Condition after chemotherapy. All possible consequences of chemotherapy

The condition of the cancer patient after undergoing a course of chemotherapy is quite severe or medium degree gravity. Of course, patients with different levels immunity, with different stages of cancer, as well as with existing other diseases of the body, tolerate treatment differently.

But it is considered common sharp deterioration the state of health and well-being of the patient after undergoing a course of chemotherapy.

ICD-10 code

Z54.2 State of recovery after chemotherapy

The body after chemotherapy

After a course of chemotherapy, patients are noted a sharp decline all indicators of the body's functioning. First of all, this concerns the state of the hematopoietic system and the blood itself. Sharp changes occur in the blood formula and its composition, which are expressed in a drop in the level of its structural elements. As a result, the immunity of patients is greatly reduced, which results in patients being susceptible to any infectious diseases.

All internal organs and systems experience the effects of toxic damage from chemotherapy drugs that contain poisons that kill rapidly growing cells. These types of cells are malignant, as well as bone marrow cells, hair follicles, mucous membranes of various organs. They suffer above all others, which is expressed in changes in the patients’ well-being, exacerbation various diseases and the appearance of new symptoms, as well as changes in the patient’s appearance. The heart and lungs, liver and kidneys, gastrointestinal tract and genitourinary system, skin and so on.

Patients after chemotherapy experience the appearance allergic reactions, skin rashes and itching, hair loss and baldness.

The peripheral and central nervous systems also suffer, which is reflected in the appearance of polyneuropathy.

At the same time, the appearance of general weakness And increased fatigue, depressive conditions.

Immunity after chemotherapy

The state of a person’s immunity is influenced by many factors, including the composition of the blood and the number of leukocytes in it various types, including T-lymphocytes. After chemotherapy, the patient’s immunity sharply decreases, which is caused by a drop in the level of leukocytes, which are responsible for the body’s immune response against various infections and pathological agents of internal and external origin.

Therefore, after a course of chemotherapy, patients are treated with antibiotics so as not to become victims of infectious diseases. This measure, of course, does not improve general condition patient, who is already reduced by chemotherapy.

The following measures can help improve immunity after treatment:

1. Taking antioxidants - vitamins that stimulate activity immune system. These include vitamins C, E, B6, beta-carotene and bioflaphonids.
2. You need to eat a lot fresh vegetables, fruits, greens and berries that contain antioxidants - currants, strawberries, bell pepper, lemons and other citrus fruits, raspberries, apples, cabbage, broccoli, brown rice, wheat germ, parsley, spinach, celery and so on. There are antioxidants in grains and legumes, in unrefined vegetable oils, especially olive.
3. It is necessary to include in preparations rich in selenium, as well as products that contain this microelement. This element helps increase the number of lymphocytes, and also improves the production of interferon and stimulates immune cells produce more antibodies. Selenium is rich in garlic, seafood, brown bread, offal - duck, turkey, chicken, cow and pork liver; beef, pork and veal kidneys. Selenium is found in brown rice and corn, wheat and wheat bran, sea ​​salt, wholemeal flour, mushrooms and onions.
4. Small but regular physical exercise help improve immunity. These include morning exercises, walks fresh air, cycling, swimming in the pool.
5. Chamomile tea is a simple remedy to boost your immunity. A tablespoon of dried chamomile flowers is brewed with a glass of boiling water, cooled and filtered. Minimal amount drinking chamomile infusion - two to three tablespoons three times a day before meals.
6. Echinacea tincture or Immunal preparation – excellent remedy to strengthen the immune system. The alcohol infusion should be drunk with a small amount liquids. The initial dose is forty drops, and then the tincture is used in the amount of twenty drops every hour or two. The next day you can take forty drops of tincture three times a day. The longest course of treatment is eight weeks.

Liver after chemotherapy

The liver is one of the important human organs, and it performs many different functions. It is known that liver cells are most susceptible to the negative consequences of the administration of chemotherapy drugs of all other organs. This occurs due to the fact that the liver takes an active part in metabolic processes, as well as excretion from the body along with bile and neutralization of various harmful and toxic substances. We can say that from the very beginning of chemotherapy, the liver is a conductor of the drug, and after treatment it begins to function in the mode of protecting the body from the toxic effects of drug components.

Many chemotherapy regimens have a strong toxic effect on the liver. Some patients experience drug effects of eighty percent liver damage.

The liver after chemotherapy can have several degrees of damage; there are four main degrees - mild, moderate, high and severe. The degree of damage to a given organ is expressed in the level of changes in biochemical indicators of its functioning.

When the liver is damaged, there is a disruption of metabolic processes in the cells of the organ, toxic changes in cell structures, disruption of the blood supply to liver cells and exacerbation of previously existing liver diseases. In this case, the immune abilities of this organ are impaired. It is also possible for carcinogenesis to occur – the appearance of tumor processes in the liver.

After chemotherapy, it is mandatory to undergo a biochemical blood test, the transcript of which shows how damaged the liver is. This takes into account the level of bilirubin and enzymes in the blood. In patients who did not abuse alcohol, did not have hepatitis, and did not work in hazardous chemical plants, blood counts may be normal. Sometimes, in patients, biochemical analysis data can deteriorate three to five times relative to normal.

Patients can be reassured by the fact that the liver is an organ that regenerates quickly and successfully. If, at the same time, apply the appropriate diet and drug therapy, this process can be significantly accelerated and simplified.

Hepatitis after chemotherapy

Hepatitis is a group inflammatory diseases liver, which is predominantly viral (infectious) in nature. Hepatitis can also be caused by toxic substances that are found in excess in cytostatics.

