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Coping Tips for Chemotherapy Patients

As with any drug, reactions to chemotherapy vary from person to person. Here you will find tips for managing some of the most common chemotherapy-related side effects.

The information here is provided for educational purposes only. Please consult with your healthcare professional if you experience these or any other side effects while on treatment.

Chemotherapy and Gastrointestinal Side Effects

It is important to try to manage any gastrointestinal side effects of chemotherapy, such as nausea, vomiting, and diarrhea. These side effects can rob the body of valuable nutrients. They can also cause too much water loss (dehydration). Certain side effects from chemotherapy, in very rare cases, may be life threatening. The following tips may help you better manage these side effects.

TIPS: For Managing Nausea and Vomiting

Eat food at or below room temperature.
Eat slowly. Chew food thoroughly.
Avoid greasy, high-fat foods, such as hamburgers, fried foods, and potato chips.
Don't lie down right after eating. Try to sit upright for 1 hour after meals.
Take some time to relax before each Eloxatin treatment.
Ask the doctor to give your loved one antiemetics (medication for nausea and vomiting) that can be taken at home.
Be aware that favorite food may taste different during your treatment.
Avoid beverages that contain alcohol.

TIPS: For Managing Diarrhea

Drink plenty of water. Water should be warm or at room temperature. Do not put ice in any beverage.
Avoid high-fat foods and milk products.
Try the BRAT diet—Bananas, Rice (white), Applesauce, and Toast (white bread). Note: The BRAT diet should be used as a short-term measure only. It does not have enough nutrients to be a regular diet. Be sure to let the doctor or nurse know if your loved one experiences diarrhea. The doctor or nurse will need to advise the continuation of the BRAT diet for more than 2 days.
Avoid nuts and seeds, raw/high-fiber vegetables (broccoli, corn, etc), and fruits with skin.
Avoid caffeine (coffee, tea) and alcohol-containing beverages, because they cause the body to lose fluids. Drink decaffeinated beverages instead.

Chemotherapy and Stomatitis

Stomatitis means inflammation of the mucous membranes of the mouth. This can lead to soreness of the tongue, the gums, and the soft areas inside the cheeks and lips.

Chemotherapy often affects these areas because the cells there grow rapidly. This side effect is temporary. It will go away after chemotherapy treatments are completed. Here are some tips to remember in the meantime.

TIPS: For Managing Mouth Sores

Brush teeth after eating, using a soft-bristle toothbrush.
Avoid mouthwash that contains alcohol.
Rinse the mouth frequently with warm salt water.
Avoid eating or drinking anything that could irritate the mouth (spicy food, citrus fruits or juices [orange, lemon, or grapefruit], nuts, and pretzels).
Avoid tobacco products.
Be sure to report any mouth sores to the doctor or nurse.

Chemotherapy and Neuropathy

Some chemotherapy drugs may cause nervous system side effects, including a nerve condition called neuropathy. Neuropathy can cause tingling or numbness in the extremities, muscle weakness, or other altered sensations.

Exposure to cold is one of the most common causes of neuropathy symptoms. The following tips may help you limit your exposure to cold and better manage neuropathy.

TIPS: For Managing Neuropathy

Avoid drinking cold beverages and eating cold foods.
Try to stay inside during cold days. If you need to go outside, make sure you dress warm, and cover your extremities with mittens and warm socks.
If you’re outside on a cold day, in an air-conditioned environment, or around an open freezer or refrigerator, try not to breathe the cold air.
During your chemotherapy treatments, avoid sucking on ice and going straight out to the cold weather or a cold automobile.
When handling frozen items, wear a pair of gloves.

Colorectal Cancer Information | Colorectal Cancer Symptoms | Colorectal Cancer Treatment | Colorectal Cancer Side Effects

ELOXATIN, used in combination with infusional 5-FU/LV, is indicated for

Adjuvant treatment of stage III colon cancer patients who have undergone complete resection of the primary tumor. The indication is based on an improvement in disease-free survival, with no demonstrated benefit in overall survival after a median follow-up of 4 years
Treatment of advanced carcinoma of the colon or rectum

Clinical Safety Considerations

ELOXATIN should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents. Appropriate management of therapy and complications is possible only when adequate diagnostic and treatment facilities are readily available.

Anaphylactic-like reactions to ELOXATIN have been reported and may occur within minutes of ELOXATIN administration. Epinephrine, corticosteroids, and antihistamines have been employed to alleviate symptoms, and discontinuation of ELOXATIN therapy may be required.

