Side Effects of Chemotherapy

We've all heard about the infamous side effects of chemo.  But before you think the worst, it is important to remember that the side effects of chemotherapy vary with the drugs you receive and their doses.  For many side effects, you can take steps to help control or minimize the effects.  Be sure to communicate with your doctor, nurses and treatment team to let them know what you are experiencing. 

The most common side effects of chemotherapy are:

Hair Loss
For many women, the prospect of losing their hair is very upsetting.  Your doctor can tell you in advance if your chemotherapy is likely to make your hair thin or fall out completely.  Some women see a wig specialist before their hair falls out, or soon after.  Wigs come in all colors and styles.  They range in price from relatively inexpensive to very costly.  Many insurance plans cover wigs for cancer patients and some organizations, including Y-ME's Wig and Prosthesis Program, provide either free or lost-cost wigs to those who need them.  Other women choose to cut their hair very short, and some women prefer wearing a scarf or head dress.
 

Nausea
Nausea, feeling sick to your stomach or vomiting, is a common side effect of chemotherapy and some targeted therapies.  Nausea can also be caused by some pain medications.  It can vary in intensity from a mild feeling of discomfort to serious vomiting and loss of appetite.  You can help manage the nausea associated with your chemotherapy by planning your diet and when you eat, and take medications that can ease the problem.  Your treatment team can provide tips and work with you to minimize the problems associated with nausea and chemotherapy.
 

Fatigue
Both radiation and chemotherapy can cause fatigue – a feeling of being tired, having no energy or strength.  Cancer treatment related fatigue can range from mild to very severe.  It can last a couple of days after treatment, or persist for months.  Doctors don't totally understand what causes treatment-related fatigue and have not developed effective means to overcome it.  No single medicine is recommended for this condition.  You should let your doctor know if you are experiencing fatigue and how it is affecting your life.  You can also help yourself by eating well, trying to exercise, planning your schedule to allow time for rest, and letting others help you by doing chores or running errands.  Many people also find that complementary approaches such as mindful meditation, yoga and acupuncture help.
 

Memory Loss/"Chemo Brain"
Many breast cancer patients experience some memory loss or a reduction in their ability to concentrate and do tasks that require mental focus – a phenomenon sometimes called "chemo brain."  Chemo brain can be scary and frustrating.  It can interfere with getting things done at work or at home.  In most cases, chemo brain is temporary and resolves either during treatment or after it ends.  If this happens to you, acknowledge it – and take some steps to alleviate the situation.  Write down appointments, names and tasks that need to be done.  Take someone with you to your doctor's appointments.  Try to keep your life and schedule as simple as possible.  Allow time for rest and relaxing activities.
 

Weight Changes
The diagnosis of breast cancer and its treatment can affect your weight – both in terms of gaining or losing.  Many women gain weight while being treated for early breast cancer.  This may result from changes in diet and exercise, stress, or other factors that are not fully understood.  Eating right and exercising regularly can be difficult when you are not feeling well, but the more you are able to maintain a healthy lifestyle, the better you will feel and the less likely you are to gain unwanted weight.

Weight loss can occur as well when breast cancer patients are stressed or when they lose their appetite or sense of taste as a result of treatment.  It can also occur in later stages of the disease.  Talk to your treatment team about any weight-related issues you have.  They can provide help with good nutrition and with strategies to maintain a normal weight during your treatment.
 

Infertility
Some anti-cancer drugs permanently damage ovaries so that they fail to produce hormones.  This may cause a patient's menstrual cycle to become irregular or to stop all together, entering menopause.  If ovulation ceases, pregnancy becomes impossible.  Oncofertility experts are available to discuss potential fertility issues at the time of cancer diagnosis.  Many new technologies are evolving – such as embryo freezing, egg freezing, and ovarian tissue preservation – through which breast cancer patients can preserve their fertility.

Next: Targeted Chemotherapy.