Symptoms and Side Effects – Chris O'Brien Lifehouse
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Cancer and its treatment can provoke a range of symptoms and side effects – some people will experience very few symptoms, while others will be quite affected.

These may come and go over time and may also interact together. For example, pain can lead to sleeplessness and therefore fatigue. Often, symptoms and side effects can be relieved or managed by medical or non-medical treatments, or a combination of both.

The Lifehouse LivingRoom – our centre for supportive care and integrative oncology – offers evidence-based complementary therapies that will help alleviate your symptoms and side effects and improve your quality of life throughout your treatment experience and beyond.

Supportive care is an integrated service that sits alongside standard cancer therapies.

Common side effects

Anxiety is one of the most common and natural emotional responses to cancer. Questions like ‘How will I cope?’, ‘What is going to happen?’, ‘Will I get better?’ and ‘Will the treatment work?’ will probably go through your mind. Anxious feelings may vary in frequency or severity.

Physical signs of anxiety

  • Fast breathing or breathlessness
  • Shaking or tense muscles
  • Dizziness
  • Heart palpitations
  • Sweating
  • Dry mouth
  • Nausea or diarrhoea
  • Chest pain or discomfort
  • A ‘lump in the throat’
  • Pins and needles
  • Reddening of the face and neck

Dealing with anxiety

When anxiety levels are high, the symptoms can be difficult to control and may be experienced as a ‘panic attack’. Relaxation techniques can help you regain control. Take some slow deep breaths and try to concentrate on what is happening right now, rather than concerns about the future.

Your doctor can help you determine whether your symptoms are related to cancer or anxiety. Understanding the reason for your symptoms can be reassuring, but if you are still feeling anxious, counselling or psychotherapy can help. Medication can be prescribed if necessary.

Diarrhoea may occur due to infection, medication, or a side effect of treatments like chemotherapy, or radiation therapy. Some types of cancer may prevent food from being absorbed properly from the bowel.

Helpful tips if you have diarrhoea

  • During episodes of diarrhoea, cut down on your fibre intake from cereals, fruit and vegetables
  • Eat peeled and cooked fruit and vegetables instead of raw ones
  • Avoid milk and dairy products until the diarrhoea has stopped
  • Drink plenty of fluids to replace the water lost, but avoid alcohol, coffee or fizzy drinks, which can cause wind and stomach cramps
  • Eat small, frequent meals made from light foods – white fish, chicken, eggs (well cooked), white bread, pasta or rice
  • Eat your meals slowly

If the diarrhoea continues for more than two days, tell your doctor, who can investigate the cause, and prescribe some anti-diarrhoea medicines for you.

Fatigue is one of the most common and difficult problems for people with cancer. Fatigue is tiredness that is unrelated to daily activity, and cannot be alleviated with a good night’s sleep.  Many people undergoing chemotherapy or radiotherapy will experience fatigue, or it may be a side effect of advanced disease or caused by symptoms, like breathlessness, anaemia or pain.

Signs of fatigue

  • A lack of energy or feeling of weakness
  • difficulty thinking or concentrating
  • becoming forgetful
  • dizziness or light-headedness
  • difficulty sleeping
  • a lower sex drive
  • feeling irritable, emotional and tearful

The right treatment for your fatigue will depend on its cause, so let your doctor or nurse know how you are feeling. Sometimes treating other symptoms, such as anaemia, will alleviate fatigue.

Managing fatigue

There are some things you can try that might help with fatigue.

  • Eat a healthy diet and drink plenty of fluids throughout the day
  • Try complementary therapies such as yoga or massage
  • Keep active with 30 minutes of moderate physical activity per day
  • Limit naps to 30 minutes or less to avoid interference with your night-time sleep pattern
  • Avoid alcohol and caffeine

The prospect of cancer treatment impacting your fertility can be overwhelming, regardless of whether or not you already have children, or have considered having them.

Before your treatment begins, your doctor will talk to you about fertility risks and what can be done to lessen the effects of treatment on your fertility. You can then decide whether to explore options such as storing embryos or storing sperm for future use.

If you have a partner, it might be helpful for you both to be present during these discussions.

Don’t be afraid to raise this with your doctor or specialist nurse and ask to be referred to a fertility specialist.

How treatment can affect sex and fertility

In women, cancer treatment can:

  • Cause an early menopause by damaging the ovaries
  • Stop you from producing hormones
  • Involve losing your womb
  • Damage the womb lining, making it difficult to get pregnant or keep a pregnancy

In men, cancer treatment can:

  • Stop the production of sperm
  • Affect the production of hormone testosterone, which can influence your sex drive and your ability to get an erection
  • Damage the nerves and blood vessels in the pelvic area, which can affect your ability to get an erection and/or ejaculate normally.

Treatments which only affect sperm production will not prevent you from getting an erection or enjoying sex.

Chemotherapy and radiation therapy can be extremely harmful to a developing baby, so it is important that you or your partner do not become pregnant during, or for some time after cancer treatment. Effective contraception such as condoms should be used.

Some chemotherapy drugs or other medicines may affect the condition and growth of your hair. Hair loss can be experienced in different ways; some people’s hair becomes thinner or falls out completely. People who have surgery or radiotherapy may find they have areas where their hair doesn’t grow back. You can lose hair from your head but also other parts of the body like eyelashes and eyebrows. Hair loss elsewhere tends to be less severe.

Even if your hair does not fall out, treatment can make it dry, brittle and more difficult to manage.