Hepatitis after chemotherapy occurs due to damage to liver cells. Moreover, the more affected this organ is, the greater the likelihood of hepatitis. Infections penetrate into a weakened liver, which lead to the development of inflammatory processes.

The possibility of hepatitis is also associated with low level immunity after chemotherapy, which causes poor resistance of the body to diseases of an infectious nature.

Symptoms of hepatitis are:

1. The appearance of fatigue and headache.
2. The occurrence of loss of appetite.
3. The appearance of nausea and vomiting.
4. Emergence elevated temperature body, up to 38.8 degrees.
5. Appearance of a yellow skin tone.
6. Changing the color of the whites of the eyes from white to yellow.
7. The appearance of brown urine.
8. Color change feces– they become colorless.
9. The appearance of sensations in the right hypochondrium in the form of pain and tightness.

In some cases, hepatitis may occur and continue without symptoms.

Hair after chemotherapy

Hair falls out after chemotherapy, and some patients become completely bald. Chemotherapy drugs damage the follicles from which hair grows. Therefore, hair loss can be observed throughout the body. This process begins two to three weeks after chemotherapy and is called alopecia.

If the course of oncological processes in the body has slowed down, there is an increase in the patient’s immunity and an improvement in his general condition and well-being. Good hair growth trends appear. After some time, the follicles become viable and hair begins to grow. Moreover, this time they become thicker and healthier.

However, not all chemotherapy drugs cause hair loss. Some anti-cancer medicines only partially deprive the patient of hair. There are drugs that have a targeted effect only on malignant cells, and allow you to keep the patient’s hair intact. At the same time, the hair becomes only thin and weakened.

After completing the course, experts advise using the following recommendations:

1. Use the drug "Sidil". But you should not purchase the drug yourself, since it has a number of side effects. It is best to consult your doctor about the use of this medication.
2. Do a daily head massage using burdock oil. Oil is applied to the scalp, a massage is done, then a cellophane cap is put on the head, and a towel is wrapped on top. After an hour, the oil is washed off with a mild shampoo. Burr oil can be replaced with hair growth products containing vitamins and ceramides.

Stomach after chemotherapy

Chemotherapy drugs damage the stomach lining, causing patients to experience a number of unpleasant symptoms. Nausea and vomiting, heartburn and acute burning pain in the upper abdomen, flatulence and belching, weakness and dizziness. These symptoms are signs of gastritis, that is, inflammatory or dystrophic changes in the gastric mucosa. In this case, there may be a deterioration in the tolerance of certain foods, as well as a lack of appetite and weight loss.

To restore correct work stomach, you must follow the diet recommended by experts and take prescribed medications.

Veins after chemotherapy

After chemotherapy, the patient’s veins experience the consequences of exposure to toxic drugs. Early (immediate) complications include the appearance of phlebitis and phlebosclerosis of the veins.

Phlebitis is an inflammatory process of the walls of the veins, and phlebosclerosis is a degenerative change in the walls of the veins, in which the walls of the vessels thicken.

Such manifestations of changes in veins are observed in the patient’s elbow and shoulder after repeated administrations of chemotherapy drugs - cytostatics and / or antitumor antibiotics.

To avoid similar manifestations It is recommended to administer the above drugs into a vein at a slow pace, and also to finish the infusion of the drug by inserting a full syringe of a five percent glucose solution through a needle left in the vessel.

In some patients, chemotherapy drugs have the following side effect on the veins - inflammatory processes begin in them, which lead to the formation of blood clots and the appearance of thrombophlebitis. Such changes primarily concern patients whose circulatory system prone to the formation of blood clots.

Lymph nodes after chemotherapy

After chemotherapy, some patients may have inflamed and enlarged lymph nodes. This happens due to hypersensitivity follicles lymph nodes to the toxic effects of cytostatics.

This happens for a number of reasons:

1. Due to damage to lymph node cells.
2. Due to a decrease in the number of blood elements (leukocytes and lymphocytes), which are responsible for the body’s immune response.
3. Due to the body's reaction to infection entering the body.

Kidneys after chemotherapy

During chemotherapy, kidney damage occurs, which is called nephrotoxicity. This consequence of treatment manifests itself in cell necrosis renal tissue, which is the result of accumulation of the drug in the tubules of the parenchyma. First of all, damage to the tubular epithelium is observed, but then intoxication processes can penetrate deeper into the glomerular tissue.

A similar complication after chemotherapy has another name: tubulointerstitial nephritis. At the same time, this disease can develop in an acute form, but then, after long-term treatment enter the chronic stage.

Kidney damage, as well as renal failure, affects the occurrence of long-term anemia, which appears (or intensifies) due to impaired production of renal erythropoietin.

After chemotherapy there is presence to varying degrees renal failure, which can be installed after laboratory tests blood and urine. The degree of this dysfunction is influenced by the level of creatine or residual nitrogen in the blood, as well as the amount of protein and red blood cells in the urine.

Feeling after chemotherapy

After chemotherapy, patients experience a sharp deterioration in their health. Appears severe weakness, increased fatigue and tiredness. The patient's psycho-emotional state changes for the worse, and depression may occur.

Patients complain about constant nausea and vomiting, heaviness in the stomach and burning in the epigastric region. Some patients experience swelling in their hands, face and legs. Some of the patients feel severe heaviness and dull pain in the right side in the area where the liver is located. Pain may also occur throughout the abdomen, as well as in the joints and bones.

There is numbness in the arms and legs, as well as a lack of coordination when moving, and changes in tendon reflexes.

After chemotherapy, bleeding of the mucous membranes of the mouth, nose and stomach increases sharply. Patients have manifestations of stomatitis, which are expressed in severe dryness soreness of the oral cavity.

