Careful attention should be given to avoid or minimize side effects of treatment. Side effects vary depending on the type of therapy, dosage and length of treatment. Normal, healthy cells that divide rapidly, including bone marrow, blood cells, cells of hair follicles and cells in the reproductive and digestive tracts, are more likely to be damaged during chemotherapy treatment. The doctor and patient must often balance possible side effects with potential benefits of treatment. Under a doctor’s care, many side effects can be prevented or managed.
The following is a table of the common side effects related to chemotherapy, targeted therapy, immunotherapy or radiation therapy. This list is not comprehensive. Side effects are individual and may not occur in each person receiving treatment.
Changes in Taste
(food can taste bland or metallic)
Avoid foods that cause unpleasant tastes. Changes in the dose of the chemotherapy and radiation therapy may help. Eat small, frequent meals. Eating tart foods may help overcome metallic or bitter taste. Cold food might taste better than hot food.
Drink plenty of non-caffeinated fluids each day. Eat foods high in fiber. Avoid fatty and fried foods. Moderate exercise can help.
Diarrhea or Abdominal Cramping
Treat with over-the-counter or prescribed medications as directed by a doctor. A variety of dietary changes can also be made under the guidance of a dietitian.
Treat with medications prescribed by a doctor. Drugs may boost red blood cells and help prevent fatigue. A dietitian can provide guidance on a variety of dietary changes. It is important to maintain activity in order to treat fatigue. Taking short walks can boost energy. In addition, taking short rests throughout the day may help.
Avoid frequent hair washing and use a gentle shampoo. Gently pat hair dry, use a wide-tooth comb instead of a brush and avoid the use of barrettes, rubber bands, hair products and hair dryers. Wear head coverings when outdoors.
(A condition that causes redness, tenderness, dryness and peeling of the palms and soles. Numbness or tingling may also develop.)
To avoid trauma to hands and feet, wear cotton socks or gloves and avoid tight-fitting shoes. You can also soak your hands in cool water for 10 minutes and then apply a mild moisturizer or petroleum jelly. Cooling the skin with ice packs may also help relieve pain and tenderness. Ask your doctor if an oral supplement of vitamin B6 is appropriate.
Loss of Appetite
Schedule 6-8 small meals and snacks per day. Medications prescribed by a doctor can help stimulate the appetite.
Lowered White Blood Cell Counts
Medications prescribed by a doctor and/or changes in the dose of the chemotherapy can increase white blood cell counts.
Lowered Red Blood Cell Counts
A blood transfusion or medication prescribed by a doctor may be required. Changes in the dose of the chemotherapy can also raise the red blood cell counts.
Lowered Blood Platelet Counts
A blood transfusion or medication prescribed by a doctor may be required. Changes in the chemotherapy dose can also raise blood platelet counts.
Eat soft, moist, bland foods. Avoid spicy and acidic foods. Caffeine and alcohol may irritate the mouth. Drinking through a straw may be helpful. High protein foods will help mouth sores recover more quickly. Rinse mouth with cool water or a mild solution of baking soda and water. Use a soft-bristle toothbrush.
Avoid biting nails, pushing back cuticles and using fake nails or wraps. Consult a doctor before having a manicure/pedicure. Wear gloves during household chores and moisturize hands and feet frequently. If the nail area becomes inflamed, it may be treated with antibacterial soap or antibacterial/antifungal ointments to prevent infection.
Nausea and Vomiting
Treat with medications prescribed by a doctor. A dietitian can provide guidance on a variety of dietary changes. Limit the consumption of fried, spicy or rich foods. Drink cool or room-temperature liquids between meals to stay hydrated and avoid feeling overly full. Using a motion sickness wrist band may help control nausea. Try wearing loose clothing and getting fresh air.
(A condition that causes tingling or numbness in the hands and feet and, sometimes, in other areas of the body.)
To protect hands and feet, wear cotton socks or gloves and avoid tight-fitting shoes. Also, avoid hot or cold temperatures. Ask your doctor if pain medications, antidepressants, anti-seizure or other treatments are appropriate.
Skin Rash, Redness or Irritation
Erlotinib is often associated with an acne-like skin rash on the body and/or face. However, it is not acne and will not respond to acne treatments. Other medications can also cause skin changes. Changes in the dose of treatments and in personal care methods may help soothe the skin. Examples include washing affected area with warm water and mild soap; using lotions without alcohol, perfumes or other irritants; avoiding direct sunlight and using sunscreen with an SPF of 15 or higher. Contact a doctor before using over-the-counter treatments.
It is important to keep the doctor informed of any side effects or pain. The doctor can only make changes in treatment or treat side effects if he or she is informed by the patient.
Managing Side Effects (Palliative Care)
This information has been taken from An Overview of Pancreatic Cancer, a booklet produced by the Pancreatic Cancer Action Network. To receive a complimentary copy of the booklet, please contact a PanCAN Patient Services Case Manager.