Chemotherapy, Immunotherapy & Targeted Therapy

A medical oncologist specializes in the use of medicines, including chemotherapy, immunotherapy, targeted therapy, and hormonal therapy to treat cancer. These medicines, usually referred to as chemotherapy, are most often given into a patient’s veins (intravenous), injected under their skin (subcutaneous), or taken by mouth in pill form.

Your medical oncologist will work with you to develop a personalized treatment plan that meets your needs. Please keep in mind that everyone’s treatment plan is unique to them, so patients with the same diagnosis could receive different therapies, be on a different schedule, and experience different side effects. If you have any questions or concerns, please talk to your doctor or nurse.

The medical oncologists work with specially trained and certified oncology nurses who will administer the chemotherapy and monitor you for side effects. The chemotherapy nurses are a great resource for tips and practical advice to help with side effects. They will teach you about what side effects to look for once you are home since many of the drugs used to treat cancer have delayed or potential long-term side effects. If you experience any side effects at any time during or after your treatment, please let your doctor, physician assistant or nurse know. There are many ways to help, so please just let us know!

Side Effects

Below are some of the most common side effects patients experience from chemotherapy, and some ways to minimize or avoid those effects.

Appetite Changes

  • Eat small frequent meals (5-6 meals/day).
  • Drink thick liquids like milkshakes, smoothies, and soups if you don’t feel like eating solid food.
  • Use plastic utensils to decrease the taste of metal when you eat.
  • Talk with our oncology certified dietitian about ways to get the calories and nutrients your body needs.

Bone Marrow Suppression

  • Low white blood cell count
    • Patients with a low white blood cell count may have trouble fighting infections.
    • Avoid crowds and sick people, including children.
    • Wash your hands often.
    • Wash hands with warm soapy water for at least 20 seconds before and after handling food, and also before you eat. Talk to our oncology certified dietitian about foods to avoid and the best foods to eat if your white blood cell count is low.
    • Call the doctor immediately if you have a fever higher than 100.5 degrees, a sore throat or a cough, or pain and redness at any surgical or catheter site.
  • Low red blood cell count
    • Patients with a low red blood cell count may feel tired and weak.
    • Avoid strenuous activity
    • Call the doctor if you are light-headed or short of breath when doing normal activities.
    • If you are passing out, or have extreme shortness of breath, call 911 and go to the nearest emergency room.
  • Low platelet count
    • Patients with a low platelet count may have increased bruising, or red/purple pinpoint dots on their skin.
    • If you have a nosebleed or cut that won’t stop bleeding, call 911 and go to the nearest emergency room.

Cardiac (Heart) Dysfunction

  • Some cancer treatments can affect the heart.
  • Patients at high risk for heart disease will be monitored closely by our Cardio-Oncology Team, comprised of medical and radiation oncologists along with cardiologists with specialized training in identifying, preventing, and managing heart disease associated with cancer treatment.
    • Patients at high risk may be given medication to minimize or completely avoid the risk of heart disease associated with cancer treatments.

Constipation/Diarrhea

  • Medications are available to control the effects of chemotherapy on the stomach and bowels. Talk to your doctor, physician assistant or nurse.
  • Talk to our oncology certified dietitian who can help you choose foods that will help regain normal digestive and bowel function.

Depression and Anxiety

  • Follow a light exercise regimen – walking, etc. Physical therapy may also help manage depression and anxiety. Ask your doctor, physician assistant or nurse about a referral to oncology rehabilitation. Note: Hunterdon Health & Wellness Centers offer discount membership for cancer patients. Talk to your doctor, physician assistant, nurse or social worker for more information.
  • Consider integrative medicine services such as meditation, yoga and guided imagery to help address these symptoms.
  • Talk to your doctor, physician assistant or nurse. There are medications that can often help.

Fatigue

  • Prioritize your activities – balance rest with activities; don’t push yourself!
  • Delegate duties when possible.
  • Eat a well-balanced diet and drink about 8 glasses of fluids a day. Talk to our oncology certified dietitian for advice about getting the nutrients your body needs to minimize fatigue.
  • Follow a light exercise regimen – walking, etc.  Ask your doctor, physician assistant or nurse about a referral to physical therapy, which is covered by most insurances. Note: Hunterdon Health & Wellness Centers offer discount membership for cancer patients. Talk to your doctor, physician assistant, nurse or social worker for more information.

Hair Loss

  • Not all drugs will cause hair loss; your doctor, physician assistant or nurse will let you know if the drugs being used to treat your cancer will cause hair loss.
  • Hair loss usually occurs 2-3 weeks after your first treatment.
  • Strategies to minimize hair loss include:
    • Use a mild shampoo, a soft hairbrush, and low heat when drying your hair.
    • Avoid dying, perming, or chemically relaxing your hair.
    • Cold cap therapy may reduce hair loss. Ask your doctor, physician assistant or nurse if cold cap therapy could be an option for you.

Paxman Scalp Cooling System

“Scalp cooling is a simple treatment that can prevent hair loss caused by certain chemotherapy drugs. The use of scalp cooling has been proven to be effective in preventing chemotherapy-induced alopecia, or hair loss, and can result in women retaining much of the hair. Some women retain all of it. For people receiving chemotherapy, scalp cooling can mean the opportunity to regain some control, ensure some privacy, and maintain a positive attitude toward treatment.” – Paxman USA

For more information, please visit: www.paxmanusa.com

Mouth Sores/Mucositis

  • Rinsing your mouth 4 times a day (after meals and at bedtime) with ¼ teaspoon of baking soda and 1/8 teaspoon of salt mixed in a glass of water can help prevent mouth sores.
  • If mouth sores do develop, tell your doctor, physician assistant or nurse since they may need to prescribe a medicated mouth rinse.
  • Talk to our oncology certified dietitian about ways to minimize mouth sores and optimize your nutritional intake

Nausea and Vomiting

  • Not all drugs will cause nausea or vomiting; your doctor, physician assistant or nurse will let you know if the drugs being used to treat your cancer will cause nausea and/or vomiting.
  • Take anti-nausea medication as directed; if you cannot afford your medication, let your doctor, nurse or social worker know.
  • Eat small, frequent meals.
  • Avoid foods with strong smells.
  • Talk to our oncology certified dietitian who can help you find foods that are gentle on your stomach and provide the nutrients you need.
  • Some people find relief with ginger, acupuncture and/or seasick bands.

Numbness or Tingling in Hands or Feet (Neuropathy)

  • Discuss with your doctor, physician assistant or nurse. There are medications that may help.
  • Physical therapy may help.
  • Some patients have found acupuncture helps relieve the pain.

Sexual changes

  • There are many strategies to address changes in sexual desire and performance.  Talk to your doctor, physician assistant or nurse.

Skin and Nail Changes

  • It is important to keep skin moisturized. Keep a moisturizing lotion handy and use after washing your hands and any time your skin feels dry.
  • It’s also important to avoid sun exposure. Wear sunscreen, protective clothing, and wide brim hats when out in the sun.
  • Wear gloves when doing yard or housework.

Sleeping Difficulty

  • Warm baths, adopting a bedtime routine, and smelling lavender may all help to improve sleep.
  • Sometimes medication is needed, so if you are experiencing sleep difficulties, let your doctor, physician assistant or nurse know.

To learn more about the Side Effects of Cancer Treatment, please click here.