Consequences after chemotherapy

After completing a course of chemotherapy, patients begin to experience various consequences of the treatment. Patients experience deterioration in health, general weakness, lethargy and increased fatigue. Loss of appetite and changes in the taste of foods and dishes appear, diarrhea or constipation occurs, severe anemia is detected, and patients begin to experience nausea and even vomiting. The patient may experience oral mucositis (pain in the mouth and throat) and stomatitis, as well as various types of bleeding.

The patient's appearance also undergoes changes. Hair usually falls out after chemotherapy. Changes appearance and the structure of the skin - it becomes dry and painful, and the nails become very brittle. Severe swelling appears, especially in the extremities - arms and legs.

The patient’s mental and emotional processes also suffer: memory and concentration deteriorate, periods of clouding of consciousness are observed, difficulties with the thinking process appear, the patient’s general emotional state is destabilized, and depressive states are observed.

The peripheral nervous system is also heavily affected by the drugs. Feelings of numbness, tingling, burning or weakness are observed in various parts of the body. First of all, such transformations concern the patient’s arms and legs. When walking, pain may occur in the legs and entire body. Possible loss of balance and falls, dizziness, convulsions and muscle twitching, difficulty holding objects in your hands or lifting them. The muscles constantly feel tired or sore. There is a decrease in hearing acuity.

The chemotherapy undergone affects the decrease in sexual desire, as well as the deterioration of the patient’s reproductive functions. There is difficulty urinating, pain or burning, as well as changes in the color, smell and composition of urine.

Complications after chemotherapy

Complications after chemotherapy are associated with general intoxication of the body through the use of drugs. Complications of a local and general nature are distinguished, as well as early (immediate) and late (long-term) consequences of chemotherapy.

Examination after chemotherapy

Examination after chemotherapy is done for two purposes:

1. Determine the success of the treatment.
2. Determine the degree of damage to the patient’s body due to the toxic effects of drugs and prescribe appropriate symptomatic treatment.

The examination procedure includes laboratory testing of blood tests: general, biochemical and leukocyte formula. It is also necessary to take a urine test to determine protein levels.

Additional testing after chemotherapy may include ultrasound diagnostics and radiography.

Tests after chemotherapy

During chemotherapy, patients undergo tests at least twice a week. This concerns, first of all, blood analysis and research. This measure is due to the need to monitor the patient’s condition during chemotherapy. If the test results are satisfactory, the course of treatment can be continued, and if the test results are poor, the dosage of the drugs can be reduced or the treatment stopped altogether.

After chemotherapy, patients also undergo tests that are aimed at monitoring the patient’s condition after chemotherapy. First of all, it is carried out general analysis blood, biochemical analysis blood and leukocyte formula. This group analyzes allow us to record the level of damage to the body after chemotherapy, namely vital organs and systems, and take appropriate measures to normalize the patient’s condition.

A common feature after chemotherapy is a change in all blood parameters. The level of leukocytes, red blood cells and platelets decreases. ALT and AST levels increase, as do the amounts of bilirubin, urea and creatine. The level is decreasing total protein in the blood, the amount of cholesterol, triglycerides, amylase, lipase and GGT changes.

Such changes in blood composition show damage to all organs and systems of varying severity after a course of chemotherapy.

What to do after chemotherapy?

Many patients who have undergone treatment with cytostatics begin to wonder: “What to do with your health after chemotherapy?”

First of all, it is necessary to determine what symptoms bother the patient after completion of chemotherapy. It is necessary to tell about them to specialists who monitor the patient’s condition after chemotherapy. The attending physician, having familiarized himself with certain symptoms, can refer the patient to a more specialized specialist for advice and appropriate treatment.

Specialists of a narrower profile as symptomatic treatment may prescribe certain medications, as well as vitamin-mineral complexes and immune-supporting therapy.

Along with alleviating the patient’s condition with the help of medications, it is necessary to set the goal of restoring the functions of damaged organs and systems. First of all, this concerns the function of hematopoiesis, the immune system, the work digestive system stomach, intestines, liver, and kidney function. It is very important to restore the microflora in the intestines, thereby stopping the course of dysbiosis. In this case, it is necessary to pay attention to eliminating symptoms general intoxication body, as well as weakness, depression, pain, swelling and loss of appetite.

Methods rehabilitation therapy include:

• Go to proper nutrition, which includes the entire range of products beneficial to the body.
• Active activities physical activity– walking in the fresh air, morning exercises.
• Using massages, physiotherapy, etc. to improve health.
• Using Methods traditional medicine and herbal medicine to restore the body.
• The use of psychotherapy methods to improve the psycho-emotional state of the patient.

Treatment after chemotherapy

Treatment after chemotherapy is based on the appearance of the most worrying symptoms in patients. Choose a method of therapy, as well as the appropriate drug treatment possible only after the results laboratory research blood and, if necessary, other tests.

Means that improve the patient’s condition after a course of chemotherapy include:

1. Changing the patient’s diet and following a certain diet.
2. Being in a state of rest, the opportunity to restore strength.
3. Walks in the fresh air, feasible physical activity, for example, therapeutic exercises.
4. Receiving positive emotions and positive impressions from others, working with a psychologist.
5. Certain physiotherapeutic procedures.
6. Drug treatment of side effects.
7. Use of traditional medicine.
8. Spa treatment.

Pregnancy after chemotherapy

Pregnancy after chemotherapy is considered controversial. If chemotherapy is accompanied by drug protection of the ovaries, this increases a woman’s chances of becoming a mother in the future. But many patients remain infertile, even despite enhanced treatment from this problem. This happens because after each course of chemotherapy, the chances of pregnancy decrease several times.

The toxic effect of the drugs affects the ovaries and inhibits their functioning. This effect is felt more clearly the closer the area of ​​chemotherapy is to the ovaries.

