Chemotherapy Side Effects

The severity of chemotherapy side effects also differs from person to person: For example, two people may suffer nausea from the same chemotherapy drug--but one feels slightly queasy for four hours, while they may vomit. Even the same individual reacts a bit differently each time he or she gets the same drug--some sessions will be harder than others. There is no way to predict how you will react to the drugs until you take them.

Chemotherapy drug doses and schedules are developed so that the drugs enter the body, kill the rapidly dividing cancer cells, and are expelled before they can damage most healthy cells, which divide more slowly. But the normal cells that make up the mucous lining of the intestinal tract, the hair producing cells, and the bone-marrow cells are also rapidly-dividing cells, hence these, too, are affected by the chemicals, causing the three most common chemotherapy side effects: nausea and vomiting, hair loss, and bone-marrow depression.

Nausea and vomiting can sometimes be controlled by anti-nausea drugs, or by meditation or biofeedback. Some people just get sick no matter what they do. Again, there is no way to predict. A few things are helpful to remember: You will recover from nausea between four and twenty-four hours after it starts; and severe nausea usually follows a pattern, with the bouts of vomiting coming farther and farther apart.

Marijuana, its constituent delta-9-tetrahydrocannabinol (THC), and related drugs have been useful in controlling nausea and vomiting due to chemotherapy in some patients. Marijuana itself is not available through legal channels. Synthetic cannabinoids such as nabilone (Cesamet) and dronabinol (Marinol) are available and may be prescribed for control of nausea by your family doctor. (Revised July 22, 1997).

Ondansetron (Zofran). The development of drugs like ondansetron have had a great impact on the treatment of drug produced nausea. It is the treatment of choice for severe nausea.

Hair Loss (alopecia) is mainly a psychological problem; there is no pain and your hair does grow back. Some people have only a little thinning; other people lose all their hair--including eyebrows and body hair. The rate of hair loss also varies tremendously -- some people have a gradual thinning over a period of weeks; others have one shot and wake up the next morning to find all their hair on the pillow. There is no way to predict your reaction.

If you do lose your hair, you should know that it will come back in two phases. The first phase starts very shortly after you lose it: Very fine, baby-type hair begins to grow. When chemotherapy is completely over, your regular hair will come back--at least as thick as before, and sometimes thicker. This is something you just have to get through; after the initial shock is over, wigs and scarves make it fairly easy. Ice caps (ice cap, cold cap, caps) sometimes retard hair loss from chemotherapy. They work for some patients but not for others. They can be found at some pharmacies that carry medical supplies

Bone Marrow Depression is a more subtle and more serious concern. Your bone marrow produces certain essential parts of your blood and immune system. Some drugs used in chemotherapy can slow down, or depress, that production, making you more susceptible to infection, among other things. If the depression is too severe, you will be put in the hospital and given antibiotics until your own immune system recovers. If the recovery takes too long, you may be switched to other drugs.

Immunization During Treatment For Cancer:

1.When a child or adult has cancer and is receiving treatment which may be suppressing their immune system e.g. chemotherapy, "live" immunizations (vaccines) should not be given until six months after
treatment is completed. "Killed" vaccines may be given although it is unclear as to their effectiveness in the immunosuppressed patient.
2.Household members may receive killed or live vaccines without risk to the cancer patient except in the rare instance of extensive immunosuppression for bone marrow transplantation, etc. Advice
should be sought from the Infection Control Service or the Transplant Service of the Children's or Vancouver General Hospital.
3.Travel Immunizations: the same rules apply as in 1 and 2 above.

obtained from BCCA Information Database