Do What You Can to Ease Side Effects from Treatment for Hodgkin Disease
Here are some common side effects from treatment and suggestions on how to ease them. You may not have all of these. We’ve listed them in alphabetical order so that you can find help when you need it.
Anemia (low red blood cell levels)
Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your red blood cell count. Red blood cells carry oxygen throughout the body. If your body does not have this oxygen, you may feel tired. Decreased red blood cell counts can be caused by small amounts of blood loss, by chemotherapy or radiation, or by the cancer itself.
If your doctor tells you that you have anemia, take these actions to feel better:
Take short rests when you’re tired. Avoid long naps during the day so that you can sleep well at night.
Add mild exercise, such as walking, to your daily routine.
Balance activity with rest. Save your energy for important tasks.
Drink plenty of water. Dehydration adds to fatigue.
Talk with your doctor about medications or treatments that may help manage your anemia.
Anxiety and depression
Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back throughout treatment.
Taking these actions may ease your mental stress:
Talk with your family or friends.
Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.
Ask your doctor about medications for depression and anxiety.
People who eat well during treatment maintain their strength better. It's important to remember that your body needs energy to heal itself. Maintaining your weight is a good way to know if you're giving your body the energy it needs. When you're being treated for Hodgkin disease, a diet high in calories and protein is often best.
The problem is that treatment, especially chemotherapy, can damage intestinal cells or affect areas of the brain controlling appetite. Radiation to the head and neck can change the way food tastes to you, make it hard for you to swallow, or reduce your appetite. Ask your doctor for a referral to a registered dietitian if you are having trouble maintaining your appetite. Also, try these tips to stimulate your desire to eat:
If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue, and cancer treatments cause you to use more protein than usual.
Ask your doctor, nurse, or dietitian about high-protein drinks that can help supplement your diet.
If you can, eat high-calorie foods to help you maintain your weight, such as oil, margarine, butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing.
Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, fruit juices, and other liquids, try these foods to increase your intake of fluids: gelatin, pudding, soups, fruit bars, and ice cream.
If you feel full quickly, eat small meals throughout the day instead of 3 large ones.
Keep snacks handy to eat when you are hungry.
Eat with friends or play your favorite music at mealtime to boost your appetite.
Eat your biggest meal in the morning. Many people getting treatment for lymphoma find this is when their appetite is largest.
If you can, increase your activity level. Doing so may stimulate your appetite.
On days you don't feel like eating, don't worry about it. Try again the next day. If you find your appetite doesn't improve in several days, talk with your doctor or nurse.
Bruising and bleeding
Chemotherapy can interfere with your body’s ability to make platelets, which are blood cells that help stop bleeding when you get a cut or bruise. That may lead to a problem called thrombocytopenia. The following are signs of excessive bruising and bleeding. If you notice them, report them to your doctor:
Small red spots under the skin
Signs of blood in your urine (reddish or pinkish color)
Black tarry stools or blood on the toilet paper after a bowel movement
Bleeding from your nose or gums
Vaginal bleeding not related to your period
Headaches or changes in vision
A warm or hot feeling in your arms or legs
If your doctor tells you your platelet count is low, take the following steps to help minimize your risk for bleeding:
Check with your doctor before taking any prescription, over-the-counter, or herbal medications. Some, such as aspirin, may further increase your risk for bleeding.
Check with your doctor before drinking alcohol.
Only use a toothbrush with soft bristles.
Blow your nose gently to reduce your risk for nosebleeds.
Be especially careful not to cut yourself when using knives, scissors, clippers, or other sharp tools.
Be careful not to burn yourself when cooking or ironing.
Avoid contact sports.
Ask your doctor if you should avoid sexual activity.
Use an electric razor instead of a blade, which decreases your risk of cuts.
Diarrhea, which is loose or frequent bowel movements, may lead to dehydration. Radiation and many chemotherapy drugs can cause bowel changes:
Avoid milk and milk products if they make it worse.
Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.
Eat low-residue, low-fiber foods, such as those found in the BRAT diet (bananas, rice, applesauce, and toast).
Increase your intake of fluids, such as water and broth, to prevent dehydration.
Ask your doctor about medications such as over-the-counter Imodium (loperamide) that may help.
Dry or irritated skin
Taking these actions may help soothe dry or irritated skin:
Protect your skin from sun exposure by covering up or wearing sunscreen of at least 15 SPF.
Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don’t use any lotion, soap, deodorant, sunblock, cologne, cosmetics, or powder on your skin within two hours after treatment because they may cause irritation.
Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.
Don’t scratch, rub, or scrub treated skin. After washing, gently blot dry.
Don’t bandage skin with tape. If you must bandage it, use paper tape and ask your nurse to help you place the dressings so that you can avoid irritation.
Don’t apply heat or cold to the treated area. Bathe only with lukewarm water.
If you must shave the treated area, use only an electric shaver, which causes less skin irritation. Don’t use lotion before shaving. And don’t use hair-removal products. Both can irritate your skin.
Keep your nails well-trimmed and clean so you are less likely to scratch yourself.
Not all chemotherapy drugs cause hair loss. Ask your doctor if yours will. If so, these steps may help you minimize or cope with hair loss:
Use a mild shampoo.
