Coping with side effects

You will find that there are physical changes as well as many emotional changes to cope with. It is important that you and the people around you are prepared. This could include your partner, employer and family members.

Tiredness

Many people find that tiredness is a major problem.

Travelling to and from hospitals and clinics for treatment and appointments is very tiring. If you work during the treatment or if you have a home and a family to care for, you will almost certainly be very tired. Some people having cancer treatment say their tiredness is overwhelming and unlike any tiredness (fatigue) they have felt before. Sometimes it cannot even be fully relieved with rest.

Your tiredness may continue for quite a while, even after treatment has finished. Some people find that it takes them up to one or two years to feel really well again. It may help to talk with your family and friends about how you feel and discuss ways in which they can help you. You may need to plan your activities during the day so that you get regular periods of rest. The Cancer Society has an information sheet titled "Cancer-related Fatigue". To receive a copy, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237), contact your local Cancer Society for a copy or view and download a copy on the Cancer Society's website.

If your fatigue is caused by low levels of red blood cells or the side effects of drugs that you are taking, your doctor will be able to treat this.

Tips that will help relieve your tiredness

Not all of these things will work for everyone but you may be surprised how small changes can help to save your energy:

  • Plan your day. Set small, manageable goals.
  • Don't be afraid to ask for help: ask a friend to do the shopping or come to clean the house once a week.
  • Try not to rush: leave plenty of time to get to appointments.
  • If you are fit enough and your doctor has said it is okay, get some exercise. This may be the last thing you feel like doing, but research shows that exercise can boost energy levels and make you feel better. Even if you just walk around the garden or block a few times a week, it all helps.
  • Smoking reduces your energy. If you smoke, talk to your doctor or the Quitline on 0800 778 778 about stopping.
  • If you have young children or grandchildren, try to play with them sitting or lying down: board games, puzzles and drawing are good ideas.
  • Eat nutritious meals and snacks throughout the day to keep your energy levels up.
  • Try to take some time out to do things that you enjoy.
  • For example, having a relaxing bath, listening to some music or just being with your pet may help you relax and, for a short time, take your mind off how tired you feel.
  • Use Facebook, texting and emails to update friends and family on how you are.
  • Use an answerphone to filter calls.

"It took me another three months after treatment to get over it. Having it every day, you get tired by the end of the week. I was determined — we got through it." Reg

Join a Cancer Support Group or education programme. Talking about your feelings can ease the burden of fatigue, and you can hear how other people in similar situations have managed. To find a group, call the cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237) or contact your local Cancer Society.

Side effects of chemotherapy and radiation treatment: Fever, nausea and vomiting

If you are having treatment, you may not feel well. Treatment (including surgery, chemotherapy and radiation treatment) can cause a variety of symptoms, including fatigue, nausea, vomiting, fever and infections. While some of these side effects are unpleasant, others can pose risks to your health and recovery.

Fever and infection are much more common with chemotherapy than they are with radiation treatment. A fever can be a sign that your body has an infection. Fevers can also cause other problems, such as chills, shivering and headaches. It is important, therefore, to investigate the cause of infection and to treat it appropriately. It is also possible to have an infection but to not have a fever – just to feel unwell. In either case, contact your doctor immediately.

If fever develops (if your temperature is 38 degrees or over) or you feel unwell, even with a normal temperature, don't wait to see what happens – take action quickly. Contact your cancer doctor or nurse and follow the advice given.

Many people are aware that nausea and vomiting are common side effects of chemotherapy. With radiation treatment, nausea and vomiting may occur depending on the site of the treatment. There are some things you can do to help with nausea:

  • Follow instructions for anti-nausea medicine.
  • Get plenty of rest.
  • Relax and try to distract yourself.
  • Wear loose-fitting clothes.
  • Rinsing can help remove a bad taste in your mouth.
  • Try taking small sips of fluids or sucking on ice cubes.
  • Crackers or toast can help.
  • Have another person stay with you.
  • See the Cancer Society booklet Eating Well During Cancer Treatment for further hints on managing nausea.

Nausea and vomiting can be signs of a serious problem, especially if they interfere with your ability to take oral medication or cause bleeding or pain. Nausea and vomiting may be due to causes other than chemotherapy or radiation treatment and should be investigated by your cancer doctor or nurse.

