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SIDE EFFECTS OF CHEMOTHERAPY
SEXUAL DYSFUNCTION - WEIGHT INCREASE | |||||||||||||||||||||||||||||||||||||
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| SEXUAL DYSFUNCTION
Feminization in Men DESCRIPTION Your chemotherapy may be a female hormone that inhibits the growth of your tumor. The side effects in men receiving a female hormone are breast enlargement, decreased sexual drive, and finer and sparser body hair. The occurrence and degree of these side effects is dosage-related: The greater the amount of the drug, the more increased the occurrence of the side effects. DURATION Feminization in men caused by chemotherapy is temporary. When your chemotherapy treatment is completed, you will return to your pretreatment breast size, sex drive, and hair texture and distribution. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about any feelings or questions you have about your altered appearance. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Sometimes physicians recommend radiation to breasts before chemotherapy to decrease gynecomastia (enlarged breasts). | |||||||||||||||||||||||||||||||||||||
| SEXUAL DYSFUNCTION
Impotence DESCRIPTION Chemotherapy may result in your inability to gain or maintain an erection. DURATION Impotence may be temporary or permanent. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Engage in other ways of expressing affection that are satisfying to you and your partner. | |||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about any feelings or questions you have. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Your symptoms are distressing you and the measures you have tried are not helping the symptoms. | |||||||||||||||||||||||||||||||||||||
| SEXUAL DYSFUNCTION
Menstrual Irregularities DESCRIPTION Chemotherapy may change your menstrual cycle. You may stop menstruating or note a change in the length of your menstrual periods. Spotting between your menstruations and breast tenderness may occur. Symptoms of menopause may appear in women who stop menstruating while receiving chemotherapy. DURATION Menstrual irregularities will continue for the duration of your chemotherapy. Once the drug is discontinued, you should resume your normal pattern. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Conception during the time of chemotherapy is a possibility. Since many anticancer drugs can damage the fetus, birth control measure should be taken. | |||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about any feelings or questions you have. | |||||||||||||||||||||||||||||||||||||
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Use a well-fitting bra to relieve breast tenderness. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Your symptoms distress you. | |||||||||||||||||||||||||||||||||||||
| SEXUAL DYSFUNCTION
Painful Intercourse DESCRIPTION Chemotherapy alters the normal moisture of the mucous membranes of the penis and vagina. Decreased lubrication is particularly noticeable during sexual intercourse and may make intercourse painful for the woman. DURATION Decreased natural lubrication caused by your chemotherapy is temporary. Normal lubrication will return when the chemotherapy is completed. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply over-the-counter lubricants such as K-Y Jelly, Slippery Stuff, or Albane. | |||||||||||||||||||||||||||||||||||||
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Avoid products such as petroleum jelly or other ointments that have an oil base. The lubricant you use must be water-soluble. | |||||||||||||||||||||||||||||||||||||
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Change positions during intercourse (e.g., woman on top or side) | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Intercourse continues to be painful. | |||||||||||||||||||||||||||||||||||||
| SEXUAL DYSFUNCTION
Sterility DESCRIPTION Certain chemotherapy drugs decrease the number and the viability of sperm in men; women often stop ovulating. During chemotherapy many men and women become sterile but do not lose potency (ability to have sexual intercourse). DURATION Sterility will continue for the duration of your chemotherapy, and sperm production may be permanently impaired by teh drugs. Some men regain normal sperm counts. Women may return to normal patterns of ovulation once chemotherapy is discontinued. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about any feelings or questions you have. | |||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about the most desirable and effective method of birth control for you, given the adverse effect of some chemotherapy drugs on fetal development. | |||||||||||||||||||||||||||||||||||||
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Talk to the physician or nurse about the possibility of freezing some of your sperm for future use before you begin chemotherapy. | |||||||||||||||||||||||||||||||||||||
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Talk to your partner. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You are having any sexual difficulties. | |||||||||||||||||||||||||||||||||||||
| SHORTNESS OF BREATH
