Chemotherapy Side Effects: Fatigue, Nausea and Vomiting

by National Cancer Institute

(Page 3 of 10)

What Causes Side Effects?

Because cancer cells may grow and divide more rapidly than normal cells, many anticancer drugs are made to kill growing cells. But certain normal, healthy cells also multiply quickly, and chemotherapy can affect these cells, too. This damage to normal cells causes side effects. The fast-growing, normal cells most likely to be affected are blood cells forming in the bone marrow and cells in the digestive tract (mouth, stomach, intestines, esophagus), reproductive system (sexual organs), and hair follicles. Some anticancer drugs may affect cells of vital organs, such as the heart, kidney, bladder, lungs, and nervous system.

You may have none of these side effects or just a few. The kinds of side effects you have and how severe they are, depend on the type and dose of chemotherapy you get and how your body reacts. Before starting chemotherapy, your doctor will discuss the side effects that you are most likely to get with the drugs you will be receiving. Before starting the treatment, you will be asked to sign a consent form. You should be given all the facts about treatment including the drugs you will be given and their side effects before you sign the consent form.

How Long Do Side Effects Last?

Normal cells usually recover when chemotherapy is over, so most side effects gradually go away after treatment ends, and the healthy cells have a chance to grow normally. The time it takes to get over side effects depends on many things, including your overall health and the kind of chemotherapy you have been taking.

Most people have no serious long-term problems from chemotherapy. However, on some occasions, chemotherapy can cause permanent changes or damage to the heart, lungs, nerves, kidneys, reproductive or other organs. And certain types of chemotherapy may have delayed effects, such as a second cancer, that show up many years later. Ask your doctor about the chances of any serious, long-term effects that can result from the treatment you are receiving (but remember to balance your concerns with the immediate threat of your cancer).

Great progress has been made in preventing and treating some of chemotherapy's common as well as rare serious side effects. Many new drugs and treatment methods destroy cancer more effectively while doing less harm to the body's healthy cells.

The side effects of chemotherapy can be unpleasant, but they must be measured against the treatment's ability to destroy cancer. Medicines can help prevent some side effects such as nausea. Sometimes people receiving chemotherapy become discouraged about the length of time their treatment is taking or the side effects they are having. If that happens to you, talk to your doctor or nurse. They may be able to suggest ways to make side effects easier to deal with or reduce them.

Below you will find suggestions for dealing with some of the more common side effects of chemotherapy.

Fatigue

Fatigue, feeling tired and lacking energy, is the most common symptom reported by cancer patients. The exact cause is not always known. It can be due to your disease, chemotherapy, radiation, surgery, low blood counts, lack of sleep, pain, stress, poor appetite, along with many other factors.

Fatigue from cancer feels different from fatigue of everyday life. Fatigue caused by chemotherapy can appear suddenly. Patients with cancer have described it as a total lack of energy and have used words such as worn out, drained, and wiped out to describe their fatigue. And rest does not always relieve it. Not everyone feels the same kind of fatigue. You may not feel tired while someone else does or your fatigue may not last as long as someone else's does. It can last days, weeks, or months. But severe fatigue does go away gradually as the tumor responds to treatment.

How can I cope with fatigue?

• Plan your day so that you have time to rest.
• Take short naps or breaks, rather than one long rest period.
• Save your energy for the most important things.
• Try easier or shorter versions of activities you enjoy.
• Take short walks or do light exercise if possible. You may find this helps with fatigue.
• Talk to your health care provider about ways to save your energy and treat your fatigue.
• Try activities such as meditation, prayer, yoga, guided imagery, visualization, etc. You may find that these help with fatigue.
• Eat as well as you can and drink plenty of fluids. Eat small amounts at a time, if that is helpful.
• Join a support group. Sharing your feelings with others can ease the burden of fatigue. You can learn how others deal with their fatigue. Your health care provider can put you in touch with a support group in your area.
• Limit the amount of caffeine and alcohol you drink.
• Allow others to do some things for you that you usually do.
• Keep a diary of how you feel each day. This will help you plan your daily activities.
• Report any changes in energy level to your doctor or nurse.

Nausea and Vomiting

Many patients fear that they will have nausea and vomiting while receiving chemotherapy. But new drugs have made these side effects far less common and, when they do occur, much less severe. These powerful antiemetic or antinausea drugs can prevent or lessen nausea and vomiting in most patients. Different drugs work for different people, and you may need more than one drug to get relief. Do not give up. Continue to work with your doctor and nurse to find the drug or drugs that work best for you. Also, be sure to tell your doctor or nurse if you are very nauseated or have vomited for more than a day, or if your vomiting is so bad that you cannot keep liquids down.

What can I do if I have nausea and vomiting?

• Drink liquids at least an hour before or after mealtime, instead of with your meals. Drink frequently and drink small amounts.
• Eat and drink slowly.
• Eat small meals throughout the day, instead of one, two, or three large meals.
• Eat foods cold or at room temperature so you won't be bothered by strong smells.
• Chew your food well for easier digestion.
• If nausea is a problem in the morning, try eating dry foods like cereal, toast, or crackers before getting up. (Do not try this if you have mouth or throat sores or are troubled by a lack of saliva.)
• Drink cool, clear, unsweetened fruit juices, such as apple or grape juice or light-colored sodas such as ginger ale that have lost their fizz and do not have caffeine.
• Suck on mints, or tart candies. (Do not use tart candies if you have mouth or throat sores.)
• Prepare and freeze meals in advance for days when you do not feel like cooking.
• Wear loose-fitting clothes.
• Breathe deeply and slowly when you feel nauseated.
• Distract yourself by chatting with friends or family members, listening to music, or watching a movie or TV show.
• Use relaxation techniques. (See the section "Complementary Therapies.")
• Try to avoid odors that bother you, such as cooking smells, smoke, or perfume.
• Avoid sweet, fried, or fatty foods.
• Rest but do not lie flat for at least 2 hours after you finish a meal.
• Avoid eating for at least a few hours before treatment if nausea usually occurs during chemotherapy.
• Eat a light meal before treatment.

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