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The side effects a breast cancer patient experiences while undergoing chemotherapy vary significantly
depending on several factors, including the types of drugs used, their dosages, and the
duration of treatment. This section discusses some of the possible side effects that breast
cancer patients may experience. Some patients experience few to no negative effects from
chemotherapy. In most cases, the benefits of treating cancer with chemotherapy far outweighs
the risks or inconveniences of any side effects.
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Most common side effects of chemotherapy:
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Some chemotherapy drugs may irritate the lining of the stomach or intestines. Examples of drugs
that may be more likely to cause nausea or vomiting include cisplatin, cyclophosphamide, doxorubicin,
etoposide (high doses), etc. Sometimes, nausea and vomiting occur within a few minutes of or after
treatment. At times, patients may experience "anticipatory" nausea, in which symptoms develop before
a treatment due to psychological associations. In most cases, drugs may be prescribed to help reduce
nausea or vomiting due to chemotherapy. See the Coping with Side Effects of Chemotherapy section for
more information.
Hair loss (alopecia) is another fairly common side effect of chemotherapy. Hair loss, which is
temporary, may occur in some women because hair follicles are weakened by chemotherapy, causing
hair to fall out at a much faster rate than normal. Most patients who experience hair loss will
not begin losing their hair until after the second chemotherapy session and will find that it
grows back, sometimes with a change in texture, after the chemotherapy is complete. There are
several options available for women who lose their hair during chemotherapy, including a variety
of wigs and head wear. Click here to learn more about coping with hair loss during
chemotherapy.
Low blood cell counts (white and red blood cells) and platelet counts are other possible side
effects from chemotherapy. White blood cells are an essential component of the body's immune
system. Normal white blood cells counts range between 4,000 and 10,000 white blood cells per
cubic millimeter. A low white blood cell count is called leukopenia. There are several types
of white blood cells, including neutrophils, which help the body fight
infection. Neutropenia is the term used for a sharp decrease in
the number of neutrophils. Special guidelines should be followed to avoid infection if
this occurs. Neutropenia can usually be treated with agents used to stimulate the immune system
and should always be monitored closely by the patient and her treating
physician. Click here for more information on neutropenia.
Chemotherapy can also cause a reduction in the number of red blood cells. Normally, the blood
has between 4.0 and 6.0 million red blood cells per cubic millimeter. A lack of red blood
cells can cause anemia. Anemia is a condition that may be associated with fatigue, dizziness,
headaches, irritability, and an increase in heart rate or breathing. Anemia can sometimes be
treated with drugs (see the Coping with Side Effects of Chemotherapy section below). In some
cases, low blood cells counts may require transfusions.
Low platelet counts can also occur in patients who undergo chemotherapy. The normal range for
platelet counts is between 150,000 and 450,000 platelets per cubic millimeter. Patients who
suffer from low platelet counts are said to have thrombocytopenia. Symptoms of low platelet
counts include the tendency to bruise easily (or develop small and large bruises), to bleed
longer than usual after cuts, or to have nosebleeds or bleeding gums. In severe cases, patients
with low platelet counts may experience internal bleeding. Platelet transfusions may be necessary
in some cases to elevate the number of platelets in the blood. Drugs such as operlvekin
(brand name, Neumega) may also be prescribed in some cases.
Cancer patients who undergo chemotherapy should also be aware that chemotherapy drugs can cause
infertility or premature menopause. The closer a woman is to menopause when she undergoes
chemotherapy, the more likely she is to experience premature menopause. Women who are given
chemotherapy often experience symptoms of menopause, such as hot flashes, vaginal dryness, and
irregular menstrual cycles. These symptoms are not uncommon and can often be managed adequately
with many different regimens. Any of these changes should be discussed with the physician or nurse
administering the chemotherapy. Chemotherapy drugs can also cause birth defects; therefore, it is
essential that women who are able to conceive use birth control during chemotherapy. Couples may
also wish to discuss banking sperm or eggs prior to chemotherapy if they wish to have children in
the future.
Other side effects of chemotherapy may include:
- Infection
- Mouth sores
- Taste changes
- Decreased appetite
- Diarrhea or constipation
- Tingling or burning sensations
- Numbness in hands and/or feet
- Skin irritations (redness, itching, peeling, or acne)
- Dark, brittle, or cracked fingernails or toenails
- Kidney/bladder infections
- Flu-like symptoms after chemotherapy sessions
- Fluid retention
When patients begin tamoxifen or any other chemotherapy regimen, they may
experience a "flare" reaction in which bone or tumor pain increases. This
may be a sign that the tumor is responsive to the treatment. Supportive
measures and pain control are generally offered until the acute "flare"
phase subsides. However, patients should discuss any bone pain with their
physicians, especially if pain persists.
In addition, certain chemotherapy drugs carry additional risks. For example, the drug
doxorubicin (brand name,
Adriamycin) can cause permanent heart damage in some patients when taken in high doses over a
long period of time. Patients should be tested for heart problems before beginning Adriamycin
and should be continuously monitored for developing problems during treatment.
Despite this long list of potential side effects, the benefits of treating cancer with chemotherapy
drugs outweighs the risk of complications for most women, and effects are often tolerable with
proper care and rest.
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