How can I manage the side-effects of chemotherapy?

Side-effects are the main concern most people have regarding chemotherapy, to the extent that they won't even go for it even if it might cure them or retard the cancer's growth.

But these days, there are plenty of medications to help you prevent or repress these side-effects. Firstly, we have to recap what sort of side-effects you might get from chemotherapy.

The type of side-effects you might get depends on the type of chemotherapy you receive.

Sometimes, you might receive a combination of drugs so as to deal a stronger blow to your cancer.

And even if that particular side-effect is common to that particular chemotherapy agent, it doesn't mean that you WILL get it.

For a good gauge of the side-effects that are associated with a certain type of chemotherapy agent, you can ask the nurse for the package insert (especially when the hospital pharmacist has mixed the drug for you to be given intravenously) or you can Google the agent.

OK. What type of side-effects can I expect?

Chemotherapy usually works by attacking cells that are rapidly dividing, such as cancer cells.

Unfortunately, it may also attack other cells in your body that are rapidly dividing, such as your hair, gut, mouth, bone marrow, ovum, sperm, etc.

In addition to killing the cancer cells, chemotherapy can give rise to (but not all the time) these side-effects:

  • Low white blood cell count. This is called neutropenia. Having a low white cell count means your body will find it more difficult to mount a response to infection, and you may get infected more easily.
  • Low red blood cell count (anaemia). This makes you tired and fatigued.
  • Low platelet count, thus leading to easy bruising or bleeding in your nose or mouth.
  • Hair loss, sometimes total. Not only is the hair on your head affected, but also that on your armpits, your pubis, eyelashes and eyebrows. Not all patients are affected equally.
  • Dry skin
  • Rashes
  • Fatigue which is unrelated to anaemia
  • Nausea and vomiting
  • Diarrhoea or constipation
  • Muscle or nerve disorders, such as tingling sensations, numbness, etc
  • Coughs or difficulty in breathing
  • Fertility and sexual problems

What can I do about the side-effects?

What can I do about these side-effects? Like hair loss. I'm most afraid of hair loss.

Let's talk about hair loss, because it's something that women, especially those who have breast cancer, are terrified of. But in itself, other than aesthetic reasons, it is not a dangerous side-effect.

The hair loss tends to occur in clumps rather than one strand at a time.

And it's very important to remember that once the chemotherapy session is over, your hair will grow back. This usually takes place six to eight weeks after your treatment ends.

And usually, what grows back may be even better than what you had prior to your treatment.

Meanwhile, while your hair is falling out during the chemotherapy sessions, you can wear a beautiful wig.

Some wigs are so well-made these days that it would be difficult for most people to tell the difference. You can even have fun experimenting with different hair colours.

Scarves, hats, caps and turbans are also very fashionable.

I have also heard about low white blood cell count. I'm terrified of that. What can I do?

There is a group of drugs called G-CSF, or Granulocyte Colony Stimulating Factors.

They can be given through your veins or as an injection in a pre-filled syringe.

They stimulate your bone marrow to produce more white blood cells. They also stimulate the lines of white blood cells in your bone marrow to mature faster and enter the blood stream faster.

Some of them are given once a day. Some once per chemotherapy cycle. They are extremely useful.

Additionally, if you have low red blood cell counts, you can take erythropoietin.

This stimulates the red cell lines in your blood marrow as opposed to your white cell lines.

If you perchance get an infection during chemotherapy, you can always be treated with antibiotics.

And if your red blood cell counts or platelets are too low, you can always be infused with packed cells or platelets.

Once the chemotherapy session is over, your bone marrow reverts to normal. So all this is temporary.

Nausea and vomiting

What about nausea and vomiting? I don't want to go through that.

This is where the group of drugs called the anti-nausea and anti-emetic agents come in.

Some of them are given once a day, and others twice a day. They come in oral form or injections.

They can be taken for as long as you think you will have the nausea and vomiting.

So don't be afraid of chemotherapy. Side-effects can be easily managed, and will go away once the chemotherapy ends.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail starhealth@thestar.com.my.

The information contained in this column is for general educational purposes only.

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