(Dyspnea, Pulmonary Fibrosis) DESCRIPTION Chemotherapy may cause permanent scarring of lung tissue and you may be short of breath. You may first notice the symptom when you are doing something that demands exertion. DURATION If lung tissue damage occurs in your chemotherapy, your drug will be discontinued and another drug will be prescribed for your disease. The lung tissue can regenerate itself in time (weeks( if damage from teh chemotherapy has not bee prolonged or severe. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Concentrate on soft, easy-to-chew and easy-to-swallow foods if your shortness of breath interferes with regular meals. | |||||||||||||||||||||||||||||||||||||
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Cut down on the number of cigarettes or cigars, or the amount of pipe tobacco, that you smoke. Best of all, stop smoking. | |||||||||||||||||||||||||||||||||||||
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Practice deep breathing at least every 4 hours while awake. Deep breathing expands the lung tissue and reduces the side effects of therapy. To deep breathe, take three deep breaths through your nose, hold your breath for 5 seconds, and then cough deeply, using your stomach (abdominal) muscles before you exhale. Coughing may not be necessary if you are not pooling secretions and you are prone to fractured bones; ask your nurse of physician. | |||||||||||||||||||||||||||||||||||||
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Rest as much as necessary to conserve your energy. | |||||||||||||||||||||||||||||||||||||
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Sit up in a chair, or rest your head in bed against several pillows, if you are having trouble breathing. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You experience any increase in breathing difficulties. | |||||||||||||||||||||||||||||||||||||
| SKIN PROBLEMS
Acne DESCRIPTION Chemotherapy may cause you to develop skin eruptions (acne) of the face. DURATION Acne is a temporary side effect of chemotherapy, and will disappear within 2 weeks after the treatment is completed. If you have had trouble with acne before chemotherapy, it is likely you will have acne after treatment. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply commercial over-the-counter products (e.g., Clearasil, Stridex) as directed. | |||||||||||||||||||||||||||||||||||||
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Avoid picking at blemishes. | |||||||||||||||||||||||||||||||||||||
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Avoid types of food that aggravated skin blemishes before yu began your treatment. | |||||||||||||||||||||||||||||||||||||
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Do no abruptly stop taking your medicine. | |||||||||||||||||||||||||||||||||||||
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Keep your face clean and dry. Wash your face with soap and water several times a day. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Your symptoms distress you and the measures you have tried are not helping. | |||||||||||||||||||||||||||||||||||||
| SKIN PROBLEMS
Burning DESCRIPTION Any medicine given intravenously is irritating to the vein. If the needle accidentally comes out of the vein, the surrounding area then becomes irritated. The irritation and local tissue damage is potentially more serious if the medicine is a chemotherapy drug for the treatment of cancer. Cancer drugs are especially powerful and cause severe irritation. The needle may come out of the vein for several reasons: It may not have been placed well. It may have been jarred out of the vein by movement of the body; or, after many intravenous infusions or having had blood drawn, your veins may have become brittle. DURATION When your physician or nurse notices the needle carrying your chemotherapy drug has come out of the vein, the medicine is immediately stopped and the needle is removed. Minor swelling and pain in the tissue should subside in several hours; more extensive tissue damage may require weeks to heal. If the burn or blister is small, the area may heal promptly. If, however, the affected area is large, you may have a non-healing sore at the injection site. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply a cold, wet cloth or an ice pack immediately to the area for 20 minutes, and then take off for 20 minutes. You can repeat this procedure for up to 18 hours. | |||||||||||||||||||||||||||||||||||||
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Apply a warm, wet cloth or a hot-water bottle after you have completed your cold, wet application. | |||||||||||||||||||||||||||||||||||||
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Apply prescription cream if it has been ordered. | |||||||||||||||||||||||||||||||||||||
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Avoid direct sunlight on the area. | |||||||||||||||||||||||||||||||||||||
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Elevate the arm on a pillow. | |||||||||||||||||||||||||||||||||||||
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Keep the affected area clean and dry and avoid irritating the area. Wear clothes that do no cover the affected area. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Needle comes out or there is burning or swelling at the site of injection. | |||||||||||||||||||||||||||||||||||||
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Your sore does not heal. | |||||||||||||||||||||||||||||||||||||
| SKIN PROBLEMS
