Chemotherapy Side Effects

Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. Unfortunately, cancer cells aren't the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the chemotherapy is going to affect them, too.

These body parts, however, have an advantage over cancer cells in that your body can repair the damage that chemotherapy does to your normal cells. This explains why your hair will grow back, your energy levels will rise, and your infections will clear up. And while your body is fighting back, supportive medications can help you control many of the side effects of chemotherapy.

While many side effects of chemotherapy fade quickly, others may take months or years to disappear completely. For example, some women experience discomfort in their hands and feet from nerve damage related to the taxanes (Taxol or Taxotere), which can persist for months. It is possible (though uncommon) that chemotherapy may cause permanent side effects. Considering these possible side effects is part of the careful process of weighing benefits versus risks that you will have to do with your medical team.

Here are some of the more serious potential side effects that you will want to be aware of and discuss carefully with your oncologist:

• Chemotherapy can lead to bone loss. Women past menopause do not produce enough hormones to maintain strong bones. Over time, thinning bones may develop into osteoporosis and increase your risk of serious fractures. If you are still pre-menopausal when you begin chemotherapy, your ovaries may stop making hormones, putting your bones at risk. The combination CMF is more likely to stop the ovaries from making hormones compared to treatment that contains Adriamycin.
• The taxanes Taxol and Abraxane can cause more discomfort in the hands and feet from nerve damage than Taxotere. This can be temporary or permanent. Your doctor may refer to this as neuropathy. Lowering the dosage of Abraxane improves the neuropathy in most women.
• Taxotere has also been found to irritate tear ducts and cause excess tearing. If it persists and bothers you, it can usually be treated by inserting tiny silicone tubes into the "pipes" that drain the tears.
• Adriamycin can have a toxic effect on the heart; your doctor will work to minimize this risk by carefully keeping your total drug dosage within a safe range. Read an article about other chemotherapy drugs that may have greater benefits for women with early-stage cancer.
• In very rare cases, cyclophosphamide (brand name: Cytoxan) may cause a treatment-induced leukemia (cancer of the blood cells).

It's impossible to list the specific side effects of every medication. Your experience with a particular drug is strongly influenced by what you've already been through and what other drugs you're taking at the same time. You and your doctor are the only people who can determine whether the expected benefits from your chemotherapy outweigh any problems you may be having. And your doctor can give you the most realistic sense of what to expect.

Here's a look at the most common side effects of chemotherapy, as well as medications and lifestyle suggestions that can help you cope with them:

• nausea
• vomiting
• diarrhea
• hair loss
• fatigue
• anemia
• infection
• mouth sores
• taste and smell changes
• menopause or menopausal symptoms
• fertility
• memory loss
• problems with hands and feet (neuropathy)