Side Effects of Chemotherapy
Side effects of chemotherapy vary depending on the drug, the dose, the combination, and the schedule in which they are given. In general, these drugs can cause varying degrees of nausea, vomiting, low blood counts, neuropathy (tingling of the fingers and toes), and weakening of the heart muscle. Your healthcare team will review the side effects you may experience from your specific treatment regimen.
Examples of side effects of chemotherapy include:
There are ways to manage some of the side effects of chemotherapy while you receive your treatment. Always inform your doctor or nurse of any side effects that are bothersome or different from what you have experienced in the past.
Supportive Medications
People receiving chemotherapy treatments are often prescribed other medications to support the body as it responds to the chemotherapy and cancer cells are killed. Many different kinds of drugs can be given to prevent or help minimize specific side effects. If a chemotherapy drug is known to cause nausea and vomiting, for example, antinausea drugs called antiemetics may be given. Agents called Colony-stimulating factors may be administered to increase the production of certain blood cells; for example, granulocyte colony-stimulating factor (G-CSF) can stimulate the body to produce white blood cells.
Blood transfusions are rarely needed. Steroids can be given for a number of reasons, but generally to reduce nausea or allergic reactions. Other drugs are also used to prevent potential allergic reactions to the therapy. Finally, some drugs exert protective effects, making it possible to give drugs that would otherwise be highly toxic.
Examples of supportive medications include:
Reproductive Issues
Many types of chemotherapy and hormonal therapies can cause reproductive problems. About one-third of all women under the age of 40 who have chemotherapy go into permanent menopause. Of those over 40, two-thirds between the ages of 40 and 45 and 90 percent of those 46 and over begin menopause. Some women experience temporary or permanent infertility or menstrual irregularities.
Methods to preserve fertility include the following:
- Embryo preservation, a process in which eggs are removed and fertilized. The embryos are stored for implantation after cancer treatment is completed and the patient is deemed ready for pregnancy.
- Experimental approaches, such as freezing of unfertilized eggs, freezing ovarian tissue and later transplanting it back into the woman's body, and suppressing ovarian function with medications to create a temporary resting state and possibly reducing the damage to the ovaries from chemotherapy.
The decision to undergo any of these treatments should only be made after a discussion with a medical oncologist. Unfortunately, there is very little available information on the safety or effectiveness of these interventions for women with breast cancer. In general, however, women are advised not to become pregnant for several years after breast cancer treatment because of uncertainties regarding the impact of high hormone levels as well as concerns that a pregnancy might be complicated by a cancer recurrence. Some of these same concerns could apply to the hormone levels needed to create the right uterine environment for embryo implantation. An additional concern is the delay in systemic treatment for breast cancer required to pursue embryo preservation.