During chemotherapy, two methods of surgical protection of the ovaries can be used:

1. Displacement of the ovaries from the area of ​​action of the drugs.
2. During general chemotherapy, the ovaries can be removed from the body and preserved until the woman is healthy. After which the ovaries return to their original place.

Experts recommend starting pregnancy planning no less than a year after the end of chemotherapy. This is caused by the need to restore a woman’s body after intoxication and remove toxic substances. IN otherwise If the timing of conception is not observed, irreversible changes in the fetus may occur during the prenatal period and the birth of a child with deviations in health and development may occur.

Sex after chemotherapy

Sex after chemotherapy is quite difficult. This is caused, first of all, by the deterioration of the general health and well-being of patients. Hormonal changes lead to a decrease in the strength of sexual desire, and in many cases, its temporary absence.

Women may experience changes in the vaginal microflora, which is expressed in the appearance of thrush, which is accompanied by unpleasant symptoms. In this case, sexual intercourse will cause discomfort and pain, which negatively affects the desire to have sex.

As a result of chemotherapy, men experience difficulties in developing and maintaining an erection, and also experience anorgasmia - the absence of orgasms.

Despite the fact that many women do not have periods after chemotherapy, it is necessary to follow the rules of contraception when having sex. Because there is always a risk of getting pregnant, and this would be undesirable immediately after finishing chemotherapy.

In men, toxic products of chemotherapy drugs penetrate into sperm and can affect the conception and birth of a child with developmental anomalies that will have birth defects.

Periods after chemotherapy

The toxic effect of chemotherapy drugs inhibits the activity of the ovaries. This manifests itself in violation menstrual cycle, the occurrence of its instability. Some patients may experience a complete cessation of menstruation. This leads to temporary infertility in women.

In order to restore reproductive functions after chemotherapy, the patient must undergo appropriate hormonal treatment so that menstruation appears again. In some cases, the body never restores its reproductive functions, which means early entry into menopause (menopause) and complete absence I've had my period forever.

Life expectancy after chemotherapy

It is impossible to accurately predict how long a patient will live after undergoing chemotherapy. These assumptions depend on many factors, including:

• Stage of the oncological process.

At the first or second stage of the disease it is possible full recovery body after chemotherapy and no relapse of the disease. In this case, patients can conduct full life and twenty and thirty years after the end of treatment.

Third and fourth stage oncological diseases does not give a rosy prognosis: patients after chemotherapy in this case can live from one to five years.

• The degree of damage to the body after chemotherapy.

The consequences after undergoing treatment are of unequal severity for all patients. There are complications from zero to fifth degree of toxic damage to the patient’s body.

With mild to moderate effects, patients can recover sufficiently to continue living a full life for a long time. At the same time, of course, it is necessary to radically change your lifestyle, making it healthy from physical and psychological aspects.

Severe degrees of damage to the body can cause serious consequences for the patient's health. Wherein death may occur a short time after chemotherapy, as well as within one year after treatment.

• Changing the patient's lifestyle.

Those patients who really intend to live long begin to take care of their health. They change their diet towards wholesome and healthy food, change their place of residence to more environmentally friendly areas, begin to engage in physical activity, and resort to methods of strengthening the immune system and hardening. Bad habits - alcohol, smoking and others are also ostracized. Those who want to lead a fulfilling lifestyle can resort to a change professional activity and place of work, if this greatly affects the patient’s quality of life. All of the above measures can lead not only to an increase in life expectancy after chemotherapy to ten - twenty - thirty years, but also to complete relief from signs of the disease.

• The patient’s psychological attitude towards recovery is very important. It has been noticed that those patients who are truly committed to living a full life after undergoing chemotherapy live a long time without experiencing relapses of the disease. Psychological attitude on recovery is very important for the patient's life expectancy. After all, it is not in vain that many diseases, including cancer, are believed to be of a psychosomatic nature.
• A huge role is played by changes in the psychological situation in the patient’s place of residence and work. It is known that negative emotions are one of the main reasons somatic diseases, including oncological ones. Immune and recovery processes in the body are directly related to the patient’s mental state. Therefore, being in an atmosphere of positive emotions, support, participation and attention is one of the factors in increasing the duration after chemotherapy. It is important to change the atmosphere in the patient’s home and work in such a way that it has a positive effect on his condition.

Also has great importance getting pleasure from life and bright, pleasant impressions. Therefore, you need to think about activities and hobbies for the patient that would give patients pleasure and fill their lives with meaning.

Disability after chemotherapy

Disability after chemotherapy is issued if an uncertain prognosis for the patient’s condition is established. In this case, the high risk of relapse, for example, the possibility of metastases, is of great importance.

If after the surgical treatment no further appointment radiation treatment and chemotherapy, this means that the patient’s prognosis for recovery is high. In this case, there are no complications that lead to persistent disturbances in the functioning of the body and limit the patient’s life. In this case, disability is not registered due to lack of grounds.

If the patient needs to go heavy treatment over a long period, he may be assigned disability group II for a period of one year. Chemotherapy can be of varying degrees of severity; this affects the disability group, which may be third.

It should be noted that disability is not assigned immediately after surgical intervention, and after three to four months from the initial moment of treatment and longer. This applies to working patients, pensioners, and non-working patients. Registration of disability cannot be longer than four months after chemotherapy treatment of the disease.

In this case, the patient passes medical commission, which issues a conclusion about obvious unfavorable clinical and labor prognoses for the patient. This does not depend on the duration of the patient’s temporary disability, but must be done no later than four months from its onset. Only citizens who have permanent disabilities or permanent disabilities and need assistance are sent to undergo the commission. social protection.

The patient’s condition after chemotherapy is the determining factor for committing further actions to improve health, improve quality of life and social protection of patient rights.

