Tips to Manage Common Chemotherapy Side Effects Effectively

Here’s how to manage physical and psychological chemotherapy side effects. Seek medical attention when these become severe.

Woman wearing a baby blue-coloured beanie and smiling

Undergoing chemotherapy in cancer treatment is not only mentally exhausting for a patient but can also aggravate various physical side effects. The severity of these can vary from person to person. Additionally, some chemotherapy drugs can induce long-term implications. 

Here are the reasons behind some chemotherapy side effects, and ways to address them effectively. 

Woman holding her face while grimacing as she experiences dizziness
Anaemia can present as dizzy spells.

Identifying Six Prominent Chemotherapy Side Effects 

Before prescribing a combined use of chemotherapy drugs, your oncologist will first analyse the possible interactions that may occur with the combination of over-the-counter medicine, vitamins or other health supplements.

Hair loss 

People who lose hair will see it take place within a few weeks of the first treatment session.

Temporary hair loss usually occurs from the head but can sometimes affect the arms, legs, and face. 

Anaemia  

Chemotherapy can also lower your body’s red blood cell count. These cells transport oxygen from the Lungs to the body’s tissues. Subsequently, the tissues utilise oxygen to produce energy and release carbon dioxide. However, a decline in red blood cells can increase a person’s risk of developing anaemia. The signs of this condition include: 

  • Fatigue 
  • Heart palpitations 
  • A pale complexion 
  • Shortness of breath 

Likewise, Traditional Chinese Medicine (TCM) believes that bone marrow suppression stems from Blood and Qi Deficiency, Blood and Jing (essence) Deficiency, and Blood Stasis. “Chemotherapy drugs may inhibit the growth of bone marrow, and elicit symptoms like fatigue, insomnia, vertigo, dizziness, heart palpitations, shortness of breath, and a pale complexion,” explains Real Health Medical Chief TCM Physician Chu I Ta.

Separately, chemotherapy reduces blood platelets, which help stop severe bleeding from a cut or injury. A poor platelet count can make a person prone to bleeding gums, severe nosebleeds, and easily-bruised skin. 

Infections 

White blood cells – also known as neutrophils – are responsible for helping the human body stave off infections. Someone undergoing chemotherapy treatment will see a decrease in their body’s white blood cells.

Stress, an unhealthy diet and a lack of sleep weaken the immune system. A combination of these risk factors can make a person vulnerable to infections. It’s worth noting that an infection can provoke multiple symptoms, such as: 

  • Diarrhoea 
  • Chills 
  • Skin rashes 
  • A cough or sore throat 
  • A stiff or sore neck 
  • A fever that’s 38˚C or higher  
  • A white coating in your mouth or on your tongue 
  • Ear or sinus pain, or a headache 
  • Bloody or cloudy urine, or pain when urinating 

Gastrointestinal disorders 

In TCM, gastrointestinal disorders happen when Liver Qi Invades the Stomach, or when there’s Dampness and Phlegm Stagnation, Spleen and Stomach Deficiency, and Stomach Yin (passive energy) Fluid Deficiency.

Consequently, symptoms like nausea, vomiting, diarrhoea and oral ulcers will arise. Liver damage may also occur, with high bilirubin, alanine transaminase, aspartate transaminase, and alkaline phosphatase readings during a blood test.

Neuropathy and neurotoxicity 

Neuropathy and neurotoxicity can arise from Spleen Qi (vital life force) Deficiency, and Phlegm Stagnation and Blood Stasis.

“High dosages of chemotherapy drugs can result in sensory neuronopathy, and a toxicity of the central and peripheral nervous systems. Toxicity of the central nervous system may damage the cerebellum and lead to symptoms like dementia and poor memory. Numbness of the face, mouth, fingers and extremities can also transpire after chemotherapy,” says physician Chu. 

Skin and nail changes 

The use of specific chemotherapy drugs can also give rise to temporary changes in the appearance of your skin and nails.

For instance, a person’s skin will become dry, itchy, slightly discoloured, or red and sore. It can also be sensitive to sunlight exposure. Fingernails, meanwhile, can become flaky or brittle and white lines may also develop.