ELOXATIN should not be administered to patients with a history of known allergy to ELOXATIN or other platinum compounds. Hypersensitivity and anaphylactic/anaphylactoid reactions to ELOXATIN have been reported and were similar in nature and severity to those reported with other platinum compounds (ie, rash, urticaria, erythema, pruritus, and, rarely, bronchospasm and hypotension). These reactions occur within minutes of administration and should be managed with appropriate supportive therapy. Drug-related deaths from this reaction have been reported
ELOXATIN may cause fetal harm when administered to a pregnant woman. Women of childbearing potential should be advised not to become pregnant while receiving ELOXATIN. It is not known whether ELOXATIN or its derivatives are excreted in human milk
ELOXATIN has been associated with pulmonary fibrosis (<1% of study patients), which may be fatal. The combined incidence of cough and dyspnea was 7.4% (<1% grade 3, no grade 4) in the ELOXATIN plus 5-FU/LV arm compared to 4.5% (no grade 3, 0.1% grade 4) in the 5-FU/LV alone arm in the adjuvant colon cancer study. In this study, one patient died from eosinophilic pneumonia in the ELOXATIN combination arm. The combined incidence of cough, dyspnea, and hypoxia was 43% (7% grade 3 and 4) in the ELOXATIN plus 5-FU/LV arm compared to 32% (5% grade 3 and 4) in the irinotecan plus 5-FU/LV arm in patients with previously untreated colorectal cancer. In case of unexplained respiratory symptoms, ELOXATIN should be discontinued until pulmonary investigation excludes interstitial lung disease or pulmonary fibrosis
ELOXATIN is associated with two types of primarily peripheral sensory neuropathy: an acute, reversible type of early onset and a persistent type (>14 days). In patients with advanced colorectal cancer, paresthesias occurred in 77% (all grades) and 18% (grade 3/4) of previously untreated patients. In previously treated patients, acute neuropathy occurred in 56% (all grades) and 2% (grade 3/4) of patients; persistent neuropathy occurred in 48% (all grades) and 6% (grade 3/4) of patients. In patients with stage II and III colon cancer, paresthesia was seen in 92% (all grades) and 13% (grade 3/4) of patients; 21% (all grades) and 0.5% (grade 3/4) of patients had residual paresthesia at 18-month follow-up
Hepatotoxicity, as evidenced in the adjuvant study by increase in transaminases and alkaline phosphatase, was observed more commonly in the ELOXATIN combination arm. The incidence of increased bilirubin was similar on both arms. Changes noted on liver biopsies include: peliosis, nodular regenerative hyperplasia or sinusoidal alterations, perisinusoidal fibrosis, and veno-occlusive lesions. Hepatic vascular disorders should be considered and, if appropriate, investigated in case of abnormal liver function test results or portal hypertension not explained by liver metastases
Monitoring of white blood cell count with differential, hemoglobin, platelet count, and blood chemistries (including ALT, AST, bilirubin, and creatinine) is recommended before each ELOXATIN cycle
The safety and effectiveness of ELOXATIN plus 5-FU/LV in patients with renal impairment have not been evaluated. Since the primary route of platinum elimination is renal, this combination should be used with caution in patients with preexisting renal impairment. Clearance of these products may be decreased by coadministration of potentially nephrotoxic compounds, although this has not been specifically studied
The incidence of diarrhea, dehydration, hypokalemia, leukopenia, fatigue, and syncope was higher in patients 65 years old
Extravasation may result in local pain and inflammation that may be severe and lead to complications, including necrosis. Injection site reaction, including redness, swelling, and pain, has been reported
There have been reports of prolonged prothrombin time and INR occasionally associated with hemorrhage in patients receiving ELOXATIN plus 5-FU/LV while on anticoagulants. Patients receiving ELOXATIN plus 5-FU/LV and requiring oral anticoagulants may require closer monitoring
The most common adverse reactions in patients with stage II or III colon cancer receiving adjuvant therapy were peripheral sensory neuropathy, neutropenia, thrombocytopenia, anemia, nausea, increase in transaminases and alkaline phosphatase, diarrhea, emesis, fatigue, and stomatitis. The most common adverse reactions in patients with advanced colorectal cancer were peripheral sensory neuropathy, fatigue, neutropenia, nausea, emesis, and diarrhea

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