Complications from chemotherapy are an integral part of the course of the fight against cancer. Adverse reactions are a consequence of the effect on the body chemical substances that effectively fight cancer. Duration feeling unwell depends on the duration of treatment, as well as the individual characteristics of the body. Properly selected symptomatic treatment helps to cope with adverse reactions in the shortest possible time.

Chemotherapy effectively fights cancer cells by inhibiting them. But such drugs do not have selectivity, so they also have a detrimental effect. healthy cells, which leads to disruption of the functioning of all organs and systems. Complications of chemotherapy include:

• blood pathologies;
• gastrointestinal disorder;
• hair loss;
• disruption of the kidneys and liver.

Treatment of complications of chemotherapy requires an integrated approach and consideration of the individual characteristics of the patient.

From the digestive system

Because the digestive tract, especially the intestines, are capable of accumulating toxins, the main symptoms adverse reactions after chemotherapy are:

1. Constant nausea - develops due to a detrimental effect on the centers for the formation of gag reflexes in the cerebral cortex. The intensity depends on the duration of chemotherapy and the characteristics of the drug.
2. Vomiting - most often occurs after eating, which is explained by inhibition of the pancreas, which suffers from the toxic effects of chemicals. A lack of enzymes causes indigestion, which ends in vomiting.
3. Diarrhea and stool upset – there are many reasons for their development. This includes not only the effects of chemicals, but also psychogenic factor. Constant stress caused by uncertainty about tomorrow, may cause persistent intestinal upset.
4. Lack of appetite - a person cannot eat food and reacts sharply to the usual smells of food, which is triggered by toxicosis.

Statistics show that the complications of chemotherapy appear especially clearly in the first hours after the administration of the drug, and after 1-2 days the condition stabilizes.

From the immune system

Rapid suppression of immunity provokes a decrease in natural protective forces body. The patient easily “catches” viruses and bacteria, but is unable to overcome the inflammatory process on his own. This manifests itself as follows:

1. Immunodeficiency – accompanied by frequent inflammatory processes.
2. Development of stomatitis – mucous membrane oral cavity becomes thinner, and any food causes pain. Infectious stomatitis develops due to activation pathogenic microorganisms, which requires symptomatic treatment.
3. Lesions of the skin and mucous membranes - conjunctivitis and skin rashes appear during the first course of chemotherapy, when the body is exposed to a huge dose of toxic substances. The protective properties of the skin and mucous membranes are significantly lost.

From the circulatory system

In the process of suppression cancer cells, all blood fractions are affected. The bone marrow stops synthesizing blood cells in the required volume, which causes pancytopenia. This condition is characterized pathological decline the number of all types of blood cells. This is accompanied by the following symptoms:

• constant drowsiness;
• increased fatigue;
• lack of mood;
• anemia;
• pallor of the skin.

In particular dangerous cases A blood transfusion may be required to stabilize the patient's condition.

From the musculoskeletal system

Synovial fluid, which is contained in the cavity of any joint and acts as a natural lubricant for two bones in contact, is capable of accumulating and retaining toxins. This leads to disruption of its basic functions, which affects the entire musculoskeletal system. This is manifested by the following symptoms:

• joint pain;
• crunching sound when moving;
• decreased range of motion and stiffness;
• decreased hand motor skills;
• inability to do minor work.

In this case, in rehabilitation period Exercise therapy is mandatory, with the help of which it is possible to restore muscle tone and avoid the development of joint pathologies.

From the nervous system

Chemotherapy has a depressant effect on the nervous system. This manifests itself in constant irritability and apathy. A person loses interest in everything that happens around him. Close and dear people who show compassion cause additional irritation and tearfulness.

Mood changes more often than wind direction. This process cannot be controlled, especially if we're talking about O female body. Mental disorders develop individually, so it is impossible to predict exactly how the body will behave on different stages chemotherapy.

Target organs

In addition to system damage, vital important organs, such as:

1. The liver is an organ that cannot cope with the load, so it performs only a third of its functions. This is accompanied by pain in the right hypochondrium and a host of other symptoms.
2. Lungs – decreased under the influence of highly toxic drugs local immunity. This is fraught with joining respiratory diseases who have enough acute form course and require long-term treatment.
3. Kidneys – During chemotherapy, almost everyone develops an acute feeling of thirst. This leads to excessive consumption of fluid, which the kidneys are not able to fully utilize and eliminate. Therefore, swelling of the limbs develops, which causes pain.

If any alarming symptoms appear, the patient undergoes an ultrasound of the organs abdominal cavity and small pelvis, which allows you to establish the cause and select the most optimal treatment.

Appearance

The appearance also undergoes changes. Hair becomes brittle and dull. They may partially or completely fall out, which leads to the need to shave your head bald. Women suffer especially acutely from this, since the lack of hair gives rise to a number of complexes.

The skin loses moisture and becomes dry. Microcracks appear, which are “open gates” for pathogenic microorganisms. This is fraught with the addition of inflammatory processes of the skin, which requires complex treatment.

Degree of complications

Depending on how pronounced clinical picture, complications are divided into degrees of severity:

1. Moderate degree - accompanied by hair loss and a slight change in blood composition. It does not require symptomatic treatment, and the body returns to normal after 2-3 months without additional intervention.
2. Progressive degree - accompanied by rapid changes in the composition of the blood, as well as a deterioration in the patient’s condition, which requires complex treatment. The patient is recommended to undergo further treatment in the hospital.
3. Advanced degree - the body experiences increased loads cytostatics, as a result of which the blood formula changes, metabolic processes are disrupted, and the general health. The condition requires immediate corrective therapy, reducing the dosage or postponing chemotherapy until the condition improves.

