Managing Side Effects

What is a blood clot?
A blood clot, also known as a deep vein thrombosis (DVT) or thrombus, is a jelly-like collection of specific blood cells called platelets, and other substances in the blood circulation called coagulation factors, that block blood flow in veins.

Under normal conditions, blood clots in response to damage to a vessel in order to prevent significant blood loss, but regulatory systems in the body prevent the clot from blocking blood flow through the damaged area.

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Calcium Rich Foods
A balanced diet has been shown to have a range of health benefits. Eating more than the serving size for a moderate or low-calcium food will make it a higher-calcium food. Foods made with high-calcium ingredients will also be high in calcium.

Calcium-fortified foods may vary widely in the amount of calcium they have. Calcium can be found naturally in milk and dairy products.

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Forgetfulness and the inability to concentrate is not uncommon during cancer treatment.
Chemotherapy has been known to impact patient’s cognitive abilities. This includes forgetfulness and difficulty concentrating.

Research has demonstrated that chemotherapy can have a negative impact on cognitive functioning. How chemotherapy might cause cognitive deficits is not clear at this time.

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Common Side Effects While Receiving Chemotherapy or Immunotherapy
Side effects often times occur when patients are receiving treatment. Listed are some common side effects and steps to take in order to feel better. Tell your medical oncology care team of any side affects you may be experiencing.

• Cancer Related Brain Fog
• Constipation
• Diarrhea
• Dehydration
• Fatigue
• Fever
• Mouth discomfort
• Nausea and vomiting
• Skin and nail changes

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Managing Constipation
Constipation occurs in 40-70% of cancer patients and is due to a number of reasons. Preventing constipation is usually easier than treating constipation.

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What is a cancer recurrence?
When cancer returns after a period of remission, it’s considered a recurrence. A cancer recurrence happens because, in spite of the best efforts to rid you of your cancer, some cells from your cancer remained.

These cells could be in the same place where your cancer first originated, or they could be in another part of your body. These cancer cells may have been dormant for a period of time, but eventually they continued to multiply, resulting in the reappearance of the cancer.

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Managing Dehydration
Dehydration is the excessive loss of body fluids. Occurs when the output of fluids exceeds the intake. This can be caused by different side effects of chemotherapy or radiation therapy. It can include: vomiting, diarrhea, infections, fever, or poor oral intake – drinking less than 64 ounces of non-caffeinated beverages in a 24-hour period.

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Managing Depression
A diagnosis of cancer often triggers feelings of sadness, grief and fears about death. A cancer diagnosis can cause interruption of life plans, changes in lifestyle, social roles, body image and self-esteem.

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Managing Diarrhea
Chemotherapy can damage healthy cells such as those that line the interior of the digestive tract. This can result in a disruption of the fluid balance that these cells maintain. Specifically, absorption of fluid from the gastrointestinal (GI) tract back into the body is decreased, and secretion of fluid and electrolytes in the stool is increased. This causes watery bowel movements, otherwise known as diarrhea.

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Healthy Living: Diet and Exercise After Treatment
Adjusting to life after cancer treatment can be a challenge. Research shows that maintaining a normal weight can help decrease the risk of recurrence and may help prevent new cancers from developing. Diet and exercise will not only help achieve weight loss goals, but can also improve mental health, reduce fatigue, and  provide more energy.

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Managing Fatigue
The type of fatigue commonly felt with cancer can be different than feeling tired at the end of a hard day. While one person may feel too tired to get out of bed, another may be able to continue a normal routine as they have always done. Fatigue can last for different periods of time. Some may feel relief after treatment ends, but others may experience it for longer periods of time.

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Gastroesophageal Reflux (GERD) is an irritation of the esophagus by acid that comes up from the stomach. Gastroesophageal reflux is also called “acid reflux.” People who have pain may call it “acid indigestion” or “heartburn.” Despite its name, heartburn has nothing to do with the heart (although some of the symptoms are similar to a heart attack).

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Managing Hair loss
Not all cancer treatments cause hair loss, please ask your care team if this side effect applies to you and your treatment.

Chemotherapy not only damages rapidly dividing cells such as cancer cells, but also healthy cells, such as hair follicles. Some chemotherapy drugs can damage hair follicles which may lead to hair loss, also called alopecia.

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What is hand-foot syndrome?
Also called Palmar-Plantar Erythrodysesthesia (PPE), hand-foot syndrome is a side effect, that can occur with several types of chemotherapy or biologic therapy drugs used to treat cancer. Following administration of chemotherapy, small amounts of drug leak out of very small blood vessels called capillaries in the palms of the hands and soles of the feet.

