Head & Neck

Side Effects

Knowing the side effects to expect and what to do if they do occur will make you more confident and better prepared to complete your treatment. Your health care team will work with you to identify, prevent and manage any side effects that may occur during and after treatment.

Immune-related adverse events (IRAEs) are the most serious side effects of immune checkpoint inhibitors, a type of immunotherapy. They are not common but can occur when treatment overstimulates the immune system, causing inflammation, swelling or redness. Close monitoring is crucial because symptoms may come on suddenly and require immediate medical attention.

Your doctor can advise you when to call the office or seek emergency care. Following are some common side effects and ways to manage them at home.

Anorexia (loss of appetite) is common among head and neck cancer patients and survivors because treatment may make eating difficult. In addition, chemotherapy and immunotherapy are associated with loss of appetite. Choose high-calorie easy to eat foods, such as pudding, milkshakes or cream-based soups. Use butter, oils and milk in food to increase calories.

Diarrhea has been associated with some treatment options for head and neck cancer. If left untreated, diarrhea can become severe and even life-threatening. Drink plenty of fluids, including water and other clear liquids, such as broth.

Fatigue related to cancer and its treatment is different from the fatigue healthy people experience. It usually lasts longer, is more severe and is unrelieved by sleep. Fatigue may be caused by many types of cancer treatments. Take frequent rests or naps, but limit each nap to 45 minutes.

Infertility, for both men and women, may be a major concern depending on your age. If you would like to explore the possibility of having a child in the future, consult with your medical team and a fertility expert before committing to any treatment option, if possible. Some treatments may affect your ability to have children, and it is best to have this information early.

Nail and skin changes can be caused by many types of cancer treatments. Radiation therapy, chemotherapy and some targeted therapy drugs can cause brittle nails or nail blemishes and skin changes. Immunotherapy has also been associated with rash, itching, and peeling or blistering skin. Avoid cutting your nails, and use mild, unscented soap.

Nausea and vomiting can cause severe dehydration and interrupt your treatment. Talk to your health care team about adding antiemetics (anti-nausea drugs) or lowering the dose of your medication. Drink plenty of fluids throughout the day to stay hydrated.

Neuropathy is pain, numbness or discomfort caused by damage to the peripheral nervous system, which includes the nerves that control movement and feeling in the arms and legs. Keep a journal of symptoms, including when they happen, how long they last and how intense they are. Share the information with your health care team. Avoid standing or walking for long periods of time.

Neutropenia (increased risk of infection) occurs when the number of neutrophils, a type of white blood cell that helps prevent infections, drops abnormally low, increasing your risk for infection. Neutropenia makes it more difficult for your body to fight infections, so wash your hands often and avoid sick people and crowded places.

Pain in muscles, bones or joints, or abdominal pain, may occur. Track your pain levels, including when it starts, how long it lasts and if it interferes with daily activities. Contact your health care team if the pain does not go away or worsens.


Addressing Your Emotional Well-Being

You may experience a variety of emotions before, during and after treatment. It’s important to acknowledge these feelings and develop ways to cope. Ask your health care team for assistance. They are equipped to help you or guide you to additional resources.

Anxiety is often described as feeling nervous, stressed, worried and/or tense. Symptoms may include fast heartbeat, upset stomach, difficulty concentrating, tightness in the chest area, or feeling shaky or dizzy. Explore relaxation techniques, such as deep breathing, meditation, muscle relaxation, hypnosis, biofeedback and yoga.

Depression is more complex than just feeling sad and can include feelings of panic, hopelessness and discouragement. Many antidepressants are available, but each has its own side effects. Consider engaging in regular physical activity, breathing exercises or meditation. Contact your doctor immediately if you have thoughts of hurting yourself or others.

Fear is a common reaction before, during and after cancer treatment. It is also a normal reaction to undergoing treatment. One way to combat fear is to learn as much as you can about your cancer and your treatment. Talk to others going through similar treatment. Support groups, both in person and online, may be helpful.

Grief is feeling distress or sorrow due to loss. It is normal to grieve the loss of your health, your appearance or your ideas of what your future would be without cancer. Allow yourself to feel a full range of emotions. Ask your friends and family for support.

Guilt is the sense that you’ve done something wrong. You may feel responsible or blame yourself for developing cancer due to actions or inactions regarding your health or lifestyle. You may also feel you are upsetting loved ones or are a burden. Talk to a trusted friend or family member or with a counselor about your feelings.

Loneliness is feeling alone and isolated. You may feel your diagnosis prevents you from living the life you once had. It may be helpful to talk to others with the same type of cancer as you have or with a member of your spiritual community.

Uncertainty is the feeling of hesitation, indecision or doubt. You may be unsure about how treatment will go and about your future, which can lead to feelings of fear, anxiety or anger. Educate yourself about your cancer, and ask your medical team how to be a more active partner in your care.


Additional Resources


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