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    Common Side Effects of Chemotherapy

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    DraganaRadulovic
    Common side effects of chemotherapy include hair loss, mouth sores, nausea and vomiting, and low blood cell counts. Hair loss is usually temporary and the hair will regrow after treatment ends. Mouth sores can be painful and require special care including soft foods and mouthwashes. Nausea and vomiting are managed with antinausea medicines and small, bland meals. Low blood cell counts increase risks of infection, bleeding, and anemia, so patients should watch for related symptoms and see a doctor immediately if problems occur.

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    Common Side Effects of Chemotherapy

    Uploaded by

    DraganaRadulovic
    186 views7 pages
    Common side effects of chemotherapy include hair loss, mouth sores, nausea and vomiting, and low blood cell counts. Hair loss is usually temporary and the hair will regrow after treatment ends. Mouth sores can be painful and require special care including soft foods and mouthwashes. Nausea and vomiting are managed with antinausea medicines and small, bland meals. Low blood cell counts increase risks of infection, bleeding, and anemia, so patients should watch for related symptoms and see a doctor immediately if problems occur.

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    Common Side Effects of Chemotherapy

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    Common side effects of chemotherapy include hair loss, mouth sores, nausea and vomiting, and low blood cell counts. Hair loss is usually temporary and the hair will regrow after treatment ends. Mouth sores can be painful and require special care including soft foods and mouthwashes. Nausea and vomiting are managed with antinausea medicines and small, bland meals. Low blood cell counts increase risks of infection, bleeding, and anemia, so patients should watch for related symptoms and see a doctor immediately if problems occur.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    186 views7 pages

    Common Side Effects of Chemotherapy

    Uploaded by

    DraganaRadulovic
    Common side effects of chemotherapy include hair loss, mouth sores, nausea and vomiting, and low blood cell counts. Hair loss is usually temporary and the hair will regrow after treatment ends. Mouth sores can be painful and require special care including soft foods and mouthwashes. Nausea and vomiting are managed with antinausea medicines and small, bland meals. Low blood cell counts increase risks of infection, bleeding, and anemia, so patients should watch for related symptoms and see a doctor immediately if problems occur.

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    of 7

    Common side effects of chemotherapy

    Hair loss occurs when hair follicles are damaged by chemotherapy. Hair loss can
    include scalp hair, eyelashes, eyebrows, axillary and pubic hair. The loss may be
    gradual, or it may happen all at once. Hair loss from chemotherapy is usually
    temporary; the hair will return, but it may regrow having different characteristics
    such as a change in color or texture.
    Mouth and throat sores are caused by the destruction of mucosal cells lining the
    mouth and esophagus. They can result in minor to severe pain.
    Nausea and vomiting are due to a number of factors related to the effect of
    chemotherapy on the gastrointestinal tract and the brain. Currently, several antinausea drugs can be given prior to chemotherapy administration that will help
    prevent this symptom.
    Diarrhea may occur after chemotherapy because of damage to the intestinal
    mucosa and changes in the intestine's ability to reabsorb liquid. Constipation can
    result from chemotherapy's effects on the nerves of the intestines, which slows
    peristalsis, or the elimination of waste.
    Destruction of red blood cells by chemotherapy can lead to anemia. This can
    cause excessive tiredness, pale skin color, shortness of breath, irritability,
    decreased attention span, headaches and dizziness. These symptoms are primarily
    due to the decrease in oxygen going to the brain and other body tissues.
    Destruction of the blood platelets can result in bruising and bleeding. Known
    as thrombocytopenia, this is caused by a lack of sufficient platelets to form a clot
    and stop bleeding.
    Destruction of white blood cells can result in infections. White blood cells destroy
    bacteria, viruses and other pathogens, and are a major defense against infection.
    When white blood cells are low, infections can occur quickly and become very
    serious.
    Chemotherapy drugs may affect organs such as the heart, lungs, kidneys, liver,
    and brain, causing temporary or permanent damage. Some drugs may affect
    hearing. It will help to discuss each drug with your oncologist, to understand
    potential side effects and the probability that they will occur.

    Sharon Frierdich, RN, MS, CPNP, University of Wisconsin Children's Hospital

    Hair loss
    Hair loss is called alopecia
    Some chemotherapy causes hair loss or thinning of the hair. Radiation can also cause hair
    loss in the area being irradiated. This may start 7 to 10 days after the treatment is given.
    In some cases, a child may lose all the hair on their head (older children may experience
    loss of body hair as well). Unfortunately, there is nothing that can be done to prevent the
    hair from falling out. Some children and parents prefer to cut the hair as short as possible
    when the hair loss begins. Others prefer to shave the head completely to avoid dealing
    with the gradual hair loss.
    Some things that may be helpful in coping with the loss of hair include wearing hats or
    scarves. Other children prefer to wear a wig. The child's social worker or child life
    specialist can provide information regarding obtaining a wig or hair accessory.
    Hair grows back when the cancer treatments are complete, or in some cases, when the
    treatment becomes less intense. In many cases, the hair may be a slightly different color
    or texture (curlier, thicker or thinner) than before the cancer treatment. In a few cases
    associated with high doses of radiation, the hair may not grow back. The child's health
    team can provide an estimate of when hair regrowth is likely to begin.