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Many individuals with cancer often use dietary and herbal products to boost their health, improve their nutrition, or reduce side effects associated with treatment. Although some herbs and supplements are often seen as “natural” and safe, there is limited data on how these substances will interact with cancer treatment.

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Home Safety After Treatment
Chemotherapy and Immunotherapy are removed from your body through urine, stool, vomit, and blood for 48 hours after your treatment has finished. Patients and caregivers should use precautions to protect themselves while receiving these medications and for 48 hours after receiving them.

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Iron Rich Foods
A balanced diet has been shown to have a range of health benefits. Eating more than the serving size for a moderate or low-iron food will make it a high-iron food. Foods made with high-iron foods will also be high in iron.

Vegetables and/or beans that are frozen or canned may have higher iron values. Iron-fortified foods may vary widely in the amount of iron they have.

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Loss of appetite or poor appetite is a common condition that occurs with cancer and its treatment.
Loss of appetite can be caused by treatment or by the cancer itself. Emotions such as fear or depression can also take away a person’s appetite.  Sometimes the side effects of treatment such as nausea, vomiting, or changes in food’s taste or smell that make a person feel like not eating. If this is the cause, work with your doctor/nurse to get the side effects under better control.

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Magnesium Rich Foods
A balanced diet has been shown to have a range of health benefits.  Eating more than the serving size for a moderate or low-magnesium food will make it a high-magnesium food. Foods made with high-magnesium foods will also be high in magnesium.

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Mouth sores are a common side effect of certain chemotherapy drugs as well as radiation to the head or neck area.
Chemotherapy and radiation therapy kill rapidly dividing cells, such as cancer cells. However, the gastrointestinal (GI) tract, including the mouth and the throat, is made up of cells that divide rapidly.

For this reason, the GI tract is particularly susceptible to damage from chemotherapy and radiation treatment. Chemotherapy or radiation-induced damage to the cells lining the mouth, throat, and gastrointestinal tract is called mucositis. This side effect of cancer treatment can significantly affect how you feel and may cause delays in treatment.

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Nail changes on fingers and toe can occur while taking certain chemotherapy drugs.  There are ways to manage these changes.

The chemotherapy drugs that most often cause nail changes are:

• Docetaxel (Taxotere®)
• Paclitaxel (Taxol®)
• Albumin-bound paclitaxel (Abraxane®)
• Capecitabine (Xeloda®)
• Pegylated doxorubicin (Doxil®)
• Fluorouracil (5FU®)

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Nausea and vomiting are frequent side effects of chemotherapy and radiation therapy. Nausea and vomiting used to be one of the most debilitating chemotherapy side effects, but the development of more effective anti-nausea drugs has significantly reduced these side effects.

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Numbness and tingling in your hands and feet is a condition called peripheral neuropathy.  Peripheral neuropathy can be a side effect associated with certain chemotherapy drugs. It is caused by damage to the nerves that transmit signals between the extremities and the central nervous system (CNS).

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Phosphorus Rich Foods
Phosphorus is an important mineral that your body uses for energy and overall health. What you eat and drink can affect the amount of phosphorus in your body. The key to selecting foods with phosphorus is having the right balance for your needs.

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Physical Activity For Older Adults
Maintaining an active lifestyle can help patients gain strength and cognitive health during cancer treatment.  The following can help patients identify areas of physical activity to add to their daily routine.

• Endurance: Endurance, or aerobic activities increase your breathing and heart rate.
• Strength: Strength exercises make your muscles stronger.
• Balance: Balance exercises can help prevent falls, a common problem in older adults.
• Flexibility: Flexibility exercises stretch your muscles and can help your body stay limber.
• Brain Health: Cognitive health is the ability to clearly think, learn, and remember.

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Potassium Rich Foods
Eating more that the serving size for a moderate or low-potassium food will make it a high-potassium food. Foods made with high-potassium foods will also be high in potassium.

Foods that are frozen or canned may have higher potassium values.

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Sexual Health
It is natural for people who have been diagnosed with cancer to be concerned about the effect on their sexuality. Right after the diagnosis, one may temporarily lose interest in sex as they focus on understanding their cancer and the treatments available. During or after treatment, a patient may not feel like themselves.  This is normal and there are ways to address these concerns.

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What is a port?
A port is a small device with a flexible tube called a catheter. The port is placed under the skin and the catheter is inserted into a blood vessel. The port acts like an IV to the bloodstream. A special needle is inserted through your skin into the soft top of the port so that medications and IV fluids can be given.

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Understanding Your CBC
One of the most common blood tests performed is a Complete Blood Count (CBC.) The important values on the CBC are explained below.

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