Common Chemotherapy Side Effects
- Suppression of bone marrow
- Anemia, low platelets, lower white blood cell count to fight infection
- Hair loss – caused by paclitaxel
- Neuropathy – numbness and tingling in hands and feet
- Fatigue
- Nausea
"For patients who have not had chemotherapy before and are having their first treatment for ovarian cancer, I review the side effects with them," says Dr. Renata Urban, gynecologic oncologist at the University of Washington. "One of the drugs that we use, called paclitaxel, will cause hair loss, so I address both that hair loss is going to happen and what strategies are available to reduce that.”
Read MoreDr. Urban also wants her patients to understand other side effects of chemotherapy that they might not be aware of. "First and foremost, there’s going to be some suppression of the bone marrow, meaning items such as anemia, low platelets, which are your blood clotting cells, lower white blood cells, which are your infection fighting cells."
One symptom that also needs to be talked about is fatigue. “This is one of the few symptoms that doesn’t necessarily come and go with chemo, but oftentimes can be constant and also go up over time,” says Dr. Urban. “I talk about calling that out, thinking about strategies the patient might have to try to address that, and addressing the importance of exercise as well as mental health care to combat the fatigue.” Fatigue varies greatly from person to person. Some women are able to return to work or daily activities almost immediately, even if they aren’t active for quite as many hours each day as before. Others will need to take time off and recuperate after each treatment.
Another side effect that women may not be aware of is called neuropathy, which is peripheral nerve damage that can cause a numb, tingly, or painful feeling in the hands and feet. "I review the potential for that and the importance for patients to bring those symptoms to our attention," says Dr. Urban.
Chemotherapy Standard of Care
For patients with advanced ovarian cancer, meaning stage III to IV disease, the recommendation is typically for six cycles of two chemotherapy drugs, typically paclitaxel and carboplatin. “Depending on the regimen, meaning the cocktail of drugs that someone is getting, it could be a treatment that’s either weekly or every three weeks, and it’s given for six cycles,” says Dr. Urban. For most women, chemotherapy treatment lasts about 20 to 24 weeks.
During the COVID-19 pandemic procedures for chemotherapy patients may be a bit different than usual. “In our clinic, as well as many cancer centers nationwide, there is now pre-screening for patients who have any concerning symptoms or contacts,” says Dr. Urban. The screening before patients come into the clinic is both to protect both that individual patient as well as all patients. “Patients who are on chemotherapy have an higher risk of any infection because of the immunosuppression, and do seem to also be at higher risk of COVID-19,” explains Dr. Urban.
But eventually the chemotherapy treatment will be done, and when it’s complete most of the side effects should disappear, too. Hair grows back, energy returns, and usually neuropathy disappears as well. In the meantime, during treatment, women should make sure that their doctors are aware of any and all side effects they're experiencing, since there are very effective ways of dealing with them.
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