Handling side effects of gastric cancer chemotherapy

1. Hair loss

Hair loss is usually the most obvious side effect of cancer treatment. Not all cancer treatments cause hair loss, and most hair loss is not permanent.

If your treatment results in hair loss, you may lose all your hair, including eyebrows, eyelashes, and pubic hair. In most cases, your hair will start to recover after the treatment. Sometimes the texture and color of new hair may be different.

Many patients are not used to sudden hair loss or become bald. They can wear a headgear to gain comfort and protect personal privacy.

It can also be cut into short hair or shaved directly before hair loss, which is an opportunity to control hair regeneration after hair loss. You can choose to wear a wig, hat, scarf or headscarf.

Wear an ice cap

Wear a hat-like system that cools your scalp. Put on an ice cap half an hour before chemotherapy and continue it for an hour and a half after chemotherapy. The US FDA approved the ice cap for chemotherapy patients in 2015 to relieve hair loss, but there are contraindications, you need to consult a doctor before wearing.

Wear a wig

If you plan to wear a wig, please go to the barber shop or wig shop before hair loss, and find a wig that matches your hair color and style. You can also choose a variety of wigs with completely different styles and colors, and change them frequently to maintain a good mood.

• Keep the pillow comfortable and soft

During active hair loss, the scalp becomes very soft. Sleeping on a satin (smooth surface) pillowcase can ensure a more comfortable scalp.

• Use mild detergent and sunscreen

During this period, use mild detergents and lotions. In case of hair loss, use sunscreen and wear a scarf or hat to protect the head from sunlight. When the weather is cold, cover your head to prevent the heat from disappearing.

2. Abnormal mouth and throat

Because chemotherapy is a systemic treatment, the goal is to divide cells quickly, so normal cells in the mouth and throat may be damaged. This may cause oral ulcers, dry mouth, or changes in taste and smell. In addition, patients undergoing head and neck radiotherapy have more severe oral changes.

Mouth ulcers (mucositis)

Mucositis refers to the inflammation and / or ulceration of the mouth, lips, or throat. How long an oral ulcer lasts depends on the type and time of treatment.

If the treatment causes oral ulcers, it is necessary to develop good oral care habits early in the treatment.

If mucositis pain affects eating, medication is needed to control the pain. If you feel pain when eating or drinking, consult a doctor or nurse to prescribe medicine.

Dry mouth

Sometimes chemotherapy and radiation therapy can reduce the amount of saliva in the mouth, causing dry mouth and thick saliva. Dry mouth makes it difficult for people to chew and swallow. Dry mouth caused by radiotherapy will still exist after the end of treatment, you can ask the doctor to increase the amount of saliva and improve symptoms.

Change in taste and smell

Cancer treatment can make food taste like metal or chalk, completely tasteless, or completely different from before. In most cases, this condition will disappear after treatment.

Taste and smell are important components of eating. The changes in taste and smell are usually temporary and will disappear within three months after the treatment is completed.

Changes in taste and smell affect your diet. Seek help from a doctor or nurse.

• Before treatment, consult a doctor about dental care. If there is a risk of infection, it may be necessary to complete dental care before treatment to prevent infection.

• Check the mouth and tongue daily for ulcers, red areas, or white spots. White spots may indicate infection.

• Drink plenty of water, chew gum or suck hard candy to keep your mouth moist.

• Brush your teeth with an ultra-soft toothbrush and use fluoride toothpaste.

• Avoid using mouthwash as it will dry your mouth. 

• When mouth ulcers, avoid eating sharp, crunchy, spicy or citrus foods, alcoholic beverages and tobacco.

• Eat cool, normal temperature, soft and easy-to-eat foods such as cooked grains, soft-boiled or scrambled eggs, yogurt and pudding.

• Ice cubes or popsicles may reduce pain. Mouth ulcers require painkillers and you need to find a doctor or nurse.

• If changes in taste and smell affect your diet, you can ask a dietitian for help.

3. Weight change

It is common for cancer treatment to cause weight changes. If you have been very thin before treatment, or have been trying to lose weight for many years. Surgery, chemotherapy side effects, new drugs, less physical activity or depression can cause weight gain. Some are temporary, some may last longer.

If you are concerned about weight loss or gain, you can consult the medical team for advice to help determine the cause of weight gain or loss and develop a solution.

Strict control of diet and exercise programs may not be suitable for cancer treatment. During treatment, doctors recommend that you not lose or gain too much weight. Nutrition and reasonable physical activity are important.

