Sunday, March 15, 2009

Side effects of adjuvant chemotherapy

Because there are many kinds of chemotherapeutic agents, the side effects due to treatment will vary from patient to patient. And even when two patients are taking the same chemotherapeutic regimen, they may suffer slightly different side effects due to genetic or other sources of variability. But there are some general patterns to the side effects, because many types of chemotherapy agents act on the cancers in similar ways.

Chemotherapeutic agents are called "cytotoxic" chemicals. This means they attack cells that are rapidly growing and dividing. While this means the cancer cells, which are rapidly growing, are attacked, other natural, rapidly dividing cells of the body are attacked. Among these are blood, hair and digestive tract cells.

Blood cells are continuously growing, to replenish old ones and keep the immune system healthy. So when they are hit by chemotherapy, patients may generally see blood-related problems, such as bruising or bleeding, lack of energy, and perhaps even trouble fighting off small infections due to compromised immune systems. Hair cells are also continuously dividing. When they are hit by chemotherapy, the result may be hair loss. And finally, the lining of the digestive tract is always renewing itself. When being treated by chemotherapy, the lining is unable to renew efficiently, and the patient may suffer from nausea, diarrhea or vomiting. How should one expect the nausea comes about? For some treatments, nausea hits immediately but for others it may arrive several hours after. Consult with the physician to get an understanding of how and when side effects arise.

Aside from waiting it out, patients or their physicians may opt for supplementing treatment with even more medication to combat the side effects. Anti-nausea medication, also known as anti-emetics, can be taken orally or via IV or injection. One will need to know not only which anti-emetics to take, but also how often and how long it needs to be taken to control these unpleasant feelings. Common anti-emetics are the following: Emend, Zofran, Kytril, or Aloxi.

There are other courses of action to take to combat the side effects other than medication. Patients can opt to control how and what they eat or drink. For example, adequate intake of water is encouraged, but not during meal times. Eating of heavy, greasy foods is not! Instead, patients should take in small amounts of dry foods, throughout the day to minimize the stomach sickness from chemo. Finally, one should be aware that surgery and chemo treatments may have averse effects on taste. Flavors may change or become dulled, and pleasant foods from before may no longer be so. Worse still, because of association, foods eaten during bouts of nausea may become disgusting for the patient and should be deferred until much later after treatment. After eating, it's recommended that one does not do exercises, which can accentuate feelings of fatigue-induced nausea. Instead, control the environment by getting into comfortable clothes and recline oneself. The setting should be made as soothing as possibly, perhaps with light music, comfortable temperature and reduced noise levels.

Finally, though it's expected that one suffers from some side effects in adjuvant chemotherapy, there are some warning signs that should be heeded to return to the physician for more advice. Excessive vomiting, pain, or hurting one's ability to take food and keep it down are signs that one should go back to a physician.

This column is really about what some expect during adjuvant chemotherapy and should not be construed as medical advice. Anyone under the care of a doctor needs to go back to that doctor and ask directly! Never self-diagnose from what you read on this website.

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