Dermatitis DESCRIPTION Chemotherapy may cause you to develop a red, bumpy rash on your skin. The skin reaction to your chemotherapy is not unlike a rash you could get from any medicine you take. A skin rash is not an indication of whether your chemotherapy is or is not destroying cancer cells. DURATION There are degrees of severity of chemotherapy-related skin rashes. If you experience a severe skin reaction, your chemotherapy will be discontinued and another drug will be prescribed to treat your disease. If you have a mild skin reaction, you may continue to receive the same chemotherapy and the rash will subside when your treatment is completed. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply lotions and creams (e.g., Alpha Keri, Hydrocortisone Cream 1%, or Caladryl) that have been prescribed for you. | |||||||||||||||||||||||||||||||||||||
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Avoid excessive exposure to direct sunlight. | |||||||||||||||||||||||||||||||||||||
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Avoid scratching. | |||||||||||||||||||||||||||||||||||||
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Do not use soap for bathing or shampoo on your scalp if your skin is sensitive. | |||||||||||||||||||||||||||||||||||||
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Take lukewarm tub baths with 1.4 cup baking soda to increase your comfort. | |||||||||||||||||||||||||||||||||||||
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Take medicine prescribed for you to decrease any itching or burning. | |||||||||||||||||||||||||||||||||||||
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Use collodal baths or oil-in-water-type lotion. | |||||||||||||||||||||||||||||||||||||
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Wear cotton gloves at night if you scratch your skin while asleep. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Rash is not alleviated by prescribed drugs. | |||||||||||||||||||||||||||||||||||||
| SKIN PROBLEMS
Hot Flashes DESCRIPTION Your chemotherapy may be an antiestrogen drug and may cause you to experience hot flashes. They occur because your drug causes the blood vessels of your skin to dilate and thus increases the flow of blood. DURATION Hot flashes will continue as long as you are receiving your chemotherapy. Once th treatment is completed, the hot flashes will subside over several weeks. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply cold compresses around your neck. | |||||||||||||||||||||||||||||||||||||
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Dress in layers and discard as needed. | |||||||||||||||||||||||||||||||||||||
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Fan yourself. | |||||||||||||||||||||||||||||||||||||
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Talk to the nurse of physician about any feelings or questions you may have. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Your symptoms distress you. | |||||||||||||||||||||||||||||||||||||
| SKIN PROBLEMS
Redness and Peeling (Sloughing) DESCRIPTION Chemotherapy may cause redness and peeling of the skin of your fingers. DURATION Your chemotherapy may be delayed, or the dosage may be reduced or discontinued if the skin on your fingers becomes red and peels. The skin will be normal again several weeks after the chemotherapy dosage is altered or discontinued. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Apply moisturizing lotion frequently. | |||||||||||||||||||||||||||||||||||||
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Check for signs of infection. | |||||||||||||||||||||||||||||||||||||
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Wear gloves for protection when gardening and cooking. | |||||||||||||||||||||||||||||||||||||
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Wear gloves with lanolin when you go to sleep. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You experience skin redness and peeling on your fingers, or pain. | |||||||||||||||||||||||||||||||||||||
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You think an open area is infected. | |||||||||||||||||||||||||||||||||||||
| STOMACH IRRITATION AND ULCERS
(Gastric Ulcers) DESCRIPTION Chemotherapy may be particularly irritating to the cellular lining of your stomach. In minor episodes, you may experience heartburn and a sensation of indigestion; in more extreme episodes, you may experience a gnawing, burning pain in the stomach area. If the irritated area ulcerates, you may experience nausea and vomiting. Your vomit may be bloody of coffee-ground-like in appearance (old blood). You may be bleeding in your stomach and not realize it until your bowel movements become black and tarry. DURATION Minor heartburn from stomach irritation does not indicate your chemotherapy should be altered. Taking an antacid drug might alleviate the symptom. If there are any indications of bleeding, however, your chemotherapy will be discontinued and another drug may be prescribed to treat your disease. The stomach ulceration will heal within several weeks after the original drug that caused the damage has been discontinued. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Avoid alcohol, caffeine, and smoking. | |||||||||||||||||||||||||||||||||||||
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Avoid spicy, hot (temperature), or acidic foods. Examples of acids are citrus juices and fruits, and tomatoes and tomato sauces. | |||||||||||||||||||||||||||||||||||||