The degree of adverse reactions depends on the drug, its dosage and the characteristics of the body. In cases where it is known that a chemotherapy drug develops a whole range of adverse reactions, the patient is hospitalized and left under constant supervision by medical staff.

If chemotherapy is carried out on an outpatient basis, the patient must tell the doctor about his condition every day. This will prevent the development serious complications by promptly prescribing symptomatic treatment.

How long do side effects last?

Complications from chemotherapy may persist long time. The duration depends on several parameters:

1. The age of the patient - the younger the body, the easier it is to cope with adverse reactions. The rehabilitation period can reach 1-2 months.
2. Type of medication and dosage - if available running forms cancer and the need to use high-dose chemotherapy, a person may experience the bitterness of adverse reactions for up to a year. During this time, all vital functions are restored.
3. The presence of individual characteristics of the body - strong immunity before oncology will allow you to quickly overcome the effects of chemotherapy. Availability chronic diseases poses a high risk of exacerbation.

On average, the rehabilitation process takes up to a year. If the patient follows all the specialist’s recommendations, does not violate bed rest and takes all prescribed medications, noticeable improvements in the condition will appear 1-2 weeks after the end of chemotherapy.

In the presence of chronic and systemic diseases The rehabilitation process can be delayed for 1-2 years, which requires the patient to be constantly in the clinic under the close supervision of specialists.

Treatment of complications

Symptomatic therapy is selected depending on the degree and type of complications:

1. Antiemetic drugs help block the gag reflex, which helps cope with persistent nausea.
2. Immunomodulators – help stimulate the immune system, which protects the body and helps protect it from the influence of pathogenic microbes.
3. Vitamin complexes – normalize metabolic processes in the body, replenishing deficiencies useful substances, which temporarily cannot be synthesized or are synthesized, but not in full.
4. Hepatoprotectors – help protect the liver from the harmful effects of chemotherapy, normalizing its performance.
5. Nootropic drugs – normalize cerebral circulation, reducing the oxygen demand of brain cells.
6. Diuretics – prevent the development of edema by removing excess fluid from the body. Helps lower blood pressure.
7. Opioid analgesics - prescribed in special cases difficult cases when the patient experiences severe pain, which cannot be relieved with conventional analgesics. They are addictive and therefore not suitable for long-term use.
8. Hormonal drugs - help block the body's response in the form of swelling, inflammatory process and pain.
9. Psychotropic substances - reduce the load on the nervous system, allowing a person to fully rest.
10. Antibacterial therapy is prescribed in the presence of bacterial damage to the mucous membranes and skin, which is associated with a decrease in local immunity.
11. Sorbents – help eliminate diarrhea by removing accumulated toxins in the intestines. Can be used throughout the chemotherapy period, which will help reduce the symptoms of diarrhea.
12. Enzymes - facilitate the work of the digestive tract, facilitating the digestion of food in full.

In the presence of acute pancytopenia, a transfusion of blood or plasma enriched with red blood cells is required. The effectiveness of the transfusion lasts 1-2 days, after which the manipulation is repeated until the bone marrow is restored and begins to fully synthesize blood cells.

To quickly restore scalp hair, it is recommended to use special cosmetical tools, whose action is aimed at stimulating the growth of hair follicles. However, manipulations should be carried out only after completion of all chemotherapy courses, since desired effect it will not be possible to obtain it when exposed to chemicals.

The choice of treatment package for complications after chemotherapy is based on the manifestation and intensity of adverse reactions. Before performing chemotherapy, the doctor tells the patient about possible complications and methods to combat them.

Prevention of complications after chemotherapy

Prevention of complications of chemotherapy consists of following tips and recommendations such as:

1. Spending more time in the fresh air - walking in the park helps reduce nausea and develop muscles. Active saturation of the body with oxygen leads to the normalization of all metabolic processes, after which the rehabilitation process goes faster.
2. Exercise therapy – physiotherapy helps eliminate stagnant processes in organism. With its help, the muscle corset is strengthened. Exercises can be performed both outdoors and while lying in bed. After the exercise, you feel cheerful and energized.
3. Proper nutrition – during the rehabilitation period it is important to eat properly. The body needs large quantities protein, since it is the basis and building material for all cells. It is recommended to eat chicken, turkey, rabbit, shrimp, and whey. You need to eat in small portions. The serving size should not exceed 100 g, and the frequency of meals should not be less than 5-6 per day. This will reduce the load on the digestive tract and avoid vomiting.
4. Quitting bad habits - this is especially true for heavy smokers. From bad habit you will have to give up, since nicotine aggravates the rehabilitation process, placing additional stress on the body.
5. Positive emotions – scientists have proven that positive emotions contribute to speedy recovery. Therefore, the patient should be surrounded with attention and care, and spend more time together.
6. Drink plenty of fluids - you need to drink often, but in small sips. The liquid promotes the rapid removal of toxins from the body, preventing their accumulation in the body.
7. Physiotherapeutic procedures are prescribed by a doctor to improve overall well-being.
8. Compliance with all doctor's recommendations - some patients forget to take medications on time or do it on purpose. It is necessary to monitor that the patient fulfills all treatment requirements, otherwise there is no point in hoping for a positive outcome.

Complications from chemotherapy for cancer should be monitored by a doctor and treated fully. To do this, a set of drugs is selected that can eliminate all the side effects of the chemistry. Side effects It is impossible to completely prevent, but the intensity of their manifestation can be reduced.

October 11th, 2011

Very detailed article about complications of chemotherapy

Content:

1. After chemotherapy
2. Decreased blood cell count
3. Hair loss
4. Stomatitis
5. Nausea and vomiting
6. Infections
7. Temperature increase
8. Vascular thrombosis and extravasation

Consequences of chemotherapy

Medications These are substances that cause some changes in the body. Chemotherapy drugs are designed to destroy tumor cells. In the treatment of lymphomas and tumors in general, a combination of several chemotherapy drugs is often used. This combination is called a “mode” or “course”.