    Stomatitis
    Mouth Care
    The cells in the mouth can be affected by chemotherapy and by radiation therapy to the
    head and neck. Keep the mouth as clean as possible to make the child feel more
    comfortable and to help avoid any infections from growing in the mouth.
    Ways to improve the condition of the mouth:

    Brush teeth after meals and before bed with a soft toothbrush.
    Use alcohol-free mouthwashes. Alcohol dries out the mouth.
    If your child has a dry mouth, give him or her a choice of hard candies.

    How to care for mouth sores


    While the child is receiving chemotherapy and/or radiation therapy to the head and neck,
    be aware that the child may develop mouth sores. The inside lining of the mouth and the
    tongue may be red, and there may be white "plaques" (small raised areas) in the mouth
    and on the tongue. These plaques are signs of a fungal infection known as thrush.

    Strategies to care for mouth sores:

    Avoid hot, spicy or acidic foods.


    Serve foods cold or at room temperature.
    Try foods that are soft, tender or pureed (beaten or blended).
    Cut foods into small pieces.
    Avoid dry or coarse foods.
    Offer a straw for drinking liquids.
    Use alcohol-free mouthwash, and rinse the mouth with water at least four times
    each day.
    Antifungal medicine may be prescribed to treat the mouth sores. If the mouth
    sores are painful, pain medicine may also be prescribed.
    Children should be evaluated if they cannot drink fluids, swallow saliva (spit) or
    if the pain medicine does not help take away the pain.

    Nausea, vomiting and dehydration


    Nausea and vomiting can be caused by chemotherapy or radiation, either through direct
    irritation to the stomach lining, or by stimulation of the vomiting center in the brain.
    Antinausea medicines called antiemetics are given before chemotherapy or radiation
    sessions to help decrease nausea and vomiting.
    Chemotherapy agents vary in the amount of nausea and vomiting that they cause. The
    type and amount of antinausea medicine will be based on your childs treatment plan and
    the expected reaction. Prior to any treatment, you should discuss the expected effect of
    the chemotherapy being given, and its management with your doctor or nurse.
    Ways to help decrease nausea and vomiting:

    Encourage the child to eat small meals or snacks


    Provide foods that are easy to digest (crackers, rice, Jello)
    Have the child take sips of cool, clear liquids
    Avoid offering fried, spicy or very rich foods
    Give the child food in a room that is free from cooking smells or other odors
    Rinse the childs mouth after vomiting

    If the child has diarrhea, tell your doctor or nurse the color, amount and number of times
    it happens in one day. Here are a few ways to help decrease diarrhea:

    Give the child a soft, bland diet (crackers, soup, rice)


    Encourage the child to eat small amounts of food more often, instead of large
    meals
    Avoid spicy, fried or fatty foods
    Avoid juices, milk or milk products (ice cream, cheese)
    Avoid foods that are high in fiber (fruits, vegetables, salad)

    Offer foods high in potassium (tomatoes, papaya, butternut squash)


    Limit the amount of high-sugar foods (juices, candies)

    Causes and signs of dehydration


    Nausea, vomiting and diarrhea can lead to dehydration (loss of fluids in the body),
    especially if the child cannot drink an amount sufficient to replace the fluid that is lost.
    Some common signs of dehydration include:

    Dry skin or mouth


    No tear production when crying
    Infrequent urination or small amounts of dark-colored urine
    If the child wears diapers, count the hours between wet diapers

    Call the doctor if the child has any of the signs of dehydration.

    How to increase food and fluid intake at home


    If the child is at home and is experiencing vomiting or diarrhea:

    Offer small amounts of clear fluids to drink every 30 minutes


    Provide foods that are easy to digest (crackers, rice, toast, soup), and avoid foods
    with strong odors
    Ask the doctor about medicines to decrease nausea

    Nausea, vomiting and dehydration


    Nausea and vomiting can be caused by chemotherapy or radiation, either through direct
    irritation to the stomach lining, or by stimulation of the vomiting center in the brain.
    Antinausea medicines called antiemetics are given before chemotherapy or radiation
    sessions to help decrease nausea and vomiting.
    Chemotherapy agents vary in the amount of nausea and vomiting that they cause. The
    type and amount of antinausea medicine will be based on your childs treatment plan and
    the expected reaction. Prior to any treatment, you should discuss the expected effect of
    the chemotherapy being given, and its management with your doctor or nurse.
    Ways to help decrease nausea and vomiting:

    Encourage the child to eat small meals or snacks


    Provide foods that are easy to digest (crackers, rice, Jello)
    Have the child take sips of cool, clear liquids
    Avoid offering fried, spicy or very rich foods
    Give the child food in a room that is free from cooking smells or other odors
    Rinse the childs mouth after vomiting

    If the child has diarrhea, tell your doctor or nurse the color, amount and number of times
    it happens in one day. Here are a few ways to help decrease diarrhea:

