Side Effects of Chemotherapy

Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized regimen to kill cancers like mesothelioma. Although it can provide benefits to killing off cancer cells, it may also causes a number of side effects. Not every chemotherapy patient experiences all possible side effects. Severity of side effects depends on several factors, including specific drugs used, dosage, and overall patient health.

There are ways to manage and minimize chemotherapy side effects. Substantial improvements in managing these side effects have been implemented in recent years. For example, nausea and vomiting are managed much more aggressively now, so the focus has shifted toward prevention of nausea before it starts. Side effects tend occur in the same pattern with each cycle of chemotherapy. Some are intermittent but others may be ongoing. If you are going through chemotherapy, it is important to understand normal side effects. Be sure to communicate early and frequently about expected side effects and how to best manage them. This will avoid delays in receiving chemotherapy treatments needed for treating your cancer.

Why Chemotherapy Causes Side Effects

Chemotherapy is one of the most effective ways to treat cancer. This aims to kill cells that are rapidly diving, such as cancer cells. Because it cannot tell the difference between cancer cells and normal cells, side effects develop. Common side effects include nausea, fatigue, diarrhea, constipation, neuropathy, hair loss, anemia, kidney damage, hearing changes, and risk for increased infections. Your medical team will closely monitor you for these side effects.

Chemotherapy only affects certain types of healthy cells. These include hair follicles, mouth, digestive, reproductive cells, and bone marrow cells that produce red blood cells, white blood cells, and platelets. These types of healthy cells will be most likely harmed by chemotherapy drugs. The consequences take the form of many of the common side effects of this treatment. Doctors try to find a balance between administering doses high enough to kill cancer cells while minimizing damage to healthy cells.

Common Side Effects

Chemotherapy has many potential side effects. Which ones any given patient will experience depend on the dos, type, frequency, and duration of chemotherapy treatment. They can be temporary or permanent Some of the most common side effects are:

• Nausea and vomiting
• Fatigue
• Bruising or bleeding
• Anemia
• Constipation or diarrhea
• Changes in appetite
• Increased risk of infections
• Mouth sores
• Taste changes
• Numbness, pain, or tingling sensation of the hands or feet
• Kidney and bladder complications
• Difficulty concentrating or focusing
• Infertility, potentially permanent
• Sexual dysfunction

Managing Side Effects of Chemotherapy

If you are going through chemotherapy it is important to discuss potential side effects with your doctor. He or she can help you find ways to manage them. For example, there are certain medications that may help relieve pain, nausea, diarrhea, constipation, infections, and anemia. For side effects that cannot be relieved by medication, other strategies may offer  some relief.

Fatigue is a very common side effect of chemotherapy. To  increase energy levels, it is important to practice healthy sleep hygiene. This means sleeping at normal night time hours and staying active during the day. While short rests may be necessary during the day, avoid excessive daytime sleeping. Routine activity that you can tolerate can also be helpful. You can also cope with fatigue by allowing loved ones to help with chores and other activities.

Another common side effect is change of appetite, which can also lead to weight loss. Chemotherapy may alter your senses, making food seem less appealing. It can also cause mouth sores and difficulty swallowing. All of these can make eating difficult. However, a balanced diet is necessary to remain as healthy as possible. Try eating softer foods that are easier to swallow. You should also avoid foods that are too hot, spicy, salty, or acidic to avoid irritating mouth sores. Good dental care can also help maintain mouth health, making eating easier and more enjoyable.

Fertility loss can be a very serious side effect, especially if you are young and plan to have children in the future. It is important to talk to your doctor about fertility concerns prior to chemotherapy treatment. There are ways to preserve fertility, such as freezing eggs or sperm.

Complementary and Integrative Practices to Relieve Side Effects

Lifestyle changes and medications that relieve side effects are important strategies in battling the discomfort caused by chemotherapy. However, there are other approaches that can help.  Research has found that practices such as massage therapy, yoga, meditation, exercise, acupuncture, and reiki, help patients cope with side effects of treatment.

Yoga, massage, and exercise have all been studied extensively in patients with cancer and going through treatment. Patients who engage in one or more of these report increased energy, less pain, and better overall health and quality of life compared to those who are inactive or do not receive massage therapy.

Emotional Impact

The side effects of chemotherapy are not limited to the physical body. Going through chemotherapy can also take a toll on your emotional well-being. Depression, anxiety, stress, fear, and other negative emotions are not uncommon. The physical discomfort of chemotherapy combined with the realities of living with cancer can combine to cause significant distress. Patients must also deal with their changing body and appearance. Most patients lose their hair during treatment and many either lose weight or gain weight. These changes can increase feelings of distress.

To cope with the emotional side effects of chemotherapy, it helps first to relieve some of the physical side effects. When you feel better physically, you should start to feel better emotionally. However, some patients may want additional support. Therapy or counseling, cancer support groups, and relying on loved ones for help and support can make a difference in a patient’s emotional well-being. This is a normal and healthy way to help your mental well being during treatment.

Serious Side Effects

Although chemotherapy has many varied side effects, for most patients they are not serious or life-threatening. Most side effects go away after treatment. In some cases, a patient may experience more serious, but less common side effects, requiring immediate medical attention. Contact your doctor immediately if you experience a fever, unexplained bruising or bleeding, pain at the injection site, intense pains, severe chills, persistent diarrhea or vomiting, bloody stool or urine, or swelling in the mouth, face, or throat.

While chemotherapy is a useful and effective treatment for mesothelioma and other kinds of cancer, it can be difficult for patients. Some will have minimal or mild side effects, although most experience significant discomfort. Talk to your doctor about any concerns you have before or during treatment. Don’t hesitate to contact your medical team after hours if you are worried about what you are experiencing. With help from your doctors and some lifestyle and alternative strategies, you can make it through chemotherapy and get the benefits of this treatment.

Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP

Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.

Connect with Doctor of Nursing Practice Anne Courtney