Chemotherapy may experience the following side effects: However, these side effects do not appear in all patients due to the large individual differences, and some patients may not experience any side effects at all. In addition, side effects may vary from treatment type to treatment type, dose administered, and repeated chemotherapy.
Most side effects of anticancer drugs affect most normal cells, but after chemotherapy, normal cells usually recover within 2-3 weeks. Therefore, most of the side effects begin to gradually disappear when treatment is complete, and the healthy cells multiply normally and enter the recovery phase in 2-3 weeks. However, the timing of this recovery depends on the type of anticancer drug and the health of the individual patient.
Most side effects are temporary, but side effects that have occurred in the heart, lungs, kidneys, and nervous system can last for years or years. However, anti-cancer chemotherapy experts predict these side effects well, so to minimize side effects, various prophylactic methods are used or the total dose is limited.
1. Hematological side effects
Most anticancer drugs have a mechanism that damages rapidly dividing cells, which are problems caused by the temporary decrease in the production of white blood cells, red blood cells, and platelets in the blood by affecting the bone marrow that constantly produces blood among normal cells.
Leukocytes are blood cells that act as a defense against external bacterial infection, and if the number of white blood cells goes below normal, they can be easily infected by bacteria. Most infections are caused by bacteria that normally exist in the skin or gastrointestinal tract. Therefore, if you have a fever after chemotherapy, you must check whether leukocytes have decreased.
Red blood cells supply oxygen to all parts of our body. When the red blood cell level is low, fatigue cannot easily come from each part of the body, and fatigue may easily occur.
Anticancer drugs also cause problems with the formation of platelets, which are responsible for hemostasis, so patients can easily bleed and bruise even on small wounds. Therefore, if blood from the gums or nose does not stop or if there are red spots on the skin, if the urine or feces is mixed with blood, you should contact your healthcare provider.
Because of these side effects, white blood cells, erythrocytes, and platelet levels are checked by blood tests before chemotherapy, and blood transfusions or chemotherapy may be adjusted or treatment may be postponed when they are not in the normal range.
2. Nausea and vomiting
Nausea and vomiting are common side effects of chemotherapy. Nausea and vomiting are due to the anticancer drug itself affecting the stomach or stimulating specific areas that stimulate vomiting in the brain, especially in young and female patients, with severe and individual differences.
Anticancer drugs are divided into four grades according to the degree of causing vomiting. Care should be taken when using anticancer drugs known to have severe vomiting effects. In recent years, however, many drugs that effectively prevent vomiting have been developed, making it possible to prevent most of them.
Some patients experience nausea and vomiting before they even receive chemotherapy because of the nausea and vomiting pains and fears of previous chemotherapy. In these cases, nausea and vomiting are minimized by administering an anti-anxiety medication in addition to an antiemetic drug.
To minimize nausea and vomiting, it is helpful for patients to limit foods other than moisture while taking anticancer drugs.
3. Hair loss
Hair loss is a common side effect of anticancer drugs, which can cause hair to fall out completely and make the hair thinner. These symptoms can be different for each type of chemotherapy agent or for individuals.
Hair loss occurs not only in the head, but also anywhere in the body. This includes hair on the face, arms, legs, and genitals. It occurs over several days or weeks after receiving anticancer drugs. When chemotherapy ends, most patients regrow hair after 3-4 weeks, but there may be changes in color or hair properties.
4. Mucositis and dry mouth
Stomatitis is an inflammation of the mouth, where the roof of the mouth, the inside of the cheeks, and the tongue become loose or dry. The reason why stomatitis occurs is that the new generation period of mucosal cells in the mouth is 7-14 days, because the existing mucosal cells fall off and inflammation develops before new mucosal cells are generated due to chemotherapy or radiation therapy. With stomatitis, infections of bacteria, fungi, and viruses can follow. Stomatitis usually appears 5-7 days after chemotherapy, and new mucosal cells develop 2-3 weeks after chemotherapy. Patients with stomatitis should avoid irritating foods (orange, grapefruit, salty, spicy, cold, hot foods).
On the other hand, a change in the salivary glands (salivary glands) may occur due to radiation treatment on the head, causing dry mouth.
Another way to prevent stomatitis and dry mouth is to put ice in your mouth for 30 minutes before chemotherapy. To prevent bacteria from multiplying, it is also recommended to rinse your mouth twice a day with a gargle prescribed by a medical staff. In addition, inflammation treatments are used to treat stomatitis. These methods are determined by the doctor depending on the patient’s condition. Chewing candy or chewing gum may be a way to reduce dry mouth.
