Dealing with the side effects of side effects

While preparing a supplement on side effects, I learned about something that many patients and caregivers are aware of but few people know how to manage: co-toxicities. The supportive care medications that are used to manage side effects of cancer treatment, such as insomnia and nausea or vomiting, also have side effects.Nausea and Vomiting

Drugs given to prevent nausea and vomiting frequently have side effects, ranging from sleepiness and headache to appetite stimulation and diarrhea. Yet uncontrolled nausea and vomiting can interfere with a patient's ability to receive cancer treatment by causing chemical changes in the body, loss of appetite, dehydration, physical and mental difficulties, a torn esophagus, broken bones and the reopening of surgical wounds. If patients do find they can't stomach anti-emetics, what alternative therapies are there? We'll discuss this and more in our special supplement, but we're always interested in hearing from you, as well.

Mouth Sores

Because fast-growing mucosa cells are particularly sensitive to chemotherapy, patients often develop mouth problems, ranging from dryness to ulcers. Yet preventive mouthwashes can adversely affect taste and stain teeth, and some analgesic and anesthetic treatments can lead to throat irritation, headache and fever. We'll discuss how choosing certain foods and practicing good oral hygiene can make eating easier, but we'd also welcome your advice.

Diarrhea

Damage to the digestive tract resulting from chemotherapy can lead to diarrhea, making antidiarrheal therapy necessary. Mild to moderate fluid intake can aid in rehydration. But when diarrhea needs to be controlled with medications such as Lomotil or Imodium, patients can sometimes experience nervousness or drowsiness. We'll discuss nonmedical management and prevention of diarrhea, such as diet and hydration products, but we'd also like to know how you manage this side-effect.

Constipation

Patients receiving certain painkillers or chemotherapy drugs may experience constipation. Although consuming adequate fluids and fruits can stimulate bowel function, many patients must take a stimulant laxative to prevent and treat constipation, with side effects ranging from stomach upset and nausea to bloating and cramping. We'll suggest ways, such as diet and exercise, to maintain normal bowel functioning that will minimize these effects, but we'd also like to learn how you handle this common problem.

Neutropenia, Thrombocytopenia and Anemia Patients being treated for cancer can experience low white blood counts (neutropenia), low platelet counts (thrombocytopenia) or low red blood counts (anemia), requiring drug interventions with side effects ranging from nausea, fever and bone pain to flushing, hypotension and hypertension. We'll discuss possible preventive measures, such as taking acetaminophen or a non-steroidal analgesic for bone pain; avoiding drugs that can affect the functioning of platelets, such as aspirin, ibuprofen and naprosyn; and early initiation of therapies at the first signs of anemia.

Fatigue

The most prevalent side effect of cancer treatment is fatigue. Medication to treat pain, depression, vomiting, seizures and other problems related to cancer can cause fatigue, as well as radiation therapy. But because fatigue is a complex condition with possible biological, psychological or behavioral causes, most of the available treatments are for treating symptoms rather than underlying causes. We'll discuss nonmedical management strategies, including diet and exercise, sleep and activity patterns, stress reduction and complementary therapies. Still, we'd like to hear from you.

Neuropathy

This is a side effect of several chemotherapy drugs that is challenging to treat, with some drugs like gabapentin able to provide relief in some situations. We'll explore this side effect in detail, but we would welcome your management strategies, as well.

So, share your side-effects strategies with us and we'll share them with our fans, followers and friends. And look for our Managing Side Effects supplement, coming soon!