Hair loss

Some chemotherapy drugs cause hair loss due to weakened hair follicles. Depending on the type of chemotherapy you receive, hair loss may start anywhere from seven to 21 days after treatment begins. After treatment finishes your hair will re-grow slowly, sometimes over a period of months. Radiation treatment to the head or scalp, however, can cause permanent hair loss.

Hair can come out at different rates. It may come out in handfuls or it may come out in patches. Your head can be sensitive when you lose your hair.

A government subsidy is available towards the purchase of a wig or head covering. A medical certificate is required for this. Your cancer treatment centre should provide you with the form and certificate.

Look Good … Feel Better

For women having treatment for cancer, Look Good…Feel Better is a programme teaching make-up and skin care techniques. Wig suppliers are also there to show you wigs, turbans and scarves.

"I"d always been proud of having really long hair and I think I coped well. I got it cut shorter and shorter as I came up to treatment." June

Bowel problems

After surgery or cancer treatments – such as radiation treatment and chemotherapy – some people have problems with their bowels; for instance, constipation, diarrhoea or wind pain. Talk to your doctor, nurse or dietitian about your symptoms. There may be some simple treatments they can advise. Some people may need to change their diet or take medication.

Some chemotherapy drugs are known to cause diarrhoea. You may be prescribed medication to control this. Make sure you take this medication as prescribed. If diarrhoea persists, seek medical attention and advice quickly.

If bowel problems develop or carry on after treatment, contact your cancer doctor.

Lymphoedema

Lymphoedema is swelling of part of the body, usually the legs or the arms. It may occur after treatment for cancer if you have had lymph nodes removed. Removal of the nodes may prevent normal draining of the lymph fluid. As a result, fluid can build up causing swelling. This usually does not occur until sometime after the original treatment.

It isn't possible to predict whether you will have problems with lymphoedema. If you do have problems, seek immediate help as symptoms are better managed if treated early. Seek advice from your specialist or nurse.

Some hospitals have lymphoedema physiotherapists who can advise you on how you may be able to reduce your risk of developing lymphoedema. They can also help you manage if lymphoedema does occur in the future.

Bladder problems

Bladder sensations or control may change after cancer treatment or surgery. Some people find they need to go to the toilet more often. Others find they need to go in a hurry and sometimes don't get there in time. Others find that they pass urine when they cough or sneeze. While these problems may improve, even a small loss of bladder control can be distressing.

If bladder control is a problem, you should seek help. Your specialist or GP will be able to suggest ways to help with bladder control. These may include exercises to strengthen the muscles of your pelvic floor. You may be referred to a physiotherapist. For more information, phone the New Zealand Continence Association Helpline on 0800 650 659. Some hospitals have continence nurses who can help you with bladder problems.

Managing cancer pain

If pain is present it could be caused by many things. Pain can be a side effect of treatments, such as chemotherapy, radiation treatment, surgery or a medical procedure. Pain can occur because of a tumour pressing on bone, nerves or body organs. Infection can cause pain. Pain can develop from conditions unrelated to cancer, such as headaches, arthritis and muscle strain. Early treatment is always more effective.

It is important to understand that pain does not always occur with cancer.

"When it was painful I transported myself to the fresh fruit market at home. I remembered songs that have no words that reminded me of home, like streams and natural sounds. I imagined myself at moments throughout my lifetime — special places on the beach, certain things we did as children. I took myself there." Silei

Coping with a sore mouth, dry mouth or mouth infections

A sore mouth or dry mouth and mouth infections are common problems for people having treatment for cancer. Early treatment of any resulting infections can improve sore mouths and dry mouths.

A sore mouth is often referred to as mucositis or, less commonly, stomatitis. Causes of sore mouth include:

  • chemotherapy: a sore mouth may be a direct effect of some chemotherapy drugs
  • radiation treatment to the head and neck region
  • the cancer itself if it is in the mouth
  • some medications, such as steroids and antibiotics, which can cause mouth ulcers and/or infection.

Follow the recommendations of your cancer nurse or doctor for the care of your mouth. Don't buy over-the-counter mouthwashes – these often contain alcohol, which will dry your mouth.

Mouthwash recipe to use

1 teaspoon salt

1 teaspoon baking soda

4 cups water

Add lemon juice for flavour if desired (although this may sting if your mouth is tender and sore).

"I find carbonated drinks are painful on the tongue, but the effect can be reduced by stirring the drink with a fork to release a lot of carbon dioxide. I call this the 'forking’ technique. In the early months after radiation treatment, even a small glass of lemonade caused pain until it was 'forked"." Brian

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