Patients and Providers Together Can Manage Chemo Side Effects
- Ovarian cancer typically responds well to chemo, but the treatment does cause side effects
- Side effects vary from person to person, but the most common include fatigue, nausea, hair loss, increased bleeding or bruising, anemia, and neuropathy
- There are ways to try to manage most of the side effects. And many will subside when treatment ends
- Hair loss
- Fatigue
- Mild to moderate nausea
- Achiness
- Neuropathy
"For paclitaxel and carboplatin, the side effects are generally the loss of hair, some fatigue, and mild to moderate nausea," says Dr. Ronald Alvarez, gynecologic oncologist at Vanderbilt University Medical Center. "Oftentimes, patients may have some achiness in their bones or joints. Over time, they may develop some neuropathy symptomssome tingling or numbness in the fingers or toes. And, we generally have to watch patients' red blood cell count, their white blood cell count, their platelet counts, and their kidney function very carefully. We do some other lab tests to make sure their blood counts recover within a very satisfactory time period."
Read MoreFor instance, you might want to cut your hair very short or even shave your head before your hair starts falling out. If you're thinking about buying a wig, we recommend buying it before your treatment starts, or soon after. Cancer.org suggests asking if the wig can be adjusted as you might need a smaller size as you lose hair. To match your hair color, they recommend cutting a swatch from the top front of your head, where your hair is lightest. Wigs and other scalp coverings may be partially or fully covered by your health insurance. If so, ask for a prescription for a "cranial prosthesis." (Don't use the word "wig" on the prescription.) Your cancer team can likely recommend wig shops in your area.
For women who would like to try to keep some of their hair during chemo, "cooling caps are an option that's available," says Dr. Alvarez, though from his experience "most patients will not necessarily use them." The caps, which are tightly fitting, are filled with a gel coolant that's chilled to between -15 to -40 degrees Fahrenheit. They work by narrowing the blood vessels beneath the skin of the scalp, reducing the amount of chemotherapy medicine that reaches the hair follicles, which can make the hair less likely to fall out. While they can’t prevent hair loss entirely, they can slow the thinning.
Managing Nausea
Nausea is a common side effect of chemotherapy treatment, but in most cases, it’s well-controlled with preventive medications. Doctors may administer either Zofran or Ondansetron, usually for 3 days after treatment, to help prevent nausea. There are other medications that can be taken if the Zofran's not controlling it such as Phenergan, also known as Promethazine, or Compazine, one oncologist says. If patients are still having a hard time, they can take the Zofran as needed afterward, and other medications can be added to their IV during infusion.
Managing Fatigue
Of course you shouldn't push yourself if you're not feeling well. But doctors say it's important to try and incorporate some light physical activity like going for a walk into your day. Exercise doesn't just help manage fatigue, it will keep you in better shape and help you get back to normal when you're done with treatment. Additionally it is beneficial to get 7-9 hours of restful sleep. Though patients should expect to feel more tired than they're accustomed to, one oncologist tells SurvivorNet that many working women on the regimens we give “are able to work 50 to 75 percent of their pre-diagnosis hours."
Managing Neuropathy
"Patients who develop neuropathy can have different degrees of symptoms," says Dr. Alvarez. Some are minimal and don’t require intervention. Most neuropathy goes away on its own, but not always. "We’ll typically recommend some B vitamins or a neuropathic [medication like] Elavil or Gabapentin to help alleviate or diminish some of the symptoms," Dr. Alvarez says. "The neuropathy is [usually] not so significant as to interrupt the daily activities of life. But patients will oftentimes have some residual symptoms, most of which can be managed, or are acceptable."
If you’re currently receiving chemotherapy, it's important to keep your doctor informed about how you're tolerating treatment. Some doctors advise keeping a daily log. If you're experiencing any debilitating side effects, your doctor may choose to modify your treatment regimen.
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