Treatment can be systemic, where drugs are injected into the blood to destroy tumor cells throughout the body, or local, where only certain areas of the body are exposed to therapy, such as radiation.

Of course, the goal of any treatment is to destroy tumor cells. But at the same time it is necessary to cause minimal damage to normal cells.

Today, selective destruction of tumor cells is only partially possible. Therefore, the goal of treatment depends on the risk associated with the disease itself and the risk of complications of chemotherapy.

Damage normal cells during a course of chemotherapy leads to the development of side effects. For example, many chemotherapy drugs act on rapidly dividing cells. Chemotherapy causes symptoms of the disease, but also damages normal rapidly dividing cells, such as cells in the hair roots, bone marrow, intestines and other tissues. leaving

Let us briefly list the consequences and complications that develop after chemotherapy or during chemotherapy:

Consequences of chemotherapy:

• Myelosuppression


• Anemia


• Neutropenia


• Thrombocytopenia


• Alopecia


• Stomatitis


• Nausea


• Thrombophlebitis


• Extravasation


• Infections


• Flu-like syndrome

Most chemotherapy drugs cause hair loss and suppress normal hematopoiesis, and these effects are dose-dependent. So, the higher the dose of chemotherapy, the more pronounced the inhibition of hematopoiesis. Many cytostatics have toxic effects on various organs: kidneys, liver and these effects may also be dose-dependent.

All types of chemotherapy are selective to some extent. Selectivity means that they act more on tumor cells and less on normal cells. The selectivity of drugs may vary. So, if the drug acts on rapidly dividing cells, then it will destroy not only tumor cells, but also normal rapidly dividing cells, of which there are a lot in the body. Therefore, the complications of such a drug are very extensive. New drugs, monoclonal antibodies, act very selectively. They damage tumor B cells and normal B lymphocytes, but do not toxic effect to other cells. Therefore, the spectrum of side effects of monoclonal antibodies is much narrower: they cause immediate reactions to the injection and immunodeficiency associated with the destruction of normal B lymphocytes. Some new treatments are highly selective only for tumor cells. But these treatment approaches are currently being researched. In general, the more selective a drug is, the fewer side effects it causes.

When choosing treatment, your doctor considers possible complications chemotherapy, both immediate and long-term, and correlates them with the prognosis of the disease (variant of lymphoma, stage, prognostic markers). For example, if this variant of lymphoma has an aggressive course, then it is appropriate to undergo intensive chemotherapy, which causes numerous complications: the risk is justified. All concomitant diseases and age are also taken into account. Finally, another important question is whether current treatments will allow other therapies to be used in the future.

Myelosuppression, or decreased number of blood cells

Blood consists of 3 main types of cells - red blood cells, white blood cells and platelets.

Red blood cells (erythrocytes), white blood cells (leukocytes) and platelets are constantly produced in the bone marrow. A condition in which chemotherapy leads to bone marrow suppression and a temporary decrease in blood counts is called myelosuppression or myelotoxic cytopenia. After chemotherapy, it can reduce the number of all blood elements - red blood cells, white blood cells and platelets. But the most dangerous is a decrease in leukocytes and platelets.

Anemia after chemotherapy

Red blood cells (erythrocytes) are constantly produced in the bone marrow.

Anemia- a decrease in the number of red cells (erythrocytes) and hemoglobin (the protein contained in red blood cells) in the blood. Hemoglobin carries oxygen to tissues. If there is little hemoglobin, oxygen transfer to tissues is reduced. Symptoms appear - weakness, fatigue, dizziness. Mild or moderate anemia is observed in many, almost all patients and does not require treatment. For severe anemia, red blood cell transfusion is indicated.

However, even if hemoglobin is significantly reduced, one should be very careful about red blood cell transfusions. On the one hand, if a person spends most of the daytime in bed, his need for oxygen is small - significantly less than that of a person leading a normal lifestyle. He does not have to have 120 g/l of hemoglobin, 70 - 80 g/l is enough, you can get by with less. The bone marrow is restored and hemoglobin levels return to normal. On the other hand, when transfusing blood components, you can become infected with hepatitis and various other viral infections. Despite numerous measures taken to prevent infection during transfusion of blood components, people become infected with hepatitis. Often. And as often happens in medicine, it is better to suffer temporary troubles, but to avoid a greater disaster - the risk of contracting hepatitis, AIDS, cytomegalovirus infection and other infections.

A growth factor, erythropoietin, which selectively leads to an increase in red blood cells, is quite widely used abroad. Erythropoietin is the same doping for which athletes are not allowed to compete or are deprived of awards. This is not a transfusion of red blood cells, this is a selective effect on bone marrow producers of red blood cells. There is no danger of contracting viruses. In our country, erythropoietin is used infrequently for the correction of anemia caused by chemotherapy, mainly due to its high cost.

Decreased white blood cell count - Neutropenia

White blood cells (leukocytes) are constantly produced in the bone marrow. There are several types of white cells (leukocytes) in the blood. The main types are neutrophils (neutrophil granulocytes), lymphocytes and monocytes.

A decrease in the number of neutrophils (granulocytes) is called neutropenia.

