Chemotherapy comes with a variety of side effects, from fatigue and neuropathy to nausea and hair loss. And while it’s expected that you’ll experience some of these, oftentimes, your care team may be able to help.
“I always say, ‘if something is bothering you, tell me,” says Cynthia Ulreich, an oncology certified nurse practitioner at Henry Ford Health. “Even if there is a side effect we don’t have a good intervention or treatment for, you don’t know unless you ask.”
That said, there are some side effects that can actually be dangerous if left ignored. Here, Ulreich shares five side effects to definitely tell your care team about.
1. Pain
While pain is likely a symptom of cancer itself – and not normally a side effect of chemotherapy – it’s an important one to communicate with your doctor. “If your pain is not well controlled, nothing else in the world matters,” says Ulreich. “You’re probably not eating, which could lead to malnutrition. You’re probably not staying active, which could lead to blood clots or pneumonia.”
Cancer increases the risk of developing blood clots and pneumonia, Ulreich explains, and being sedentary further increases this risk. “If we can manage to keep pain under control – or at least tolerable – those risks become lessened,” says Ulreich.
2. Fever
A low-grade fever can be a side effect of some types of chemotherapy, but if your fever is above 100 degrees Fahrenheit, it could signify a more dangerous issue. “Chemotherapy weakens your immune system, which makes it more difficult for your body to fight off illness,” says Ulreich. “If your fever is higher than 100 degrees Fahrenheit, it could indicate an infection or sepsis.”
3. Bleeding
Chemotherapy can decrease platelet levels in your blood, making you prone to bleeding. “Anywhere blood can get out, bacteria can get in,” says Ulreich. “Especially when you’re immunocompromised, this could lead to infection. Nosebleeds, blood in your urine – we have to investigate any bleeding.”
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4. Watery diarrhea or intense nausea
If you have watery diarrhea or you're nauseated to the point where you can’t eat, it could lead to malnutrition and the loss of electrolytes, which help the body function harmoniously. “While there’s unfortunately not an easy fix for this, we have strategies to help,” says Ulreich. Everything from ginger and fresh air to medication, acupuncture and aromatherapy may ease discomfort from nausea.
5. Weight loss
It’s not uncommon to lose weight during chemotherapy, especially since it can make you nauseated and change your sense of taste. But losing weight rapidly is dangerous. “Whether it’s from not eating, dehydration or disease progression, rapid weight loss is important for us to look at,” says Ulreich. “It’s alarming if you’re losing 5% of your body weight in a week or 10% in a month.”
At the end of the day, however, anything that’s making you uncomfortable is worth getting checked out – especially because studies show that survival is linked to quality of life.
“Having cancer and undergoing cancer treatment is obviously a huge challenge,” says Ulreich. “We are always looking for ways to boost your mental and physical health - and being in communication with us will help. You know yourself best and quality of life is a huge part of cancer care.”
Reviewed by Cynthia Ulreich, an advanced oncology certified nurse practitioner who works at Henry Ford Cancer - Detroit.
