As each patient is an individual your experience will be different to other patients receiving chemotherapy. Common side effects that you may experience during treatment are:
• Nausea and vomiting (sickness)
The severity of any nausea and vomiting will vary from person to person. An anti-sickness injection will be given before your chemotherapy. You will also be given some anti sickness tablets to take home. If you continue to feel sick, contact the day unit as your anti-sickness medication may need to be changed or increased.
• Sore Mouth
Following treatment you may develop a sore mouth and may notice mouth ulcers. Very hot spicy foods should be avoided. To help prevent oral infections brush your teeth regularly (at least twice a day) and drink plenty of fluids. To prevent any mouth ulcers becoming infected you should use an anti-bacterial mouthwash. Ask your doctor or nurse to recommend one that is suitable. Occasionally during treatment you may experience a strange taste sometimes described as a metallic or bitter. A strong flavoured sweet or mint may help disguise this.
• Bone Marrow Suppression
Your bone marrow is where your blood cells are made (these are the red cells, white cells, and platelets) to replace those naturally worn out by the body. Chemotherapy interferes with this process and the number of the cells in your blood can become lower than normal. This means following your treatment you could become:
• Prone to infection: White cells fight infection. A low white count can make you prone to infection. You may develop a sore throat, cough, high temperature, shivering or other symptoms, which may be due to infection. A normal temperature is between 36°C and 37°C. A raised temperature is:
Above 38°C (100.4F) at any time or Above 37.5°C (99.5F) at any two readings taken an hour apart.
• Anaemic: Red cells carry oxygen around your body. A shortage of these cells is called anaemia. You may feel dizzy, out of breath or unusually tired and you may look pale.
• Prone to bleeding: Platelets help to clot your blood and slow down bleeding. A low platelet count may make you prone to bleeding, this usually takes the form of nose-bleeds, bruising or bleeding gums.
You will have a routine blood test prior to each treatment to monitor the effects of the chemotherapy. Please contact Ward 6b or Ward 8 if you experience any of these symptoms.
• Hair loss
Unfortunately as a result of your treatment you will experience hair loss. The hair falls out gradually 10 to 14 days following your first course of treatment. The time scale varies for each person. Please remember that this is a temporary side effect and your hair will grow back when your treatment is completed. Your nurse will arrange for you to be provided with a wig if required. A scalp cooling service to prevent or reduce hair loss is available in this trust but is located at the Northern Centre for Cancer Treatment (NCCT) .If you wish to have further details please ask your nurse or doctor.
• Sex, pregnancy and family planning
If you are having chemotherapy it does not mean that you shouldn’t have sex, but you may not feel like it. If there is a chance of pregnancy, you must use effective contraception while on chemotherapy. If you suspect that you or your partner may be pregnant please tell your doctor immediately. Chemotherapy may affect your ability to have children in the future – please discuss this with your doctor or chemotherapy nurse before treatment.
Many people feel tired and have low energy levels whilst undergoing chemotherapy. There is very little you can do to avoid this but research has shown that patients who suffer fatigue need to take gentle exercise and rest often. This feeling of fatigue is quite normal and energy levels will begin to improve once treatment is completed.
Please remember side effects are usually temporary. If you experience any of them, discuss them with your doctor or nurse.
• Heart damage
Adriamycin (Doxorubicin) may be harmful to your heart. However there is an established safe maximum dose and your treatment will stay well within this. As a precaution your doctor may arrange for you to have an ECG (heart tracing) or other tests to check your heart before your treatment.
• Tingling or numbness in fingers and toes
Occasionally, loss of feeling, tingling and numbness of the hands and feet may occur. This is usually temporary and may decrease over several months when your treatment is completed. If you experience any of these symptoms please report them to your doctor or nurse.
• Nail ridging
The chemotherapy can cause your fingernails to develop ridges. This is temporary and the ridging will grow out.
• Discoloured urine
Because of its red colour, doxorubicin may discolour your urine red or pink for the first few times following treatment. This is perfectly normal and nothing to worry about.
Try to drink plenty of fluids and eat foods high in fibre such as fruits and cereals. Report this to your hospital doctor who may prescribe a suitable laxative.
• Flu-like symptoms
One of your drugs called bleomycin may cause flu-like symptoms such as fever, aches and pains and shivering about 3-5 hours after it is given. These symptoms are temporary and should go within 12 to 24 hours. To prevent this you will be given an injection of an anti-inflammatory drug called Hydrocortisone. Paracetamol will also help. If your symptoms are particularly severe, tell your doctor on your next visit.
The drugs you are about to receive are known as “cytotoxic “ or “chemotherapy” drugs. Most of these drugs need to be administered directly into the blood stream through a cannula (a plastic needle inserted directly into a vein.) In most cases it should not cause pain on administration and often the only sensation you may experience is a “coldness “ running up your arm. The exception to this is Dacarbazine which may cause pain along the vein during treatment. Tell your nurse if this happens and the infusion can be slowed down.
If the drip becomes dislodged from the vein an “extravasation” could occur with chemotherapy leaking outside the vein, causing damage to the surrounding tissues. This happens very rarely. Indications of this are pain, redness or swelling around the cannula site. Your nurse will be looking for any signs of extravasation while your chemotherapy is in progress but it is essential that you inform your nurse if problems arise. Very occasionally patients may notice pain and discomfort around the area only after their chemotherapy has been completed. This also must be reported immediately so that appropriate treatment may be prescribed.