    Give the child a soft, bland diet (crackers, soup, rice)


    Encourage the child to eat small amounts of food more often, instead of large
    meals
    Avoid spicy, fried or fatty foods
    Avoid juices, milk or milk products (ice cream, cheese)
    Avoid foods that are high in fiber (fruits, vegetables, salad)
    Offer foods high in potassium (tomatoes, papaya, butternut squash)
    Limit the amount of high-sugar foods (juices, candies)

    Causes and signs of dehydration


    Nausea, vomiting and diarrhea can lead to dehydration (loss of fluids in the body),
    especially if the child cannot drink an amount sufficient to replace the fluid that is lost.
    Some common signs of dehydration include:

    Dry skin or mouth


    No tear production when crying
    Infrequent urination or small amounts of dark-colored urine
    If the child wears diapers, count the hours between wet diapers

    Call the doctor if the child has any of the signs of dehydration.

    How to increase food and fluid intake at home


    If the child is at home and is experiencing vomiting or diarrhea:

    Offer small amounts of clear fluids to drink every 30 minutes


    Provide foods that are easy to digest (crackers, rice, toast, soup), and avoid foods
    with strong odors
    Ask the doctor about medicines to decrease nausea

    Anemia
    Anemia means a low red blood cell count
    Red blood cells carry oxygen throughout the body. Oxygen enters the lungs with each
    breath, and binds (attaches) with hemoglobin in the red blood cells. Hemoglobin delivers
    the oxygen to all the organs and tissues in the body. Two laboratory tests are used to
    measure the number and function of red blood cells.

    Hemoglobin shows how much oxygen the red blood cells are able to carry. A
    normal hemoglobin level is between 12 and 16.

    Hematocrit is the percentage of red blood cells in the blood. A normal hematocrit
    is between 36 and 50.

    Signs of a low red blood cell count


    When the red blood cell count is low, the body is not able to get as much oxygen to
    different parts of the body. Some of the symptoms include:

    Feeling of tiredness
    Shortness of breath
    Headache
    Fast heart rate
    Paleness of the skin or gums
    Dizziness

    Thrombocytopenia
    Thromboctyopenia means a low platelet count
    Platelets stop bleeding in the body by forming clots. A normal platelet count is between
    150,000 and 300,000. When the platelet count is low, a child is at risk of bleeding.

    Signs of a low platelet count


    If a child has a low platelet count, you may see any of the following signs:

    Bruising or petechiae (small red, pinpoint freckles on the skin)


    Bleeding (from the nose, gums or central venous access device) that doesnt stop
    with pressure within 10 minutes
    Black stools or vomit (this means there is some bleeding in the stomach or bowel)

    CANCER CONTROL ACTIVITIES


    A. INFECTION AND MUCOSITIS
    Cancer itself is the main cause of death in most cancer patients. However, infection is the
    second most common cause of death in some children who require very intensive
    treatment. These infections are caused by common bacteria and/or fungi that are present
    in everyones mouths and intestines or in the air.

    Cancer Control is proposing a study to prevent fungal infections in children with


    acute myeloid leukemia by giving children an antifungal agent, Caspofungin,
    when the immune system is very weak.

    Mucositis or mouth sores is an important side effect of some chemotherapy and may be a
    risk factor for infection as it allows bacteria normally present in the mouth to enter the
    bloodstream.

    We have completed a randomized trial of Traumeel, a homeopathic mouth rinse in


    children undergoing stem cell transplantation. Preliminary analysis indicates that
    Traumeel is not effective at preventing mucositis in this setting.
    We are about to start a randomized study of keratinocyte growth-factor, a normal
    human protein developed through recombinant DNA technology, that replenishes
    the cells in the mouth damaged by chemotherapy. This study will include children
    undergoing stem cell transplantation and is expected to open in the Spring of
    2009.

    B. NUTRITION
    In the nutrition domain, we have three foci of activity. First, we are studying agents to
    prevent or ameliorate malnutrition in children undergoing chemotherapy. Second, we are
    trying to preserve weight by preventing nausea and vomiting which are common side
    effects of chemotherapy. Third, obesity has become a common problem in healthy
    children. Obese children with cancer have poorer outcomes compared to normal weight
    children. The activities of CCLS also include trying to understand why obese children
    have poorer outcomes.

    We completed one study of Periactin for malnutrition and found that


    administration was associated with a significant increase in weight after a four
    week treatment period.

    We have two studies to prevent chemotherapy related nausea and vomiting.

    An ongoing CureSearch COG study asks if electro-acupuncture can help control


    delayed vomiting in patients with solid tumors.
    We are planning a study to determine whether a newer drug called Palonosetron
    can reduce nausea and vomiting in children undergoing stem cell transplantation.

    CCLS is conducting two studies to try and determine why obese children have worse
    outcomes by measuring the amount of drug in the blood in obese, middleweight and
    underweight children

    One study examines chemotherapy drug levels according to height and weight
    (body mass index ) in children with acute lymphoblastic leukemia.
    We also are studying drug levels of a common chemotherapy called daunorubicin
    in children who have different body mass indices.

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