Woman smiling as she brushes her hair with a soft-bristle brush
Brushing hair with a soft-bristle brush can help manage hair loss during cancer treatment.

Tips to Manage Chemotherapy Side Effects 

The majority of side effects are short-term and manageable. These may improve gradually after a person completes treatment and their body generates new, healthy cells. 

Adhere to a customised hair care regimen 

Generally, following a particular set of tips can help with hair loss management. 

  • Keep your hair and scalp clean using baby shampoo 
  • Apply a lotion that contains moisturiser to your head 
  • Comb or brush your hair gently with a large comb or soft-bristled hairbrush 
  • Use a cotton, polyester or satin pillowcases for your pillows 
  • Wear a light, cotton head cover or beanie if you feel cold at night 

Another effective way to reduce or prevent hair loss is to use a ‘cold cap’. The cap is worn during chemotherapy, and is attached to a cooling unit that fills the cap with cold liquid. It helps to briefly minimise blood flow and chemotherapy drug quantity that reaches the scalp.

Switch up your daily routine 

It’s normal to feel extremely tired after chemotherapy. Thus, you should allow your body to recover by taking regular breaks.

In doing so, you’ll be able to plan activities for periods when you feel most energetic. Incorporating light to moderate workout routines can ease fatigue and boost your mood. 

Consume herbal formulas 

According to physician Chu, proposing the right formula starts with differentiating the syndromes that relate to distinct chemotherapy side effects. To treat gastrointestinal disorders, physician Chu recommends the use of: 

  • Pinellia and Magnolia decoction (Ban Xia Hou Po Tang, 半夏厚朴汤) for Liver Qi Invasion of the Stomach 
  • Two-matured Ingredients Decoction (Er Chen Tang, 二陈汤) and Poria, Cinnamoni Twig, Ovate Atractylodes and Liquorice Decoction (Ling Gui Zhu Gan Tang, 苓桂术甘汤) for Phlegm-Stagnation and Dampness 
  • Si Jun Zi Decoction (四君子汤) for Spleen and Stomach Deficiencies  
  • Ophiopogon Decoction (Mai Men Dong Tang, 麦门冬汤) for Stomach Yin Fluid Deficiency 

Bone marrow suppression can be addressed by consuming formulas likesuch as: 

  • Eight-treasure Decoction (Ba Zhen Tang, 八珍汤) for Blood and Qi Deficiencies 
  • He Che Da Zao Wan (河车大造丸) and Tao Hong Si Wu Tang (桃红四物汤) for Blood and Jing Deficiencies  

Neuropathy and neurotoxicity, on the other hand, can be remedied with:  

  • Bu Zhong Yi Qi Tang (补中益气汤) for Spleen Qi Deficiency  
  • Two-matured Ingredients Decoction (Er Chen Tang, 二陈汤) and Tao Hong Si Wu Tang (桃红四物汤) for Phlegm Stagnation and Stasis 

Stimulate acupoints 

Applying daily acupressure to acupoints like Zu San Li (ST36, 足三里), Nei Guan (PC6, 内关), San Yin Jiao (SP6, 三阴角), Zhong Wan (CV12, 中脘), Guan Yuan (CV4, 关元), and He Gu (LI4, 合谷) can also alleviate the symptoms of neuropathy and neurotoxicity. 

Ultimately, you should seek immediate medical attention if chemotherapy side effects impair your ability to function. If you wish to use herbal formulas, speak to an oncology-trained TCM practitioner beforehand. Having this conversation can help you avoid potential contraindications.

References

  1. American Cancer Society. Chemotherapy Side Effects. [Accessed 24 March 2022]
  2. NHS. Chemotherapy. [Accessed 24 March 2022]
  3. Cleveland Clinic. Function of Red Blood Cells. [Accessed 24 March 2022]
  4. NATIONAL CANCER INSTITUTE. Infection and Neutropenia during Cancer Treatment.  [Accessed 24 March 2022]
  5. Cancer Council Victoria. Chemotherapy. [Accessed 24 March 2022] 

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