Studies have shown that obesity can cause the recurrence of certain types of cancer. Healthy eating is an excellent way to improve cancer.

How to lose weight?

• Eat more vegetables, fruits, whole grains and beans and other low-calorie foods with high fiber content to make you feel full.

• Eat less food.

• Eat only when you are hungry.

• Exercise regularly.

How to gain weight?

• Eat small meals instead of three meals a day.

• When you are hungry and have a good appetite, eat high-calorie foods and drinks.

• Plan your biggest meal when you are probably the most hungry.

• Even if you are not hungry, eat snacks regularly.

• Exercise lightly to increase appetite.

• Drink a drink instead of a staple food between meals. 

4. Nausea and vomiting

Nausea (feeling upset in the stomach) and vomiting are side effects associated with cancer treatment in many people, especi
ally chemotherapy. There are many drugs that can be controlled and even prevented.

A nutritious diet is important, and it is difficult for cancer patients to maintain a healthy diet and proper eating habits. Nausea and vomiting can affect treatment and quality of life.

• Try sucking popsicles or ice cubes.

• Drinking carbonated drinks, cola and ginger beer (cleaner than the gas inside) can nourish the stomach.

• Eat toast, biscuits or gel foods.

• Eat cool or warm (not cold or hot) food.

• Avoid eating spicy, fried, greasy or strong aroma foods.

• Eat a light meal or snack before treatment.

• Eat 5-6 small meals during the day instead of 3 large meals.

• Avoid eating foods with strong smells, severely seasoned foods or very greasy or fried foods.

• Try listening to music, meditation or deep breathing before and during treatment to relax.

• Use antiemetic drugs before treatment, or you can continue to use them for a few days after the end of treatment. Consult your doctor for specific medication. 

• As soon as you start to feel upset in your stomach, take antiemetics immediately and do not wait until your nausea worsens.

• If you feel sick after taking the medicine, tell the doctor immediately so that you can consider alternative antiemetics or a different combination of medicines.

• Ask your doctor about acupuncture or acupuncture. Some people find it can help relieve nausea.

5. Constipation

Difficulty in defecation is a common problem for people undergoing cancer treatment. Surgery, inactivity, eating a low-fiber diet, and drinking less water can cause changes in normal bowel function. Pain medicine and some chemotherapy drugs can also cause constipation.

If you have long-term abdominal pain, or if you have difficulty defecating or do not have enough gas for more than two days, seek medical help.

• Drink 8 to 12 glasses of water or liquid drinks every day.

• Mild drinks such as prune, apple or pear juice may also help.

• Stay active and try 15-30 minutes of moderate physical activity (such as walking) every day.

• Increase fiber intake by eating whole grains, fresh fruits, prunes, or other fiber-rich foods.

• Before using fiber supplements, laxatives, or stool softeners, be sure to talk to a nurse or doctor. If you have a small amount of blood, suppositories and enemas are particularly dangerous.

• Consult your doctor before adding high-fiber foods to your diet.

• If there is no bowel movement or abdominal pain or cramps within 72 hours, it may be a sign of intestinal obstruction, and inform the doctor in time.

6. Changes in skin and nails

Cancer treatment causes little change in the skin and nails, and it will get better once the treatment is completed. Certain types of chemotherapy can cause redness, swelling, and blisters on the hands and feet, known as hand-foot syndrome. If this happens, please inform the doctor immediately. This is a serious side effect and may require delayed treatment.

Some biological therapies may cause acne, and it is recommended to use mild soap-free cleansers and daily sunscreen. Do not use over-the-counter products to treat acne at will, follow the doctor’s advice. In severe cases, steroid creams and antibiotics can be prescribed.

Due to cancer treatment, nails and toenails can become black, yellow, or brittle and cracked. The cuticle may swell. If your nails are loose or there is fluid or pus, please notify your doctor.

How to respond to changes in skin and nails?

• Avoid hot baths or massage baths, which will dry the skin and shower with warm water.

• Use moisturizing soap, pat dry after washing, apply cream or lotion while keeping skin moist.

• Itchy body, you can try the colloidal oatmeal bath.

• Apply sunscreen, including sunscreen lipstick.

• When you go out, cover your skin as much as possible.

• Do not sunbathe.

• Do not bite your nails or wear false nails.

• Consult a doctor before manicure / pedicure.

• Wear gloves when washing dishes or doing housework.

• Apply moisturizing milk to hands and feet often.

• If your nails become inflamed, please tell your doctor.

