Some Important Anticancer Drug Effects

Nerve and Muscle Effects

Sometimes anticancer drugs can cause problems with your body's nerves. One example of a condition affecting the nervous system is peripheral neuropathy, where you feel a tingling, burning, weakness, or numbness or pain in the hands and/or feet. Some drugs can also affect the muscles, making them weak, tired, or sore.

Sometimes, these nerve and muscle side effects, though annoying, may not be serious. In other cases, nerve and muscle symptoms may be serious and need medical attention. Be sure to report any nerve or muscle symptoms to your doctor. Most of the time, these symptoms will get better; however, it may take up to a year after your treatment ends.

Effects on Skin and Nails

You may have minor skin problems while you are having chemotherapy, such as redness, rashes, itching, peeling, dryness, acne, and increased sensitivity to the sun. Certain anticancer drugs, when given intravenously, may cause the skin all along the vein to darken, especially in people who have very dark skin. Some people use makeup to cover the area, but this can take a lot of time if several veins are affected. The darkened areas will fade a few months after treatment ends. Your nails may also become darkened, yellow, brittle, or cracked. They also may develop vertical lines or bands.

While most of these problems are not serious and you can take care of them yourself, a few need immediate attention. Certain drugs given intravenously (IV) can cause serious and permanent tissue damage if they leak out of the vein. Tell your doctor or nurse right away if you feel any burning or pain when you are getting IV drugs. These symptoms do not always mean there is a problem, but they must always be checked at once. Don't hesitate to call your doctor about even the less serious symptoms. Some symptoms may mean you are having an allergic reaction that may need to be treated at once.

Acne

* Try to keep your face clean and dry. * Ask your doctor or nurse if you can use over-the-counter medicated creams or soaps.

Itching and dryness

* Apply corn starch as you would a dusting powder. * To help avoid dryness, take quick showers or sponge baths. Do not take long, hot baths. Use a moisturizing soap. * Apply cream and lotion while your skin is still moist. * Avoid perfume, cologne, or aftershave lotion that contains alcohol. * Use a colloid oatmeal bath or diphenhydramine for generalized pruritis.

Nail problems

* You can buy nail-strengthening products in a drug store. Be aware that these products may bother your skin and nails. * Protect your nails by wearing gloves when washing dishes, gardening, or doing other work around the house. * Be sure to let your doctor know if you have redness, pain, or changes around the cuticles.

Sunlight sensitivity

* Avoid direct sunlight as much as possible, especially between 10 a.m. and 4 p.m. when the sun's rays are the strongest. * Use a sun screen lotion with a skin protection factor (SPF) of 15 or higher to protect against sun damage. A product such as zinc oxide, sold over the counter, can block the sun's rays completely. * Use a lip balm with a sun protection factor. * Wear long-sleeve cotton shirts, pants and hats with a wide brim (particularly if you are having hair loss), to block the sun. * Even people with dark skin need to protect themselves from the sun during chemotherapy.

Radiation Recall

Some people who have had radiation therapy develop "radiation recall" during their chemotherapy. During or shortly after certain anticancer drugs are given, the skin over an area that had received radiation turns red — a shade anywhere from light to very bright. The skin may blister and peel. This reaction may last hours or even days. Report radiation recall reactions to your doctor or nurse. You can soothe the itching and burning by:

* Placing a cool, wet compress over the affected area. * Wearing soft, non-irritating fabrics. Women who have radiation for breast cancer following lumpectomy often find cotton bras the most comfortable.

Kidney and Bladder Effects

Some anticancer drugs can irritate the bladder or cause temporary or permanent damage to the bladder or kidneys. If you are taking one or more of these drugs, your doctor may ask you to collect a 24-hour urine sample. A blood sample may also be obtained before you begin chemotherapy to check your kidney function. Some anticancer drugs cause the urine to change color (orange, red, green, or yellow) or take on a strong or medicine-like odor for 24-72 hours. Check with your doctor to see if the drugs you are taking may have any of these effects.

Always drink plenty of fluids to ensure good urine flow and help prevent problems. This is very important if you are taking drugs that affect the kidney and bladder. Water, juice, soft drinks, broth, ice cream, soup, popsicles, and gelatin are all considered fluids.

Tell your doctor if you have any of these symptoms:

* Pain or burning when you urinate (pass your water). * Frequent urination. * Not being able to urinate. * A feeling that you must urinate right away ("urgency"). * Reddish or bloody urine. * Fever. * Chills, especially shaking chills.

Flu-Like Symptoms

Some people feel as though they have the flu for a few hours to a few days after chemotherapy. This may be especially true if you are receiving chemotherapy in combination with biological therapy. Flu-like symptoms — muscle and joint aches, headache, tiredness, nausea, slight fever (usually less than 100°F), chills, and poor appetite — may last from 1 to 3 days. An infection or the cancer itself can also cause these symptoms. Check with your doctor if you have flu-like symptoms.

Fluid Retention

Your body may retain fluid when you are having chemotherapy. This may be due to hormonal changes from your therapy, to the drugs themselves, or to your cancer. Check with your doctor or nurse if you notice swelling or puffiness in your face, hands, feet, or abdomen. You may need to avoid table salt and foods that have a lot of salt. If the problem is severe, your doctor may prescribe a diuretic, medicine to help your body get rid of excess fluids.