Lung Cancer

Other Side Effects of Treatment

Fear of treatment-related side effects can increase the stress of a person with lung cancer, but you can prevent and manage side effects. All treatments have side effects, but they vary from person to person. Not everyone who gets the same treatment will have the same side effects. Some may be minor inconveniences, while others may cause more discomfort, pain or emotional distress. Described here are some of the most common side effects of lung cancer treatment along with suggestions for managing them.

Bone loss

Cancer and its treatments, including radiation therapy and chemotherapy, can cause loss of bone mass. Bone density is lost when the cells that rebuild bone are not replaced as fast as they get destroyed. As a result, bones become thin, porous and brittle. Bone loss also occurs when cancer metastasizes (spreads) to bone.

Once bone is lost, it cannot be replaced. Your doctor can monitor your bone mass with bone density scans taken before, during and after treatment. Several bone-modifying agents that prevent or delay bone fractures can be prescribed. External-beam radiation therapy can be used to relieve symptoms of bone loss, and low-level radiation can be injected into your veins if you have multiple sites of painful metastases.

Tips to try:

  • Get enough calcium by eating dairy products, leafy greens and beans. Get enough vitamin D by eating salmon or fortified breakfast cereal. Or, with your doctor’s approval, take supplements to ensure you get plenty of both.
  • If possible, exercise daily to help stimulate bone-forming cells.
  • Reduce your risk of falling by wearing shoes that fit well and by eliminating clutter in your home. Maintaining a healthy weight can help to prevent bone fractures.

Cough and upper respiratory infection

Common side effects of targeted therapy and immunotherapy include a cough or an upper respiratory infection. These may subside as your body adjusts to the treatment. If they persist or you become concerned, talk to your doctor.

Diarrhea

Diarrhea is the passing of loose or watery stools three or more times a day, which may cause abdominal cramps, rectal pain and/or discomfort. When mild, diarrhea is an inconvenience but, left untreated, it can lead to serious problems, such as dehydration, loss of important nutrients, weight loss and fatigue. If you have diarrhea, don’t be embarrassed to talk to your doctor. It is a common problem.

Tips to try:

  • Along with drinking six to eight glasses of water per day, try Gatorade, Pedialyte or even broth.
  • Eat foods that are easier to digest (such as applesauce, bananas, boiled white rice, mashed potatoes, plain toast and crackers).
  • Avoid high-fiber foods, caffeine, alcohol, fried or greasy foods, creamy sauces, spicy foods, dairy and chocolate.

Fatigue

The fatigue that can come with cancer and its treatment is stronger and lasts longer than typical fatigue. For some people with lung cancer, fatigue persists even when they get enough sleep. Fatigue often occurs with chemotherapy and radiation therapy.

Tips to try:

  • Accept help from others who volunteer to prepare meals, complete chores and perform other tasks.
  • Be active, if you can do so safely and comfortably. Regular moderate exercise, especially walking, decreases fatigue.
  • Set a routine for sleeping and waking. Try to get eight hours of sleep per night.
  • Nap when you can, but try to keep naps to about 30 minutes. Longer naps can reduce your energy level.
  • Conserve energy. Do the most important things when you have the most energy.

Hair loss (alopecia)

Hair loss can be one of the most emotionally difficult side effects of cancer treatment. Chemotherapy targets quickly dividing cells, and hair follicle cells as well as cancer cells divide quickly. As a result, chemotherapy can harm your hair follicles and you may lose hair on your head along with your eyebrows, eyelashes, pubic hair and other body hair. Radiation therapy can also cause hair loss in the treated area. Not everyone receiving these treatments will experience hair loss.

Tips to try:

  • Buy a wig before treatment. Asking a stylist to cut and color the wig to more closely match your current look may make you more comfortable.
  • Your health insurance may cover wigs. Ask your doctor for a prescription for a “cranial prosthesis.”
  • Shop for turbans, scarves and hats.
  • Use a soft brush or wide-toothed comb, and be gentle when brushing or combing your hair.
  • Don’t use hair dye or hot styling tools such as rollers or curling irons.
  • Sleep on a satin pillowcase.
  • Avoid elastic hair bands.
  • Use a mild shampoo and conditioner.

Loss of appetite (anorexia)

The loss of appetite or desire to eat is a common symptom of cancer and its treatments. To prevent weight loss, try to maintain a nutritious diet during and after treatment.

