Cancer treatments have been improving for decades. Researchers are not only developing treatments that are more effective, but they are also highly focused on reducing their side effects. This is important, given that here in the United States we now have nearly 16 million people living with a history of cancer. That number is expected to increase to more than 20 million by 2026.
Any problem that affects your healthy tissue and organs and arises as a result of cancer treatment is called a cancer treatment side effect. Side effects can vary from person to person and from treatment to treatment, to the extent that two people receiving the same treatment may experience very different side effects. Some experience side effects that arise during treatment and improve over time, which is the most common scenario. But some people experience severe side effects that last for months or even years after treatment is completed. If you are experiencing any side effects from your cancer treatment, it’s important to discuss them with your doctor. Treatment of side effects is an important part of cancer care and your quality of life.
At the Cancer Survivorship Program at Smilow Cancer Hospital, a team of health care providers helps patients deal with side effects they’re experiencing.
“Everybody is different, but there are common themes related to the side effects of treatment, like gaining weight,” says Tara Sanft, MD, a medical oncologist who is the program’s director. “Other concerns have to do with fatigue related to treatment, getting back to or trying to start an exercise regimen, and intimacy and sexual side effects.”
What are the most common side effects of cancer treatments?
Some of the most common side effects of cancer and its treatment include pain and fatigue, anemia, mouth problems, nausea/weight change/dietary issues, and hair, skin and nail problems.
- Pain. The term “pain” describes a broad category of types of symptoms and it is common to all cancers and cancer treatments. Pain can drastically interfere with your quality of life by making it difficult or impossible to eat, sleep and socialize. It’s important to understand that your pain can and should be treated. Treatment options include pain medication and other therapies like acupuncture, massage therapy and physical therapy.
- Fatigue. Cancer-related fatigue (CRF) is a severe form of fatigue often described by people with cancer as an overwhelming tiredness, exhaustion and weakness that doesn’t go away with sleep and rest. Fatigue is perhaps the most common and distressing symptom of cancer treatment and is especially common as a result of chemotherapy.
- Anemia. Anemia develops when there aren’t sufficient red blood cells to carry oxygen throughout the body. This can cause dizziness, weakness, faintness and racing of the heart. Treatments that can cause anemia include chemotherapy, radiation therapy and some immunotherapies. This happens because these treatments can inadvertently destroy healthy red blood cells in the process of killing cancer cells.
- Hair, skin and nail problems. Radiation therapy can bring hair loss (sometimes called alopecia) to the part of the body receiving radiation, while chemotherapy can lead to loss of hair on the head and other parts of the body. Different chemotherapy drugs can cause different types of hair loss, or no hair loss at all. Hair loss usually happens within two weeks of treatment, getting worse over the first month or two of ongoing treatment. Regrowth can begin while treatment is still happening, or within one to three months after it is done. Skin-related side effects of chemotherapy and radiation therapy can include dryness, itchiness, redness and swelling. You should also be careful in the sun while receiving cancer treatment because you may be more susceptible to sunburn. You may also experience changes in your nails, like darkening, yellowing or cracking of the nails and/or cuticles.
- Mouth problems. Mouth problems are common with many types of cancer treatments. Anticancer drugs and radiation to the head and neck can damage your salivary glands and tissues in the mouth, throat and lips. This can cause difficulty swallowing, changes in taste, dry mouth, infections in the mouth, mouth sores, tooth decay and sensitivity to hot and cold food.
- Nausea and vomiting. Immunotherapy, radiation therapy to the abdomen, and chemotherapy (with results varying by the type of drug and its dose) are all known to cause nausea and vomiting in people receiving cancer treatment. Nausea and vomiting can cause weight changes, dehydration and malnutrition, which can worsen the overall symptoms of the side effects.
What are some other side effects of cancer treatments?
Other side effects of cancer treatment include the following:
- Bleeding and bruising
- Bone density loss
- Edema (swelling)
- Heart damage
- Lymphedema (lymphatic system blockage)
- Fertility issues
- Memory or concentration problems, or delirium
- Nerve problems
- Sexual health issues
- Sleep disturbances and insomnia
- Urinary issues
What should you do if you’re experiencing side effects from your cancer treatment?
If your cancer treatment side effects are disrupting your life, discuss the problem with your doctor. Options include lowering your dose, changing to a different treatment or halting treatment altogether. If, however, the treatments are working well, your doctor may suggest various treatments to manage your side effects, such as the following:
- For pain: Options include pain medications, physical activity and acupuncture.
- For anemia: This condition requires careful monitoring of the blood and can be treated by blood transfusions or certain drugs.
- For hair, skin and nail problems: There are many programs available for patients experiencing hair, skin and nail problems as a result of cancer treatment. Many benefit from working with beauty professional volunteers who teach simple techniques on skin care, makeup and nail care, and give practical tips on hair loss, wigs and head coverings. When more care is needed, an onco-dermatologist can help prescribe medications to help manage dermatitis (skin irritation), sores and nail changes to help you continue with your cancer treatment.
- For mouth problems: Some mouth problems occur because of infection, which can be treated with an antibiotic or antifungal medication. Good oral hygiene should also reduce mouth problems as a side effect of cancer treatment. Nutritionists and speech and swallow experts can help patients cope with mouth sores and also help with strategies to make it easier to take in the calories and nutrients your body needs to heal.
- For nausea, vomiting, and weight change: Nausea and vomiting can be treated with anti-nausea medication taken orally, through an IV, as a suppository or a patch that sticks to your skin. These medications should help prevent drastic changes in weight, and additional dietary issues can be managed with support of a dietician.
What makes Yale Medicine unique in its approach to managing side effects of cancer treatment?
At the Cancer Survivorship Program, a team that includes doctors, a physical therapist, nutritionist and social worker is available to help patients make healthy lifestyle interventions to counteract unpleasant side effects they may be experiencing.
Dr. Sanft advises that patients request a list of potential late- and long-term side effects that they may expect with their treatment.
“Side effects of cancer are important things for patients to talk about with their doctors during treatment or in the survivorship period after treatment ends,” Dr. Sanft says.