Do What You Can to Ease Side ... Health Article

The side effects of cervical cancer therapy are different for everyone. They depend on these things.

• The type of surgery you had

• Whether or not you are having radiation treatments

• The type of chemotherapy drug you’re taking

• How long your treatment lasts

Here are some common side effects for the most commonly used treatments for cervical cancer. They’re listed in alphabetical order so you can find help easily when you need it. You should talk with your healthcare team about which ones you are most likely to have.

Anemia (Low Red-Blood-Cell Levels)

Throughout your treatment, your doctor will take small samples of your blood for testing. One thing he or she is checking for is your level of red blood cells. Red blood cells carry oxygen throughout the body. If your body does not have this oxygen, you may feel tired. This condition is called anemia.   Decreased red-blood-cell counts can be caused by small amounts of blood loss, by chemotherapy or radiation, or by the cancer itself.

If you doctor tells you that you’re anemic, take these actions to feel better.

• Take short rests when you’re tired. Avoid long naps during the day so that you can sleep well at night.

• Add mild exercise, such as walking, to your daily routine. It may help you sleep better.

• Balance activity with rest. Save your energy for important tasks.

• Drink plenty of water. Dehydration adds to fatigue.

• Talk with your doctor about medications or treatments that may help manage your anemia.

Anxiety and Depression

Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back during treatment. And if treatment has caused infertility, you may have strong feelings if you had planned to have children. Talk with your doctor or nurse about ways to manage these feelings and try these tips.

• Talk with your family or friends. Be as open as you can with loved ones about your fears.

• Remember that exercise, sleeping, and eating well can greatly influence moods.

• Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.

• Get a referral to a psychiatrist, psychologist, or other counselor.

• Ask your doctor about medications for depression and anxiety.

Appetite Changes

People who eat well during cancer treatment maintain their strength better, are more active, and lower their chance of infection. It’s important to remember that your body needs energy to heal itself. Maintaining your weight is a good way to know if you are giving your body the energy it needs.

When you’re being treated for cancer, a diet high in calories and protein is best. The problem is that side effects of treatment, especially chemotherapy, can make you not want to eat. Some chemotherapy treatments can change the way food tastes to you. If this is the case for you, focus on getting a balanced diet and increasing your activity level. Ask your doctor for a referral to a registered dietitian if you are having trouble maintaining your appetite or your weight.

Also, try these tips to stimulate your desire to eat.

• If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue, and cancer treatments cause you to use more protein than usual.

• To maintain your weight, eat high-calorie foods such as margarine or butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing.

• Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, fruit juices, and other liquids, try gelatin, pudding, soups, fruit bars, and ice cream.

• Eat small meals throughout the day instead of three large ones.

• Keep snacks handy to eat when you are hungry.

• Eat with friends or play your favorite music at mealtime to boost your appetite.

• Eat your biggest meal in the morning. Many people getting treatment for cancer find that this is when their appetite is greatest.

• If you can, increase your activity level. Doing so may boost your appetite.

• On days when you don’t feel like eating at all, don’t worry about it. Try again the next day. If you find your appetite doesn’t improve in several days, talk with your doctor or nurse.

Constipation

This may be a side effect of surgery or chemotherapy. Constipation, which includes difficult or infrequent bowel movements, can range from mildly uncomfortable to painful. Taking pain medications can also lead to constipation, so it’s wise to take these preventive actions. These same steps will give you relief if you are already constipated.

• Drink plenty of fluids, especially water and prune juice.

• Eat foods high in fiber, such as cereals, whole grains, fruits, and vegetables.

• Exercise.

• Take stool softeners or a laxative only as prescribed by your doctor.

Diarrhea

Diarrhea includes loose or frequent bowel movements, or both. It may be a side effect of external radiation therapy. Many drugs can cause bowel changes, too. Diarrhea may lead to dehydration if you don’t take these precautions.

• Avoid milk and milk products.

• Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.

• Eat low-residue, low-fiber foods such as those included in the BRAT diet (bananas, rice, applesauce, and toast).

• Drink more fluids, such as water and broth, to prevent dehydration.

• Ask your doctor about medications that may help.

Hair Loss

Losing your hair (called alopecia) can be upsetting because baldness is a visible reminder that you are being treated for cancer. Chemotherapy and radiation can cause hair loss. Keep in mind that your hair will probably grow back after treatment. 