If you cannot eat enough food to maintain your weight, talk to your doctor.

Tips to try:

  • Discuss nutrition counseling with your medical team.
  • If eating is too difficult, ask your doctor about adding supplements to your diet.
  • Eat smaller meals frequently throughout the day rather than two or three big meals.
  • Have healthy snacks between meals.
  • Stick to a schedule of eating meals and snacks at the same time each day, even when you are not hungry.
  • Keep snacks handy. People tend to eat more when food is readily available.
  • At times when your appetite is not good, rely on foods you really like.

Nausea and vomiting

Nausea is feeling sick to your stomach and may come with an urge to vomit. Nausea and vomiting are often caused by chemotherapy but can be caused by other treatments for lung cancer, too. Your doctor may prescribe medicines to prevent or reduce nausea before or during your treatment.

Tips to try:

  • Eat smaller, more frequent meals throughout the day instead of three big meals a day.
  • Eat when you feel best. You don’t have to stick to a standard meal schedule.
  • Avoid spicy, citric and fatty foods. Bland foods, such as rice, bananas and crackers, are easier to digest.
  • Try soothing foods and drinks that include ginger, such as ginger ale or ginger tea. Peppermint can also relieve nausea.
  • Drink plenty of fluids.

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 include numbness, pain, burning, tingling or loss of feeling in the hands or feet. If you have these symptoms, write down when they happen, how long they last and how intense they are. Be as specific as possible so you can share the information with your medical team.

Chemotherapy can cause neuropathy, but not everyone who receives chemotherapy will experience it. If you do, your doctor may switch to a different chemotherapy drug or change how your chemotherapy is given. Your doctor may prescribe pain medicines, steroids or numbing creams or lotions.

Tips to try:

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

Neutropenia (low white blood cell count)

White blood cells are quickly dividing cells that are affected by chemotherapy. White blood cells are the cells that fight infection, and if too many are destroyed, the condition is known as neutropenia. The risk of infection is higher for people with neutropenia. Although chemotherapy is the most common cause of neutropenia, it can be caused by something else.

People with neutropenia usually do not know they have it because there are no obvious symptoms. You usually learn you have neutropenia by having a blood test. However, you can watch for symptoms of infection. The most important one is fever.

Tips to try:

  • Wash your hands often, and encourage people who come into contact with you to do the same.
  • Avoid contact with sick people.
  • Clean and bandage all wounds.
  • Avoid raw foods, large crowds, and swimming in hot tubs, ponds, lakes and rivers.

Skin reactions

Dry, itchy skin, red, itchy rashes and acne-like rashes are common side effects linked with immunotherapy and targeted therapy. Skin reactions can range from mild to severe. Small rashes that are not uncomfortable or infected usually don’t require treatment. If the rash spreads over a larger area and causes itchiness or pain, your doctor may prescribe a mild corticosteroid cream or an antibiotic gel. Severe rashes are usually treated with an oral antibiotic and perhaps an oral corticosteroid.

Other types of treatment can cause skin reactions. People taking certain chemotherapy drugs have an increased risk for skin photosensitivity, which is an inflammation of the skin caused by the combination of sunlight and certain medications or substances. Photosensitivity leads to redness of the skin similar to sunburn.

Skin reactions caused by radiation therapy often begin about two to three weeks after the first treatment and typically resolve within a few weeks after treatment ends. In some cases, the treated skin may stay darker than it was before. These skin reactions are usually minor and do not require treatment.

Tell your doctor about symptoms as soon as they appear, as early treatment can prevent skin reactions from becoming severe.

Tips to try:

  • Ask your doctor about possible side effects, and discuss them with your dermatologist before beginning treatment.
  • Use a mild soap in the shower, and avoid soaps and laundry detergents with strong scents and perfumes. Shower with lukewarm water and avoid long, hot showers.
  • Apply a cream-based moisturizer to all of the skin within five minutes of showering or bathing. Use hypoallergenic moisturizers that do not have perfumes or preservatives.
  • Avoid the sun, and use a sunscreen with a sun protection factor (SPF) of at least 15. If the sunscreen causes a burning sensation, try sunscreens that contain zinc oxide or titanium dioxide.
  • Don’t use medicines that treat acne because these may dry or irritate your skin even more.

 

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