Side Effects of Treatments
Almost everyone who receives cancer treatment experiences side effects. Relieving side effects is an important part of treatment.
Chemotherapy commonly causes nausea, vomiting, loss of appetite, weight loss, fatigue, and low blood cell counts that lead to anemia and risk of infections. With chemotherapy, people often lose their hair, but side effects vary according to the type of drug.
Side effects from radiation therapy depend on how large an area is being treated, the dose given, and the tumor's proximity to sensitive tissues. For example, radiation to head and neck tumors often causes damage to the overlying skin. Radiation to the stomach or abdomen often causes irritation of the stomach (gastritis) and of the intestine (enteritis), resulting in nausea, lack of appetite, and diarrhea.
Nausea and vomiting can usually be prevented or relieved with drugs (antiemetics). Nausea may be reduced without using drugs by eating small meals and by avoiding foods that are high in fiber, that produce gas, or that are very hot or very cold.
Low blood cell counts (cytopenia, a deficiency of one or more types of blood cell) can develop during cancer treatment because of the toxic effect of drugs on bone marrow. For example, a person may develop abnormally low numbers of red blood cells (anemia), white blood cells (neutropenia or leukopenia), or platelets (thrombocytopenia). If anemia is severe, erythropoietin or darbepoietin can be given to increase red blood cell formation, or packed red blood cells can be transfused. Similarly, if thrombocytopenia is severe, platelets can be transfused to lower the risk of bleeding.
A person with neutropenia is at increased risk of developing an infection. A fever higher than 100.4° F in a person with neutropenia is treated as an emergency. Such a person must be evaluated for infection and may require antibiotics and even hospitalization. White blood cells are rarely transfused because, when transfused, they survive only a few hours and produce many side effects. Instead, certain substances (such as granulocyte-colony stimulating factor) can be administered to stimulate white blood cell production.
Other common side effects include inflammation or even ulcers of the mucous membranes, such as the lining of the mouth. Mouth ulcers are painful and can make eating difficult. A variety of oral solutions (usually containing an antacid, an antihistamine, and a local anesthetic) can reduce the discomfort. On rare occasions, nutritional support must be given by a feeding tube that is placed directly into the stomach or small intestine or even by vein. A variety of drugs can reduce the diarrhea caused by radiation therapy to the abdomen.
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