Preparing for hair loss

You could consider having your hair cut short before your treatment starts, or have it cut in stages to give you time to adjust to a new length. Some people prefer to shave their heads completely before they start losing their hair, which can help to give a sense of control over what is going to happen.

Alternative headwear such as scarves or turbans may be useful for those who do not wish to cut their hair for religious or cultural reasons.

Looking after your hair:

If your hair is dry or brittle during or after cancer treatment

  • Use gentle hair products and non-medicated shampoo
  • Brush or comb your hair gently using a brush with wide prongs or a wide-toothed comb
  • At night, wear a soft cap, turban or hairnet to stop your hair becoming tangled
  • Maintain a healthy diet
  • Avoid hair dryers or heated rollers, as this can over-dry the hair and make it break
  • Avoid wearing your hair in a tight band or tight plaits, as this can damage and break your hair

Look Good Feel Better is a free program to help women manage the side effects of cancer treatment that affect your appearance. Ask your nurse for more information.

Lymphoedema is the swelling of an arm, leg or other part of the body because of an abnormal build-up of a fluid called lymph in the body tissues.

Lymph assists the immune system to destroy bacteria and remove waste products from tissues, passing through the body via vessels and nodes.

When these vessels or nodes become blocked by cancer, or have been removed by surgery, the lymph fluid is unable to pass along it and builds up, causing swelling.

Radiation therapy can cause lymphoedema when scar tissue is formed in the lymph nodes.

Lymphoedema is commonly experience by people with breast, gynaecological and prostate cancer and melanoma. It can arise soon after treatment or not until many years later.

Minimise your risk

  • Avoiding swelling and infection by using insect repellent to reduce the risk of insect bites. Also use sunscreen to avoid sunburn which may lead to swelling
  • Treating insect bites or minor scratches with antiseptic cream
  • Maintaining daily exercise and a healthy weight to promote lymph drainage
  • Seeking a referral for a lymphoedema specialist early if you do develop swelling. Early referral means treatment is less intensive and much more likely to be successful.

Further information
Lymphoedema – what you need to know

The effects of cancer or its treatment can lead to mouth problems such as a dry mouth, infection or ulcers. These can affect your ability to eat, drink and speak comfortably.  Following a regular mouth care routine can help to prevent or lessen mouth problems.

Mouth care routine

  • Brush your teeth every morning and evening using a small, soft-bristled toothbrush and fluoride toothpaste
  • If you can, gently brush your tongue when cleaning your teeth
  • Use water or an alcohol-free mouthwash to rinse your mouth after meals, or more often if needed to keep your mouth fresh. You can make a mouthwash with one teaspoon of salt dissolved in 250ml of fresh water. If your doctor prescribes a mouthwash for you, use it as prescribed
  • Rinse dentures after meals
  • Remove dentures at night. Clean them with a toothbrush and toothpaste or denture paste and soak overnight. Rinse well before using again
  • Gently floss daily
  • Keep your lips moist by using Vaseline, or a flavoured lip balm
  • Avoid smoking and alcohol
  • If your mouth does become sore, cut food into small pieces and mix with sauces and gravy to make chewing and swallowing more comfortable. Avoid rough or dry foods, spicy and salty foods and citrus fruits as they will cause irritation. Applying a mouth gel before eating may help too.

Nausea and vomiting can be an unpleasant side effect of cancer and its treatment. Although it may be difficult to completely control sickness caused by chemotherapy, there are many treatments available that can drastically reduce it.

There are many causes for nausea which include cancer therapies, pain, constipation, irritation of the stomach lining or a high level of calcium in the blood. Speak to your doctor or nurse for advice.

You may be prescribed an anti-sickness drug. These are usually most effective when taken regularly, so the sickness doesn’t have a chance to come back.

Complementary therapies such as cannabis and acupuncture can be used to help reduce nausea and vomiting.

Helpful tips for reducing nausea

  • If possible, have someone else prepare your food
  • Try to eat when you feel less sick
  • Avoid fatty, fried or strong-smelling foods that can increase nausea
  • If the smell of hot food makes you feel sick, eat cold or warm food
  • Have small, regular meals and chew food thoroughly
  • Take plenty of liquids throughout the day, taking small, slow sips
  • Try not to drink too much fluid before you eat
  • Sea-bands (acupressure wristbands) can help to reduce nausea – these are available from many chemist shops
  • Ginger can be helpful – try eating ginger biscuits or drinking ginger beer

Pain is a personal experience, and even people with the same illness can experience pain very differently. Your experience of pain is unique and should be treated according to your own needs. It is important to tell the doctors and nurses looking after you if you are in pain, so that it can be effectively treated.

The causes of pain are now well understood and there are many effective ways of treating it. There is rarely any need for anyone to suffer uncontrolled pain.

The amount of pain you have is not related to how severe your cancer is. Having pain does not necessarily mean that the cancer is advanced, or more serious than if you have no pain. Pain does not automatically get worse as the cancer develops.

About three in 10 people having treatment for cancer will have some pain. If the cancer is advanced, around seven in 10 people will have pain, although it is important to remember that a new ache or pain does not necessarily mean your cancer has returned, worsened or spread.

Pain can occur for a number of reasons

    • A tumour may press on the tissues around it, or on a nerve
    • Infection can cause pain by creating inflammation in the affected part of the body
    • Damage to tissues or nerves following surgery or radiotherapy may lead to pain
    • A cancer may spread from its original place in the body to form other tumours. These may cause pain, especially in the bones
    • Sometimes, pain is felt in parts of the body far away from the cancer that is causing it

Further information

The Cancer Council is an excellent source of information on living with cancer, its treatments and managing its side effects.

Visit their website.

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