Talking With Your Doctor About Chemotherapy Pain and Side Effects
Everyone experiences chemotherapy—or chemo—differently. Chemo is powerful medicine that can cause powerful side effects. But not everyone has problems with side effects and side effects may be mild for some people. While most side effects are short-term, some can be chronic and even persist after your treatment is complete.
It’s vital to talk with your doctor before you start chemo to find out what to expect. There are treatments that can prevent or treat many chemo side effects. Your doctor or oncology nurse can also give you tips for coping with side effects. But they can’t help if they don’t know there is a problem. Read on to learn about common side effects and how to talk to your doctor about them.
Pain can be a side effect of chemo or due to cancer itself. Chemo can cause headaches, muscle pains, painful mouth sores, stomach pain, and nerve pain. Nerve pain can feel like burning, numbness, tingling, or shooting pains. If you experience pain, tell your doctor about it. Your doctor will want to know where the pain is, how long it lasts, how intense it is, what makes it better or worse, and what it feels like—stabbing, shooting, throbbing, dull. Your answers can help your doctor find the best way to treat and prevent your pain.
Nausea and Vomiting
Many—but not all—chemo drugs can cause nausea and vomiting. Doctors know which ones have a high risk of causing a problem and which ones do not. If your chemo regimen is likely to cause nausea and vomiting, it’s important to know that ahead of time.
Today, there are very effective medicines that prevent nausea. Using them before your first treatment can help you avoid nausea and vomiting. And that can help prevent anticipatory nausea with subsequent treatments. Anticipatory nausea is when people feel nauseous before a treatment. The sight or smell of the treatment room or even the thought of going for a treatment can trigger it. It occurs because the brain connects these thoughts or senses to nausea. It’s a form of classical conditioning.
Fatigue is the feeling of being constantly tired and having no energy. It’s one of the most common side effects with chemo. It’s important to tell your doctor if you are battling fatigue. There may be a treatable cause, such as anemia, infection or dehydration. If not, your care team can help you cope with fatigue through lifestyle changes.
Some chemo drugs can cause diarrhea. Diarrhea can be dangerous if it leads to dehydration. If your regimen is likely to cause diarrhea, it’s important to know that. You can prepare by having plenty of electrolyte drink on hand. If diarrhea lasts for more than a day or two, call your doctor. You should also call if the diarrhea is bloody or if you have a fever or other symptoms.
Hair loss is another side effect that most people associate with chemo. But not all chemo drugs cause it. Talking with your doctor beforehand to find out if you’re likely to lose your hair can help you prepare for it. If you start to lose your hair, be aware of how it affects your emotions. It’s often a difficult part of chemo. Your doctor can help you find support for this potentially emotional side effect.
Chemo can lower your white blood cell count. White blood cells are the cells that fight infections. This puts people on chemo at risk of developing serious—even life-threatening—infections. Your doctor will likely test your blood cell counts on a regular basis. It’s important to know those numbers and what they mean for you. Your doctor will want to know when you are running a fever. A low-grade fever can be normal for chemo patients, but anything over 100.5 degrees Fahrenheit warrants a call to your doctor. Fever is often the only sign of infection in someone taking chemo.
Some chemo drugs affect the lining of the mouth, throat and esophagus, resulting in painful sores. Call your doctor if you develop mouth sores or have painful swallowing. There are a variety of over-the-counter products that your doctor may recommend. There are also prescription options, including a mouth rinse to coat and numb the sores and ease swallowing.
Questions to Ask
To help you anticipate chemo side effects, review this list of questions for your doctor:
- Which chemo drugs will I have?
- What side effects am I likely to have right after each treatment?
- What side effects am I likely to have later?
- How long do the side effects tend to last?
- Are there side effects that may continue after my treatment is complete?
- Are any of the side effects preventable?
- How will we treat the side effects?
- Are there coping strategies to manage these side effects?
- When should I call you about these side effects? Ask for numbers to call during regular office hours and after hours.