Head & Neck

Side Effects

People with head and neck cancers often have side effects from treatment. Knowing the side effects to watch for — and what to do if they happen — will help you improve your quality of life.

Not every person has the same response to treatment. Even if these side effects don’t apply to you right now, it’s a good idea for you and your caregiver to be aware of what to watch for in case your treatment changes.

Tell your health care team as soon as any side effects begin.You can take some steps at home to control them, and your health care team can help before the side effects become severe.

If you are having trouble eating because of oral pain or discomfort, see Dental Side Effects for ways to manage dental and oral side effects.

Diarrhea

Treatment for head and neck cancer can irritate the bowel lining, which may cause diarrhea. If left untreated, diarrhea can become severe and even life-threatening.

What to try

  • Drink plenty of fluids, including water and other clear liquids, such as broth.
  • Eat several small meals throughout the day rather than three big meals.
  • Eat bland, low-fiber foods such as boiled white rice, boiled chicken or white bread.
  • Eat foods that have potassium such as boiled or mashed potatoes and bananas.
  • Avoid alcohol, caffeine and fatty foods.
  • Ask your doctor about using over-the-counter anti-diarrheal medications.

Fatigue

The fatigue related to cancer and its treatment is different from the fatigue that healthy people feel. It usually lasts longer, is more severe and is unrelieved by sleep.

What to try

  • Take frequent rests or naps, but limit each nap to 45 minutes.
  • Sleep eight hours each night.
  • Participate in regular physical activity, such as walking, yoga or bike riding.
  • Set a routine for sleeping and waking.

Hair loss (alopecia)

Hair loss is often caused by chemotherapy and radiation therapy. Hair loss associated with chemotherapy can occur all over the body, affecting not only the head but also the eyebrows, face, chest, pubic area, etc. Hair loss associated with radiation therapy occurs only in the area receiving radiation.

What to try

  • Use a soft-bristled hairbrush or wide-toothed comb.
  • Avoid using hair dye and heating devices (dryers, curling irons, etc.).
  • Sleep on a satin or silk pillowcase.
  • Do not use hair elastics.
  • Use a gentle, pH-balanced shampoo.

If you decide you want to wear a wig, ask your oncologist to give you a prescription for “cranial (or skull) prosthesis due to alopecia caused by chemotherapy for cancer.” A prescription phrased this way may increase the likelihood that your insurance company will cover the cost of the wig.

Loss of appetite (anorexia)

Loss of appetite is common among people with head and neck cancer because treatment may make eating more difficult.

What to try

  • Eat foods high in calories that are easy to eat (such as pudding, milkshakes or cream-based soups).
  • Use butter, oils and milk in food to increase calories.
  • Try liquid meals or protein shakes if you don’t feel like eating foods.

Nail and skin changes

Radiation therapy and some targeted therapy drugs can cause brittle nails or nail blemishes and skin changes, such as redness, rash and dryness.

What to try

  • Avoid cutting your cuticles.
  • Use mild, unscented soap.
  • Wear gloves when you work with your hands.

Nausea and vomiting

Nausea and vomiting can cause severe dehydration and interrupt your treatment plan. Talk to your health care team about adding antiemetics (anti-nausea drugs) to help control your nausea or about whether the dose of your anticancer drug can be lowered.

What else to try

  • Eat five or six small meals instead of three large meals, and eat a light meal a few hours before receiving certain treatments.
  • Drink plenty of fluids throughout the day.
  • Identify and avoid foods, drinks or smells that trigger nausea.
  • Sip ginger ale or suck on peppermints to settle your stomach.
  • Avoid alcohol, spicy foods and caffeine.
  • Wait to exercise until you’ve had time to digest your meal.

Neuropathy

Neuropathy is pain or discomfort caused by damage to the peripheral nervous system, which includes the nerves that control movement and feeling in the arms and legs. Symptoms of neuropathy are numbness, pain, burning, tingling or loss of feeling in the hands or feet. If you have these symptoms, keep a journal of when they happen, how long they last and how intense they are. Share the information with your health care team.

What to try

  • Wear comfortable shoes and loose clothes.
  • Keep your hands and feet warm.
  • Avoid standing or walking for long amounts of time.

Neutropenia and increased risk of infection

Neutrophils are a type of white blood cell that helps prevent infections. When the number of neutrophils drops to an abnormally low level, the condition is known as neutropenia. Neutropenia increases your risk for infection and makes it more difficult for infections to resolve.

What to try

  • Wash your hands often.
  • Avoid sick people and crowded places.
  • Wear gloves when doing dishes or gardening.
  • Ask your doctor about drugs that may help you produce more white blood cells.

For more in-depth information on side effects please visit our Treatment Side Effects section.

Additional Resources

 

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