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Avoid using aspirin or aspirin products, since these increase stomach irritation and bleeding. Us an aspirin substitute (e.g., Tylenol). | |||||||||||||||||||||||||||||||||||||
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Eat bland foods, for example, milk products, ice cream, custards, puddings, soft-boiled eggs, cooked cereal. | |||||||||||||||||||||||||||||||||||||
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If spicy or acidic foods are irritating, avoid them. | |||||||||||||||||||||||||||||||||||||
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Only stop taking your medicine if you are bleeding from your stomach (bloody vomit, bloody and tarry stools). | |||||||||||||||||||||||||||||||||||||
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Take an antacid (e.g., Maalox, Mylanta, Gelusil, Riopan, Amphojel) to help control heartburn. Follow the directions on the bottle for taking the antacid. | |||||||||||||||||||||||||||||||||||||
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Take your medication with food. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You experience any of the signs or symptoms of stomach ulceration: gnawing, raw pain in the stomach region, bloody vomit, bloody and tarry stools. | |||||||||||||||||||||||||||||||||||||
| SWALLOWING DIFFICULTY
DESCRIPTION Difficulty in swallowing may occur because the mucous membranes (lining) of the mouth and throat are affected. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Avoid lying down immediately after eating. When you are lying down, keep your head elevated. | |||||||||||||||||||||||||||||||||||||
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Chew your food well to facilitate ease of swallowing. | |||||||||||||||||||||||||||||||||||||
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Choose foods with a consistent texture (such as oatmeal) instead of foods with varied textures (such as stew). They may be easier to swallow. | |||||||||||||||||||||||||||||||||||||
| TASTE AND SMELL CHANGES
DESCRIPTION Chemotherapy may cause changes in your sensations of taste and smell. Foods may taste bitter or rancid and you may develop aversions to eggs, fish, meat, poultry, fried foods, or tomatoes and tomato products. These changes occur because your drug alters the receptor cells in your mouth that send impulses to your brain telling you what flavor you are tasting or what odor you are smelling. DURATION Your symptoms of altered taste, smell, or both will continue as long as you are receiving chemotherapy. The changes in sensation tend to be most pronounced when you first begin treatment. Once the treatment is completed, your sensations of taste and smell should return to normal after several weeks. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Look for alternate foods that are palatable and are equally good sources of protein, like cottage cheese, yogurt, milk, ice cream, and peanut butter. A vegetarian or Chinese cookbooks can provide useful non-meat, high-protein recipes. | |||||||||||||||||||||||||||||||||||||
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Prepare foods that look and smell appetizing. Fresh fruits, gelatin salads, and lettuce have been found to be appealing, and well tolerated. | |||||||||||||||||||||||||||||||||||||
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Use seasoning - including lemon juice, mint, and basil - to help improve the taste and aroma of food. Also try extra sugar and salt. Do not try to follow any particular rule in seasoning; use your imagination and experiment. Marinating meats may help. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Your symptoms distress you and the measure you have tried are not helping. | |||||||||||||||||||||||||||||||||||||
| URINE RETENTION
DESCRIPTION Chemotherapy may prevent you from passing all the urine that is in your bladder. The signs and symptoms of this side effect are decreased urges to urinate, urinating small amounts in a dribbling stream, and a sensation of fullness in your bladder. The drug affects the nerves tot he bladder and thereby decreases the impulses to the brain that initiate the "need-to-urinate" message. DURATION The symptom will continue as long as you are receiving chemotherapy. As with all side effects of chemotherapy, there is variation in the intensity of the experienced side effect. If you have retention of urine in its mildest form, a diuretic may be prescribed. If it does not work, your drug may be reduced in amount. If your retention of urine is marked, your drug will be discontinued and another drug will be given to treat your disease. Once the original drug has been discontinued, urinary retention will subside over weeks or months, depending on the severity of nerve involvement. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Ask the nurse of physician how to perform Crede's method (which is putting external pressure on your bladder to assist you to urinate). | |||||||||||||||||||||||||||||||||||||
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Drink two to four quarts of fluid a day to dilute the urine in your bladder. | |||||||||||||||||||||||||||||||||||||