Try these coping tips.

• Consider cutting your hair before treatment starts.

• Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair, and you’ll be ready with head coverings if you choose to use them.

• Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats or scarves.

Infection

Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your white-blood-cell count. Many types of chemotherapy can cause low white-blood-cell counts, called neutropenia. Without enough white blood cells, your body may not be able to fight infection.

If your doctor tells you that your white-blood-cell count is low, take these actions to stay healthy.

• Avoid crowds or people with colds.

• Wash your hands often or use a hand sanitizer throughout the day to kill germs.

• Call your doctor right away if you have any of these signs of infection: a temperature of 100.5° or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.

Mouth Sores (Mucositis)

Some types of chemotherapy may cause mouth sores. Mouth sores may hurt and make eating an unpleasant experience.

To prevent sores in your mouth, take these actions.

• Brush your teeth after meals and before bedtime; floss every day.

• Keep your mouth and lips clean and moist. 

• Use sugar-free candies or gums to increase moisture in your mouth.

To ease the pain if you get sores in your mouth, take these actions.

• Avoid alcohol and mouthwashes containing alcohol because they may irritate the sores.

• Avoid hot, rough, or spicy foods because they may irritate the sores.

• Avoid tobacco because it may irritate the sores. Smoking can also make you more susceptible to sores.

• Ask your doctor about topical mouth medications.

• Take over-the-counter pain medication, such as Tylenol (acetaminophen), if necessary.

• Call your doctor or nurse if your temperature reaches 100° or higher.

Nausea or Vomiting

Nausea or vomiting as a result of chemotherapy or radiation treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea.

• Acute-onset nausea and vomiting occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be 5 to 6 hours after treatment, and the symptoms end within the first 24 hours.

• Delayed-onset vomiting develops more than 24 hours after treatment.

• Anticipatory nausea and vomiting are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.

• Breakthrough vomiting occurs despite treatment to prevent it. It requires additional treatment.

• Refractory vomiting occurs after one or more chemotherapy treatments--essentially, you’re no longer responding to anti-nausea treatments.

To prevent nausea, take these actions. Most nausea can be prevented.

• Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

• If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

To help ease nausea or vomiting if you have it, try these tips.

• Try eating foods and drinking beverages that were easy to take or made you feel better when you’ve had the flu or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.

• Do not eat fatty or fried foods, very spicy foods, or very sweet foods.

• Eat room-temperature or cold foods. The smells from hot foods may make your nausea worse.

• Ask your doctor or nurse if he or she can help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.

• Ask your doctor or nurse about using acupressure bands on your wrists, which may help to decrease your nausea.

Numbness, Tingling, or Muscle Weakness in Your Hands or Feet (Peripheral Neuropathy)

If you have numbness, tingling, or weakness in your hands and feet, you may have nerve damage called peripheral neuropathy. Some types of chemotherapy, such as Taxol (paclitaxel), can cause this. Other signs of this problem are ringing in your ears or trouble feeling hot or cold. If you have symptoms such as these, take these precautions to protect yourself.

• Take extra care walking and moving so that you don’t fall.

• Use warm, not hot, water for bathing to prevent burns. Consider using a shower chair or railing so you’re less likely to slip.

• If your daily activities become too difficult, ask your doctor for a referral to an occupational therapist or a physical therapist. They can help teach you new ways of doing things so that you can stay as active as possible.

• Take extra care when driving (you may have trouble feeling the gas and brake pedals). Ask friends and family to drive you places.

Pain

You may have pain from the cancer itself, from surgical incisions, or from other causes. Try these tips to ease the pain.

• Take your pain medications regularly; don’t wait for your pain to become severe. (Take steps to avoid constipation, a common side effect of pain medications.)

• Change your activity level. See if you feel better if you rest more or move around more--either may help.

• Distract yourself with music, funny videos, or computer games.

• Use relaxation techniques, such as yoga or meditation, or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.

Sexual Problems

A woman’s sexuality may also be affected by surgery, especially a hysterectomy. Sexual intercourse may be difficult after radiation therapy because the skin in the treated area can be sensitive. Feelings of depression from having cancer or fatigue from other treatments can also have a negative impact on your sexual desires. Here are some ways you may cope.