Use a soft hairbrush.
Dry hair on a low setting.
Have your hair cut short. This will help hair look fuller. If hair loss occurs, it can be less noticeable with shorter styles.
Use a sunscreen, sunblock, scarf, or hat to minimize sun exposure to your scalp.
Avoid roller-type brushes and styling appliances.
Avoid chemical styling treatments, such as dying, perming, or relaxing your hair.
Use a cover such as a hat, scarf, or turban to cover your hair and conceal hair loss.
Plan ahead. If you will use a wig, you may want to have your hair color and style matched before treatment begins. Wigs can be purchased at retail shops or by mail order or through the Internet. Some insurance companies cover the cost of hairpieces. If yours does, ask your doctor for a prescription.
Talk about your feelings. Hair loss, even temporary, can be hard to accept. It can help to talk with other people who have undergone or are undergoing chemotherapy about their hair loss.
Because chemotherapy and stem cell transplants can weaken your immune system, they can decrease your body’s ability to fight off infection.
Take these actions to reduce your risk for infection:
Wash your hands often, especially before eating and after going to the bathroom or touching animals.
Stay away from people who are sick with an illness you could catch, such as a cold or the flu.
Avoid crowds. If you must go out, choose a time when fewer people will be out, such as during the week or late at night.
Avoid children who have recently been given “live virus” vaccines.
Use an electric razor instead of a blade to minimize the risk for cuts.
Do not cut or tear your cuticles, which can allow germs into your bloodstream.
Take extra care when using knives, scissors, or other sharp objects so that you don’t cut yourself.
Take good care of your teeth and gums because even small wounds can let in germs.
Do not squeeze or scratch cuts or blemishes.
Clean any cuts or scrapes right away. Wash them with soap and warm water, followed by an antiseptic. Continue to wash cuts and scrapes once a day until they heal.
Take a warm bath, shower, or sponge bath every day. Do not use harsh bath products, such as skin scrubs. Do not rub your skin too hard with washcloths or towels.
If your skin is dry or cracked, ask your doctor if lotion or oil will help.
Avoid germs; ask someone else to clean up litter boxes, animal waste, fish tanks, and bird cages.
Avoid standing water, such as bird baths, vases, and humidifiers.
Wear protective gloves when gardening or cleaning.
Do not get any immunizations, such as a flu shot, without asking your doctor first.
Do not eat raw or undercooked seafood, fish, meat, or eggs because they carry bacteria.
Sores on your mouth and lips, called mucositis, may hurt and make eating an unpleasant experience. Radiation and some chemotherapy drugs cause mouth sores. In addition, you may experience a strange taste in your mouth following a stem cell transplant. This is due to the preservative used to freeze the stem cells.
Taking these actions can either help prevent or ease these problems:
Keep your mouth and lips clean and moist. Brush your teeth with a soft-bristled toothbrush after meals and before bedtime. If you normally floss, keep doing so at least once a day. If you don't usually floss, talk with your doctor before you start.
Sip water frequently.
Eat soft and pureed foods, which are easier to swallow if you have a dry mouth.
Suck on sugar-free candies or fruit bars or chew sugar-free gum to increase moisture in your mouth and to help with changes in taste.
Avoid alcohol and mouthwashes that have alcohol in them because they may irritate the sores.
Avoid hot, rough, or spicy foods because they may irritate the sores.
Avoid tobacco because it may irritate or make you more susceptible to sores.
Ask your doctor about topical mouth medications.
Take pain medication, if needed.
Call your doctor or nurse if your temperature reaches 100.5°F (38.1°C) or higher.
Nausea or vomiting
Nausea or vomiting as a result of chemotherapy treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea:
Acute-onset nausea and vomiting occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be five to six hours after treatment, and the symptoms end within the first 24 hours.
Delayed-onset vomiting develops more than 24 hours after treatment.
Anticipatory nausea and vomiting are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.
Breakthrough vomiting occurs despite treatment to prevent it. It requires additional treatment.
Refractory vomiting occurs if you’re no longer responding to antinausea treatments.
To prevent nausea, take these actions. Most nausea can be prevented:
Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.
If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.
To help ease nausea or vomiting if you have it, try these tips:
Try eating foods and drinking beverages that were easy to take or made you feel better when you’ve had the flu or were nauseated from stress. These may be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.
Do not eat fatty or fried foods, very spicy foods, or very sweet foods.
Eat room-temperature or cold foods. The smells from hot foods may make your nausea worse.
Ask your doctor or nurse if he or she can help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.
Ask your doctor or nurse about using acupressure bands on your wrists, which may help decrease your nausea.
Tiredness is a very common symptom of cancer and can also be a side effect from chemotherapy and radiation treatments. You may feel only slightly tired, or you may suffer from extreme fatigue.
Take these actions to help increase your energy level. Fatigue can last several weeks after treatment ends:
Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.
Add mild exercise, such as walking, to your daily routine. It may help you sleep better.
Save your energy for important tasks.
Drink plenty of fluids. Dehydration leads to increased fatigue.
Take action to treat a poor appetite, because eating improperly can make you tired.
If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.