Diarrhea involves watery stools more than 3 times a day, and diarrhea can occur when anticancer drugs affect mucosal cells in the intestine. If you have diarrhea for more than 24 hours or if you have severe abdominal pain with diarrhea, you should contact your doctor or health care provider right away. Severe diarrhea can lead to a lack of moisture and electrolytes, which can jeopardize the patient’s condition.
Some anticancer drugs can cause constipation, and medications to prevent side effects of anticancer drugs can cause constipation. Anti-cancer chemotherapy may result from reduced dietary intake, reduced water and dietary fiber intake, reduced activity, and narcotic analgesics also cause constipation. If you haven’t seen your stool for more than two days, you should contact your healthcare provider. Do not use constipation medications or do not enema without prescribing a doctor.
7. Nervous system toxicity
Side effects of the nervous system are the most common feelings of numbness and tingling in the hands and feet, including feelings of dullness in the hands and feet, tingling, and pain in the jaw. If you feel dull, be very careful when holding a pointy or hot object, and if you have problems with balance or muscles, make sure to move slowly. If side effects appear in the nervous system that regulates intestinal movement, intestinal obstruction, which stops intestinal movement, may appear. In severe cases, administration of anticancer drugs is discontinued and the dose of the drug is adjusted.
Few patients, regardless of the drug, are hypersensitive to certain drugs. Anticancer drugs also cause hypersensitivity reactions, the main symptoms being itching, angioedema, redness, and abdominal pain. If such a hypersensitivity reaction occurs, the anti-cancer drug will be stopped immediately and emergency measures will be taken. In the case of hypersensitivity to anti-cancer drugs, re-medication may be performed using pre-treatment therapy or desensitization in consultation with allergists.
9. Discoloration of skin and limbs
If an anticancer drug is injected through a vein, it may irritate the skin and darken the skin along the blood vessels, but after treatment, it gradually fades and disappears. Skin exposure from anticancer drugs may increase when exposed to UV light. It is also a good idea to use a hat or sunscreen lotion, as your skin may burn better in the sun. The skin becomes dry and itchy, and the surface of the skin occurs or acne is formed. If you have acne, clean your face, use medicinal cream or soap, and if the skin is dry, apply cream or lotion.
10. Amputee syndrome
Some anticancer drugs cause the skin of the hands and feet to peel off or lift, and the hand and foot syndrome refers to this phenomenon. When a hand and foot syndrome develops, it can interfere with normal activity due to sensory abnormalities, tingling, peeling of the skin, blisters, and severe pain.
When an anticancer drug is given intravenously, the anticancer drug may leak out of the vein for weak or other reasons. In some cases, it may be painful and gradually improve, but it can have serious consequences that cause the skin to leak out of the area where the anticancer drug has leaked. Symptoms at this time may include burning sensation, itching, and erythema at the injection site.
Any such extravasation should be immediately notified to the medical staff. Treatment methods include removing all spilled anti-cancer drugs as much as possible, applying hot compresses, cold compresses, or injecting or applying some therapeutic drugs.
12. Toxicity to organs such as kidney, liver and lungs
Some anticancer drugs may cause temporary or permanent damage to the kidneys. However, to prevent these kidney problems, medical staff will prevent and adjust the dose in advance. Drinking plenty of water during chemotherapy can help protect kidney function.
As most drugs are metabolized in the liver, anti-cancer drugs are also metabolized in the liver, which can lead to liver damage. Medical staff tests liver function before chemotherapy and adjusts the dose if necessary.
Some anticancer drugs can be toxic to the heart, which is not experienced by all patients, and the amount of anticancer drugs used in the meantime is cumulative to some extent. That’s why medical staff always review how much medication they have used, and if necessary, do tests for the heart and use anticancer drugs.
Some anticancer drugs are toxic to the lungs. These drugs also cause toxicity when the amount used has been exceeded to some extent, so medical staff always pay attention to this.
13. Other side effects
Patients receiving chemotherapy may have abnormalities in germ cells. It may cause infertility, and if you become pregnant during chemotherapy, birth defects may occur, so contraception during treatment is recommended. And unmarried patients or those who want to have a child after treatment can discuss in advance about storing healthy sperm before treatment in a sperm bank before chemotherapy.
Patients undergoing chemotherapy may also change their appetite or make their taste difficult. Avoid foods that are too stimulating, such as morning sickness, so be careful not to let the smell of food affect the patient when cooking. When a patient eats food, it is recommended to cool it off and then eat it in small portions. It is also a good idea to get dental treatment in advance because gum disease can get worse and cavities can cause trouble.
Cancer patients receiving chemotherapy may develop depression due to the stress of the cancer diagnosis and treatment process. Depression can lead to insomnia and loss of appetite, and it can also cause a major obstacle to treatment due to lack of motivation in everything. Active treatment can help.
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