• Talk with your partner about changes in your desire and ability to have sex.

• Explore new ways to share affection and intimacy.

• See a counselor who specializes in sexual problems.

• Talk about it with your doctor and other members of your healthcare team. They may be able to refer you to a sexual rehabilitation program.

• If childbearing is an issue, talk with your doctor about this before your treatment. There may be ways to preserve your fertility.

• Your healthcare provider may recommend a vaginal dilator to stretch your vagina after radiation treatment. Intercourse can also help stretch your vagina.

• Cancer treatments can cause vaginal dryness. Water-based vaginal lubricants can help make intercourse more comfortable. Prescription vaginal hormones are also available.

Skin Dryness or Irritation

Skin dryness or irritation can be a side effect of treatment, such as radiation. Try these tips to protect your skin

• Protect your skin from sun exposure by wearing sunscreen of at least 15 SPF (sun protection factor).

• Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don’t use any lotion, soap, deodorant, sunblock, cologne, cosmetics, or powder on your skin within 2 hours after treatment because they may cause irritation.

• Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.

• Don’t scratch, rub, or scrub treated skin. After washing, gently blot dry.

• Don’t bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

• Don’t apply heat or cold to the treated area. Bathe only with lukewarm water because it’s less dehydrating.

• If you must shave the treated area, use only an electric shaver because it’s less irritating. Don’t use lotion before shaving. And don’t use hair-removal products. Both can irritate skin.

• Keep your nails well trimmed and clean so you don’t accidentally cut yourself.

Swelling

You may have bruising or swelling. Always tell your healthcare provider about painful leg swelling, since it can be a symptom of blood clots. Here are some ways to ease leg swelling.

• Place an ice pack over the area for as long as it’s comfortable for the first 24 hours after the procedure.

• Take a warm sitz bath.

• Take pain medicine to ease pain as directed by your doctor.

Tiredness

Tiredness is a very common symptom and side effect from chemotherapy and radiation treatments. You may feel only slightly tired, or you may suffer from extreme fatigue.

Fatigue can last 4 to 6 weeks after treatment ends. Taking these actions may help increase your energy level.

• Take action to treat a poor appetite, because eating improperly can make you tired.

• If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.

• Follow the tips under “anemia.”

Trouble Thinking and Remembering

You may have mild problems with concentration and memory during and after chemotherapy. Being tired can make this worse.

Taking these actions may help.

• Make lists and write down important information.

• Use other tools to help organize your life, such as calendars, pill dispensers, or alarm clocks.

Urinary Problems

Since the cervix is near the bladder, treatment for cervical cancer may cause problems with urination. If you’ve had surgery, you may find it hard to empty your bladder. Or you may have a constant urge to urinate. These problems are usually temporary. Tell your healthcare provider about any urinary problems, including pain and changes in the color or frequency of urination.

• Keep track of your symptoms so you can report them to your doctor. This might include how frequently you urinate, how many incontinence pads you use, and the kind of activity that leads to incontinence.

• Ask your doctor about medications, exercises, or other options to prevent spasms or incontinence.

• Drink more liquids during your treatment period to help prevent burning or spasms.

• Try to urinate regularly--about every 3 hours.

• Avoid drinking caffeinated beverages because caffeine causes the kidneys to make more urine and irritates the bladder. Spicy or acidic foods, such as orange juice, may also irritate the bladder, so try to avoid them.

Vaginal Narrowing or Other Vaginal Problems

Vaginal dryness, narrowing, and discharge can result from surgery or radiation. This may cause difficult or painful intercourse. Vaginal infections may also occur more often. You may also briefly experience bleeding and discharge after surgery. When you talk with your doctor about these problems, make sure he or she knows you’ve had cancer. Try these methods to ease symptoms.

• If needed, use sanitary pads for bleeding or discharge.

• Use over-the-counter vaginal moisturizers and lubricants, such as Replens, Gyne-Moistrin, or Lubrin.

• Before sexual activity, use water-soluble lubricants, such as KY Jelly or Astroglide, or any vaginal moisturizers.

• Apply vitamin E oil to the area to ease irritation and burning.

• If needed, ask your doctor about products that may help replace estrogen vaginally.

• As relief for infections, try over-the-counter antifungal creams, but see your gynecologist for symptoms that do not go away.