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Urinate every four hours while awake and prior to bedtime. | |||||||||||||||||||||||||||||||||||||
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Your nurse of physician may insert a catheter (a plastic or rubber tube) into your bladder to monitor your retention of urine. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You are unable to urinate during a 10-hour period when you have been drinking fluids. | |||||||||||||||||||||||||||||||||||||
| WEIGHT INCREASE Fat Deposits DESCRIPTION Chemotherapy may increase the fatty tissue in your body. You may experience fullness or rounding of the face (moon face) and fat deposits between your shoulder blades. These fat deposits are to be expected and do not mean that anything is wrong. Chemotherapy may cause an increase in appetite, which is expected. DURATION The intensity of these side effects (fat deposits or increase in appetite) decreases as the amount of the drug you are taking is lowered. Once the treatment is over, the fat deposits may return to normal. Your appetite will return to normal. SUGGESTIONS | ||||||||||||||||||||||||||||||||||||||
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Avoiding concentrated sweets (sugar, honey, candy) may help you stay at your normal weight and may decrease rounding of the face. | |||||||||||||||||||||||||||||||||||||
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Engage in activities that divert your attention from food. | |||||||||||||||||||||||||||||||||||||
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Try to stay at your normal weight, if you are not overweight. If you gain five pounds, eat nutritious, low-calorie foods, for example, raw vegetables, fruits, low-fat cheeses, and margarine. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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You need some guidance with your diet. | |||||||||||||||||||||||||||||||||||||
| WEIGHT INCREASE
Fluid Retention (Edema) DESCRIPTION Chemotherapy may cause you to experience to retain excess fluid in your body. The excess fluid will be most noticeable in swelling of the ankles or hands or in weight gain. Clothes may become too tight. DURATION There are degrees of fluid retention. Slight symptoms may require a diuretic (water pill) prescription. If it is not effective, it may be necessary to decrease drug dosage. With sever retention of fluids, your drug may be discontinued. Once the drug has been discontinued, the problem subsides within several day. SUGGESTIONS: | ||||||||||||||||||||||||||||||||||||||
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Change body position frequently (every two hours) to prevent skin breakdown in edematous areas. | |||||||||||||||||||||||||||||||||||||
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Do not abruptly stop taking your medicine. | |||||||||||||||||||||||||||||||||||||
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Elevate your feet as much as possible. Do not stand in one place for a long time. Do not cross your legs or wear tight-fitting clothes, girdles, or tight shoes. Continue to wear TED hose or Jobst stockings. | |||||||||||||||||||||||||||||||||||||
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Restrict the amount of salt you eat or the amount of fluid you drink if your fluid retention is severe. Your doctor will tell you if this must be done, but do not eat very salty foods (e.g., pork, ham, bacon, tomato juice, nuts, bouillon, potato chips and other snack foods, canned soups, solid cheese, salted crackers, celery salt, soy or Worcestershire sauce, catsup, canned meats, fish, corned beef, sausage, or peanut butter). | |||||||||||||||||||||||||||||||||||||
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Take your medicine (diuretic) if prescribed, and include foods high in potassium in your diet. Potassium-rich foods are apricots, bananas, cantaloupe, dates, figs, milk, orange juice, potatoes, prunes, raisins, tangerines, and unsalted tomato juice. Your doctor may also prescribe a commercial potassium supplement. | |||||||||||||||||||||||||||||||||||||
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Try salt substitutes such as Co-Salt and Adolph's Salt Substitute. Some salt substitutes taste better than others, so try several brands. Also, some substitutes contain sodium, so read the label and do not buy those that contain sodium. | |||||||||||||||||||||||||||||||||||||
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Weigh yourself daily and check your body (ankles, feet, hands and area at base of spinal column) for edema. | |||||||||||||||||||||||||||||||||||||
| CONSULT PHYSICIAN OR NURSE IF: | ||||||||||||||||||||||||||||||||||||||
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Feet and hands become cool to touch. | |||||||||||||||||||||||||||||||||||||
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You experience a sudden or sever degree of fluid retention. | |||||||||||||||||||||||||||||||||||||
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You experience shortness of breath when exerting yourself or when coughing. | |||||||||||||||||||||||||||||||||||||
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You have a concurrent kidney disease before you increase your intake of potassium or try a salt substitute. | |||||||||||||||||||||||||||||||||||||
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