at daily doses of 0.5 to 1.0 gram significantly aids in reducing the severity of acute chemotherapy-induced nausea in adult cancer patients.
Other options include:
- Put 1 tablespoon of sliced ginger root in 1½ cups of hot water and allow it to simmer for 5 to 10 minutes. Stain and add a little honey and lemon juice for taste. Drink this ginger tea daily to aid digestion and ease nausea and vomiting. You can also take ginger in supplement form after consulting your doctor. As an added benefit, ginger is good at fighting cancer cells, so it can help increase the effectiveness of your chemotherapy treatment.
- Locate the acupressure point P6 between the two large tendons under your thumb. Press this point in circular motions for a couple of minutes. Repeat on the other wrist as well. Do this once or twice a day.
- Avoid eating greasy foods that can upset your stomach.
- Eat bland foods in small quantities throughout the day.
- Eat five or six small meals rather than three big ones.
- Take your time when you eat and drink.
- Do not lie down right after eating, as it may lead to vomiting.
- Drink plenty of water to prevent dehydration.
3. Hair Loss
Many types of chemo treatments can lead to hair loss. Losing one’s hair, especially for women, can be very depressing.
Along with the hair on the head, chemotherapy can affect one’s eyelashes, eyebrows, armpit hair and pubic hair. Hair loss generally occurs about one to three weeks after the initial treatment.
A 2014 study published in the British Journal of Dermatology reports that hair loss is most prominent after six weeks of chemotherapy. Within three months after cessation of chemotherapy, hair growth rate returns to baseline values.
While it is not possible to stop the hair loss completely, you can try and manage it.
A 2017 study published in the Journal of the American Medical Association reports that scalp-cooling caps can help prevent hair loss in patients going through chemotherapy.
To deal with hair loss:
- Wash your hair with mild moisturizing shampoos and conditioners.
- Use soft-bristle brushes to brush your hair, a couple of times a day.
- Avoid hair products with harsh chemicals, such as hair dyes or permanents.
- Try a new hairdo. Cutting your hair short can make it look thicker and fuller. If needed, wear a wig or decorative scarf.
- Wear a scarf in cold weather.
- If you have lost your hair to chemotherapy, do not be disheartened. Take care of your scalp by applying a gentle lotion and using sunscreen to protect your it from the sun to help. This will help in healthy hair growth after chemotherapy.
4. Diarrhea
During chemotherapy, the lining of your stomach and intestines become damaged. This can cause diarrhea. Patients may experience loose, watery stools several times a day. It can also be accompanied by nausea, bloating and cramps.
A 2007 study published in Current Oncology reports that chemotherapy-induced diarrhea is a severe and frequently undertreated side effect of cancer therapy that requires prompt and effective management to prevent complications, maintain the chemotherapeutic regimen and improve patients’ quality of life.
Another study published in 2010 in Therapeutic Advances in Medical Oncology reports that chemotherapy-induced diarrhea is caused by changes in intestinal absorption and might be accompanied by excessive electrolyte and fluid secretion.
Also, diarrhea may be a consequence of biochemical changes caused by chemotherapy.
There are ways to deal with this side effect.
A 2009 study published in the Journal of Parenteral and Enteral Nutrition demonstrates that probiotics should be considered for advanced breast cancer patients with chemotherapy-induced diarrhea.
- Eat a cup of yogurt with live, active cultures a few times a day to maintain a healthy balance of “good” bacteria in your gut.
- Eat small, frequent meals for easy digestion. Also, choose foods that are easy to digest, such as applesauce, white rice and bananas.
- Avoid high-fat as well as fried foods.
- Limit milk and milk products, as they are hard to digest.
- Drink plenty of fluids, including water.
5. Mouth Sores
Some types of chemotherapy can cause sores inside the mouth and on the mucous lining of the throat and digestive tract. These sores are known as mucositis, which can cause pain and infections, making it difficult to eat, drink and swallow.
A 2004 study published in Neoplasia reports that oral mucositis is an extremely serious and challenging complication of both radiation and chemotherapy in cancer patients.
A 2008 study published in Dental Clinics of North America reports that management of oral mucositis is largely focused on palliative measures, such as pain management, nutritional support and maintenance of good oral hygiene.
To deal with mouth sores:
- Dissolve 1 teaspoon of salt in a glass of warm water and use it to rinse your mouth 5 or 6 times a daily. You can also use ½ baking soda instead of salt.
- Choose a soft-bristle brush for brushing your teeth.
- If toothpaste irritates your mouth, look for other alternative options. Here’s a recipe you can use to whip up your own natural homemade toothpaste.
- Drink plenty of fluids. Use a straw to drink water and other liquids, if it’s helpful.
- Try to eat slowly. Food should be cut into small pieces and chewed completely.
- Avoid extremely hot and cold foods as well as crunchy and spicy foods.
- Avoid acidic foods and beverages like tomatoes, grapes, apples or apple juices, alcohol and sodas.
- Rinse your mouth with water before and after every meal.
- Do not smoke or chew tobacco.
Other Side Effects of Chemotherapy
- Some types of chemotherapy can affect your sense of taste. Your favorite food may taste differently.
- Short-term mental fog after treatment is common.
- Some people may become more sensitive to sunlight in the months following treatment.
- Some may experience constant and unpleasant itchiness. In some cases, the skin may become extremely dry and red.
- Men recovering from bladder, colon, prostate and rectal cancer may experience sexual dysfunction.
- Platinum-based chemotherapy drugs can cause progressive, irreversible hearing loss in some patients.
- Chemotherapy sometimes causes headaches, muscle pain, stomach pain and even pain from nerve damage.
- Chemotherapy related to neuropathy can cause problems with balance and difficulty walking.
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