Side Effect Management

It is hard to protect healthy cells from the harmful effects of cancer treatment. Because treatment does damage healthy cells and tissues, it often causes side effects. The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, the effects may not be the same for each person.

The following is a guide to many common side effects and how to manage them. It is important to keep your Cancer Center medical team informed of all side effects, and know when to call for medical assistance.

Please call your Cancer Center if you experience the following:

  • Fever, chills or temperature of 100.5 or greater
  • Vomiting or uncontrolled nausea
  • Diarrhea not controlled by Imodium AD
  • Shortness of breath
  • If you are unsteady, dizzy or lightheaded
  • Mouth sores

Infections
Fatigue
Nausea
Mouth Care
Diarrhea
Constipation
Bleeding
Skin Care
Fluids and Nutrition

Infections

Check your temperature twice a day. This is an effective way to monitor for infection even if you do not have other symptoms. Take your temperature before you call your doctor or the clinic with a problem.

Always call if your temperature is 100.5 or greater orally, no matter what time of the day or night, weekend or holiday. You may have an infection. Signs and symptoms of infection include:

  • Shaking chills which may signal a rapidly rising temperature. If these occur, take your temperature immediately and call your doctor if it is 100.5 degrees or greater.
  • Foul smelling, cloudy or bloody urine, pain and/or burning upon urination.
  • Persistent cough; productive cough.
  • Redness, swelling, and/or pain anywhere else, such as an old IV site or a stubbed toe that will not heal.

*Remember: Always call if you are not feeling well and have a fever. All fevers go up and down. Do not wait to call the doctor or nurse.

To prevent infections, do the following:

  • Wash your hands often during the day. Be sure to wash them well before you eat and after you use the bathroom.
  • Stay away from people who have illnesses you can catch such as cold, flu, measles, or chicken pox. Also try to avoid crowds.
  • Avoid major dental work. Call your nurses to discuss routine cleaning.

Fatigue

  • Get plenty of rest.
  • Balance rest with mild exercise (walking is great exercise).
  • Limit strenuous physical exertion.
  • Eat and drink as well as you can.
  • When sitting or lying down, get up slowly. This will help prevent dizziness.

Nausea

  • Avoid heavy meals and fatty foods.
  • Prescriptions for nausea are often given when chemotherapy is started. If you have taken the medication as ordered and you continue to be nauseated and/or vomit, please call in the morning early so you can be assessed and IV fluids can be given if needed.

Mouth Care

  • Use a non-abrasive toothpaste or paste of baking soda and water. Brush your teeth after every meal.
  • Avoid commercial mouthwashes that contain large amounts of alcohol such as Listerine, Scope, etc.
  • Rinse mouth after brushing with salt and soda rinses at least 4 times a day (1 teaspoon salt plus 1 teaspoon baking soda in an 8 ounce glass of water), swish and spit.

Diarrhea

  • If you have three liquid stools in one day, start over-the-counter Imodium AD. For your first dose take 2 pills, and take one additional pill with every loose stool thereafter. Take a maximum of 8 pills per day. Call the office if diarrhea persists.

Constipation

For maintenance:

  • Drink fluids, 8-10 glasses per day.
  • Increase the fiber in your diet.
  • Peri-Colace or Senokot-S may be taken, one pill twice a day.
  • Milk of Magnesia-30m1 (2 tablespoons) every evening at bed time. This may be increased to twice a day if needed.

Use discretion: If bowels become loose, it may be that you do not need Milk of Magnesia every day. Anytime you take pain killer medication such as Vicodin or morphine it is wise to begin a program to prevent constipation. Call your nurse if the above recommendations don’t work.

Bleeding

  • Avoid daily intake of aspirin or ibuprofen. Occasional or infrequent use is okay. Tylenol does not thin your blood and is okay to use. If you are prescribed aspirin by your doctor for a heart condition, continue taking it.
  • You might bruise easily while on chemotherapy.
  • Use a soft toothbrush and a gentle touch when brushing your teeth.
  • Be careful shaving with razors.
  • Report any bleeding that does not stop.

Skin Care

  • Avoid dry skin. Use moisturizers.
  • Avoid sunburns. Always use sunblock with SPF 15 or greater.

Fluids and Nutrition

  • Drink 6 to 8 eight ounce glasses of non-caffeinated liquid a day (i.e. water, juice, Jell-O, Sprite, 7-Up, popsicles, milk soup or ice cream). This helps “flush” the chemo through your kidneys and keeps your body well hydrated.
  • Unless contraindicated by your doctor for other health reasons, increasing your fluid intake while on chemotherapy is beneficial.
  • Avoid alcoholic drinks on the day of chemotherapy. Alcohol dehydrates your body of the fluids needed to help flush out the chemotherapy.
  • Your weight will be checked each visit. Do not begin any weight loss diet without consulting your doctor. A well balanced high-protein, high-carbohydrate diet is very important to help normal cells repair themselves.