• If a rash occurs, tell the doctor if it does not affect the appearance. Viral infections, such as herpes zoster, may appear as rashes and should be treated as soon as possible to prevent complications.

7. Anemia

Cancer treatment usually results in a reduction in the number of red blood cells, causing anemia. When the anemia is severe, you will feel weak, tired, dizzy, short of breath, and sometimes depression.

Anemia can affect the effectiveness of treatment and cause the heart and lungs to contract. Treatments include blood transfusions or drugs that promote the growth of red blood cells. The treatment of anemia depends on the cause and extent of the condition.

Common symptoms of anemia:

• Shortness of breath

• Rapid heartbeat

• Confusion, difficulty concentrating

• Dizziness or fainting

• Tired of daily activities

• Ensure adequate rest.

• When energy is low, seek help from family and friends.

• Eat a healthy diet, drink plenty of water, and eat foods rich in iron.

• Move slowly when you get up or sit up.

• Tell your doctor if your fatigue is getting worse.

• Seek medical treatment or blood transfusion to increase the amount of red blood cells.

8. Fatigue

Fatigue is one of the most common and troublesome side effects in cancer treatment. This feeling will not disappear with the rest. Fatigue usually decreases with the passage of time after treatment, and can sometimes be caused by anemia or blood loss caused by medication. Sometimes fatigue is easily confused with depression.

Fatigue is a cumulative side effect. There may be only a small amount of fatigue after the first treatment, but as the treatment continues, the degree of fatigue may increase. Fatigue will improve after the treatment.

Pay attention to physical fatigue, record daily fatigue time, grade fatigue on a scale of 0-10 (10 is the most tired), fatigue duration, and communicate with the doctor in time.

• • Reactivate when you are energetic

  • Eat healthy foods and avoid greasy and fried foods

  • Rest more, don’t feel guilty when you rest

  • Less activity

  • When fatigue occurs, inform the doctor to seek treatment

  • Maintain physical activity as much as possible, start slowly, and exercise for at least 3 days a week for 150 minutes

  • Sleep at least 8 hours every night, regular rest time

  • Need time to rest or take a nap during the day (no more than 45 minutes)

  • Unless otherwise directed by the doctor, drink at least 8 glasses of water or beverages every day and avoid drinking

  • Try meditation, prayer or other strategies to relax and reduce stress

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9. Bleeding and bruising

Cancer treatments, such as chemotherapy and targeted therapy, can increase the risk of bleeding and bruising. After radiotherapy and chemotherapy, bone marrow hematopoietic function is suppressed, platelet production is reduced, or liver function is impaired, and the amount of coagulation factors synthesized by the liver is reduced, which can cause bleeding.

When the platelet count is low, bruising or bleeding can easily occur, and there are tiny purple or red spots on the skin.

Bleeding in the mouth, nose, or vomiting, can’t stop for a few minutes; during the non-menstrual period, the vagina will bleed; the urine is red or pink; the stool is black or bloody; the bleeding during treatment may last longer than normal. There will also be headaches and blurred vision.

• Avoid taking certain medicines. Aspirin or ibuprofen can increase the risk of bleeding.

• Low platelet count, it is recommended that you limit or avoid drinking.

• Be extra careful to prevent bleeding.

• Keep the toothbrush soft and brush gently.

• Wear less slippers, protect your feet, and pay attention to the comfort of your shoes.

• Use extreme caution when using sharp objects; use an electric shaver, not manually.

• Use lotions and lip balm to prevent dry, chapped skin and lips.

• Inform your doctor if you experience constipation or bleeding in your stool.

• To handle bleeding, hold the bleeding area firmly with a clean cloth until the bleeding stops.

• If there are bruises, use ice.

10. Infection

When receiving anti-cancer treatment, white blood cells will be damaged, causing the patient’s self-immune function to decline and become a susceptible to infection. Major surgery, chemotherapy, radiotherapy, and other cancer treatments can cause infections.

The general condition of cancer patients is often worse. Once an infection occurs, it will develop rapidly, sometimes it is difficult to control, and it is prone to life-threatening.

• Keep warm and avoid colds and fever.

• See your doctor immediately if your body temperature exceeds 39 ° C.

• During treatment and recuperation, try to reduce the video frequency to avoid bacterial and viral infections.

• Wash your hands frequently with soap and water, or use alcohol-based hand soap.

• Change clothes and wipe your body frequently to keep your skin clean.

• Moderate exercise, high-calorie, high-protein diet.

• Keep your mouth clean, rinse your mouth and brush your teeth after meals, before going to bed, and wear a mask when you go out.