Miscellaneous side effects
Allergic reactions
Allergic Reactions, also know as hypersensitivity reactions, refer to an overactive immune response to a medication or other substance. These reactions can be caused by many factors including chemotherapy treatments. Hypersensitivity reactions can be broken into four categories:
Type I – these reactions are immediate and may occur within seconds or minutes of the body being exposed to the foreign substance. Examples of this type of reaction include hay fever, allergic asthma, hives, food allergies and allergies to IV contrast dye.
This type of allergic reactions can present as hives with itching, facial/neck flushing and rashes. In severe cases, there could be swelling of the tongue, lips, eyelids and airway, lowering of blood pressure, shock and even death.
These types of reactions have been known to occur with chemotherapy and targeted therapy agents. When we know that a medication has a strong propensity for causing hypersensitivity reactions, we administer medications prior to therapy (Benadryl, steroids, cimetidine) to prevent or lessen it.
Type II reactions involve antibody and antigen responses and occur most often in transfusion reactions and autoimmune hemolytic anemia.
Type III reactions are similar to type II reactions but are more wide spread. This process can occur in hours to days from the substance that triggered the response. Examples of this type of reaction are: systemic lupus erthematous, serum sickness.
Type IV reactions are called “delayed” and can occur 2-3 days after exposure to the offending substance. Examples of this type of reaction are: contact dermatitis such as poison oak or poison ivy and rejection of a transplanted organ.
Management of hypersensitivity reactions is directed toward prevention and relief of symptoms. Your physician and nurses have experience with these types of reactions and have the necessary medications on hand to administer should you need them. Some things that you can do to minimize your potential for this type of reaction are:
Take prescribed pre-medications prior to treatment as directed. If you forget let your nurse know before starting therapy.
Make sure your physician and nurse are aware of any allergies you may have. This includes medications and foods. If you have ever had a reaction to a chemotherapy medication it is important you let us know prior to therapy.
If you have had a reaction in the past but are unsure if it was an allergic reaction bring it to our attention so that we can discuss it.
If you experience any unusual symptoms or feelings during treatment, notify the nurse immediately.
If you are not at the clinic and experience symptoms such as shortness of breath, wheezing, difficulty breathing, swelling of face (including tongue, lips) or hives Seek Emergency Help Immediately .
Contact your physician or nurse within 24 hours of noticing a skin rash, itching or hives.
Fatigue
Fatigue is one of the most common side effects of cancer and cancer treatment. If you experience it, you may have an increased need for rest, difficulty in regaining energy after resting, problems concentrating or a lack of interest in activities or events.
Many factors contribute to fatigue: treatment induced anemia, anemia brought on by the cancer itself, uncontrolled pain, lack of exercise, poor nutrition, not getting enough sleep, anxiety, depression, low thyroid function, as well as infection or other medical problems such as diabetes, heart disease, or renal failure. Severe fatigue can also be a complication of certain chemotherapy agents.
Anemia induced by cancer treatment is one of the most common factors. As discussed in the section on anemia, chemotherapy or radiation therapy to certain parts of the body can lower the number of red blood cells in circulation. Red blood cells carry hemoglobin, which attaches to oxygen and carries it to different parts of the body. Drops in red cell numbers and/or amount of hemoglobin can decrease oxygen supply to tissues and organs. Anemia can make you feel very tired; if it is severe, you may experience difficulty in thinking, feel dizzy, experience rapid heartbeats, shortness of breath or have difficulty staying warm.
Treatment of fatigue is dependent on the cause. However, fatigue has many different causes and it may require the use of multiple strategies for treatment. If your fatigue is caused by treatment or diseased induced anemia there are treatments available to help. Be sure to share your concerns with your health care team.
Some things that you can do to help yourself are:
- Conserve your energy – it is important to not push yourself. Do only the things that are the most important and don’t be afraid to ask friends and family for help.
- Good nutrition is essential to meet the increased nutritional demands placed on the body by cancer and cancer treatment. Often this can be a challenging task. It is important to let your health care team know if you are having problems with eating or drinking.
- Rest – try to maintain normal rest and sleep patterns as closely as you can. Plan daily activities around the time of day that you feel you have the most energy. Schedule rest periods between activities. Try to limit daytime naps to less than an hour so that you don’t interfere with normal sleep patterns.
- Exercise – mild exercise is as important as getting adequate rest and conserving energy. A mild-moderate daily exercise regimen such as walking can help increase your energy level.
- Manage your stress. This could include counseling, use of support services or medications. Stress is a normal response to the diagnosis of cancer and cancer treatment. If stress if out of control it will affect all other aspects of your health. Don’t be afraid to share concerns about stress with your health care team.
Flu-like symptoms
Flu--Like Syndrome is a side effect of several cancer treatment drugs. It is believed that the body responds to these medications in a same way it responds to a “flu” virus - by activating normal inflammatory mechanisms of the immune system. Symptoms of this syndrome include:
Fever with sudden onset; timing of the fiver differs from drug to drug.
Chills
Muscle and joint aches and pains
Headache, usually across the forehead; it can be accompanied by sensitivity to light or visual disturbances.
Runny nose (clear and watery)
Fatigue (low energy, sense of apathy)
- Cough (dry and hacking)
- Nausea and vomiting
- Diarrhea
Flu-like syndrome is associated with biologic therapies, some targeted therapies and several standard chemotherapies. Treatment for this syndrome is focused on symptom relief and therefore depends on the specific symptoms you are experiencing. Your physician or nurse will discuss your potential for developing this side effect.