Managing Cancer Treatment Side Effects

Starting your personalized cancer treatment plan usually brings a sense of relief because you're taking steps toward the hope for a cancer-free future. But along with that relief can come some concerns about the treatment's side effects. 

Because cancer treatments seek to disrupt or destroy cancer cells, they can affect healthy cells while on their mission. When healthy cells are affected there can be side effects. They vary based on the treatment being used and your body's reaction to them. 

That’s why it’s important to discuss expected cancer treatment side effects with your care team early on. Our patients experience a thorough treatment education session with an RMCC team member prior to starting the particular treatment that's being used. Feel free to take notes so you can recall information later. It is also helpful to keep a journal so that you can remember questions or concerns you may have along the way to discuss at office visits. Your cancer specialists can help you understand what to expect and how to cope. 

While undergoing cancer treatment, you may have trouble falling or staying asleep. That, in turn, can make other side effects, like fatigue, even worse. You may need to have a sleep study to pinpoint the type of sleep problem you’re having. To help you sleep, try out some of the strategies listed below.

• Ensure your bedroom is dark, cool, and quiet.
• Develop a calming nighttime ritual.
• Create an energizing ritual in the morning with light exposure and exercise.
• Go to bed and wake up at consistent times.
• Keep electronic devices out of your bedroom, and don’t use them for at least two hours before bedtime.
• Avoid or reduce caffeine, alcohol, and sugary foods.
• Utilize blue light reduction to watch TV or use computers in the evening.
• Consider melatonin replacement therapy after discussing with your provider.
• Use aromatherapy such as lavender for relaxation.

Perhaps no side effect is more closely associated with cancer treatment than hair loss. The good news: it's not something every cancer patient will experience. Some chemotherapy can cause widespread hair loss, and radiation therapy can cause hair to fall out in the area receiving treatment. Hair loss usually begins one to three weeks after treatment starts, according to the American Cancer Society. Fortunately, hair is resilient and sometimes regrows with more volume or curl than it had before – it usually starts returning before treatment concludes. Using a cooling cap – a device that keeps the scalp cold before, during, and after chemotherapy – may reduce your risk of hair loss. Steps you can take to manage hair loss include:

• As hair begins to fall out, choose a look you’re comfortable with, whether it’s cutting or shaving off your hair, or wearing a wig or scarf
• Handle your hair with care by combing it gently, washing it less often – use a mild shampoo – and patting it dry
• Talk with family, friends, or other individuals undergoing cancer treatment about your emotions surrounding hair loss
• Use lotion to moisturize your scalp
• Wear a hat or sunscreen to protect your scalp

Surgery to remove lymph nodes as well as radiation therapy in a lymph node area can cause lymph (lymphatic system fluid) to accumulate, often in an arm or leg. This is a condition called lymphedema, which can cause swelling and skin changes.

To treat lymphedema, your cancer specialist may recommend wearing a compression stocking or sleeve to help reduce swelling. You may also see a certified lymphedema therapist, who can perform a special type of massage to help lymph drain away from your arm or leg.

It is important to stretch and massage areas daily as early intervention can be preventative. There are many therapy resources for education including oncology rehabilitation and other therapists specializing in this field. Your providers can help connect you.

You can help manage and prevent lymphedema using additional tactics such as:

• Exercise and stretch regularly to help keep lymph from accumulating.
• Protect your skin. Moisturize with lotion and use sunscreen so you avoid burns. Skin in the area where lymphedema is occurring can get drier and crack easier than other areas of the body which can then get infected easier. 
• Try to keep the area elevated to allow the fluid to drain if you start to notice swelling.
• Avoid tight fitting or restrictive clothing in the area of your body where you've received treatment. This can cause lymph fluid to collect and swelling to begin. 

Chemotherapy and radiation therapy can cause pain in many parts of the body. For example, chemotherapy can lead to headaches and muscle pain, and both chemotherapy and radiation therapy can cause painful nerve damage. Treating pain is key because it can hinder your immune system and delay healing, according to the National Cancer Institute.

Your cancer specialist may prescribe pain medication, and it’s important to take it as directed. In addition, he or she may refer you to a pain specialist to treat specific types of discomfort, such as nerve pain. Applying heat or ice to painful areas, and avoiding activities that make pain worse, may also help.

Download guide from ASCO on managing cancer-related pain.