Very deep decline (<500 нейтрофилов в микролитре крови) называют агранулоцитоз. Нейтрофилы играют очень важную роль в борьбе с инфекциями. При снижении уровня нейтрофилов возникает риск инфекций, в том числе серьезных, требующих срочной госпитализации и назначения массивной антибиотической терапии. Между курсами химиотерапии нужно следить за уровнем нейтрофилов - сделать анализы крови 1 или 2 раза (если курс проводится амбулаторно; в стационаре, обычно, чаще). Пациент должен знать о том, что у него нейтропения или агранулоцитоз и соблюдать меры предосторожности в этот период. Инфекции в период агранулоцитоза могут развиваться очень быстро и здесь все зависит от скорости оказания помощи. О каких симптомах необходимо обязательно сообщить врачу, по возможности, быстрее:

• Temperature rise over 38 degrees


• Chills


• Sore throat


• Rash


• Diarrhea


• Swelling, tenderness, redness of the skin around wounds, in the genital area, buttocks

If profound neutropenia persists at the start of the next course, it may be necessary to delay the administration of chemotherapy or reduce the dose. This is usually not recommended because it reduces the effectiveness of the treatment.

It is very important that increasing white blood cells does not become an end in itself. It is not the level of leukocytes in itself that is dangerous, but the tendency to infections that arises. We must focus maximum efforts on preventing infections and continue treatment. A level of 3,000 - 2,000 leukocytes is not that dangerous.

There is no point in prescribing drugs such as prednisolone and its analogs, ACTH and its analogs. These substances cause a redistribution effect: the total number of leukocytes does not change, they simply appear more in the blood. This sometimes has a calming effect on the patient and the doctor; in reality, nothing changes. On the other hand, prednisolone itself attacks the immune system and weakens it. This is one of its very important effects; Otherwise, why is it prescribed for autoimmune diseases?

Derinat - may help with stomatitis, but has only a distribution effect on leukocyte levels, if at all.

The only way to increase leukocyte levels with medication is to prescribe granulocyte growth factors (filgrastim, lenograstim). These drugs stimulate the production of white blood cells in the bone marrow. They are included in many chemotherapy courses and allow you to shorten the intervals between courses. For example, growth factors are included in chemotherapy courses widely used for lymphomas, such as enhanced BEACOPP, 2-week CHOP, hyperCVAD.

Thromocytopenia - a condition in which platelets are low

Platelets help start the blood clotting process in case of tissue damage - injuries, cuts.

A decrease in platelets in the blood is called thrombocytopenia.

Normally, 1 microliter of blood contains 180 - 320 thousand platelets. The degree of thrombocytopenia determines the presence of symptoms. With a slight decrease in platelets, there are no symptoms. If the platelet count decreases significantly (up to 20 thousand per microliter), bleeding may appear in the gums, in the form of red spots on the skin (usually on the shins), and nosebleeds. Hemorrhages in organs, especially the brain, are dangerous; bleeding is dangerous - gastric, intestinal, uterine. Nosebleeds can be very severe.

Treatment depends on the cause and severity of thrombocytopenia. Mild to moderate thrombocytopenia does not need to be treated at all. The main treatment for dangerous thrombocytopenia that develops after the use of chemotherapy drugs is platelet transfusion. There is a platelet-derived growth factor (interleukin 11; oprelvekin, nyumega), but it is practically not used in Russia yet.

It is important to remember that this is only a temporary effect and that the hair will grow back after chemotherapy is completed. At first they may be thinner and a slightly different color, but then they are completely restored.

• After washing your hair, gently pat it dry with a towel rather than rubbing it.


• To wash your hair, use mild protein-based shampoos and conditioners. Baby shampoos work well.


• To comb, use a soft, wide-tooth comb.


• Do not use curlers, curling irons, or blow-dry your hair.


• Do not dye your hair, do not use hair sprays or other chemicals.


• Use satin bed linen: on a satin pillow, hair practically does not rub. You can wear a special cap at night.


• Open sun and temperature changes increase hair loss.


• It is better to wear a hat when outside.


• If hair loss begins, it is better to shave it off immediately or cut it short.


• If your hair has fallen out, people get out of the situation in different ways - a scarf, a shawl, a wig, ladies' hats without a brim, caps. Please purchase a wig, a hat, whatever you like in advance.

Stomatitis after chemotherapy

Stomatitis is an inflammation of the oral mucosa. Stomatitis is one of the common complications of chemotherapy. This section contains tips for caring for your mouth during and after chemotherapy.

• How to care for your oral cavity?


• What to do if stomatitis still appears How to reduce pain

How does chemotherapy affect the oral cavity?

Chemotherapy drugs act on all dividing cells, regardless of whether they are tumor or normal. Normal cells regenerate faster than tumor cells, so with each cycle of chemotherapy there are fewer and fewer tumor cells. However, damage to normal cells leads to complications. Damage to the cells lining the oral mucosa leads to stomatitis. Epithelial cells slough off from the oral mucosa, it becomes red, swollen, and small ulcers form. The mouth becomes very dry, cracks appear on the lips. There may be bleeding gums.

It is important that stomatitis is only a temporary complication of chemotherapy. It will disappear when treatment is completed and your white blood cell count rises. The likelihood of developing stomatitis depends on the type of chemotherapy and your condition.

Naturally, in this condition, infections easily occur on the oral mucosa, especially when there are few leukocytes in the blood. Leukocytes and, in particular, neutrophils, play an important role in protection against infections. A decrease in leukocytes especially often leads to stomatitis and other infectious complications of the gastrointestinal tract. The faster the leukocyte count increases between courses, the lower the risk of infections.

Most often, thrush appears in the mouth - an infection caused by fungi of the genus Candida. Thrush looks like white plaques or a curd-like mass on the mucous membranes of the cheeks and tongue. Treatment consists of prescribing antifungal drugs.

How to take care of your mouth

It is within your power to avoid stomatitis or significantly reduce its manifestations. Firstly, before starting chemotherapy, it is advisable to go to the dentist and try to eliminate all chronic problems (we are talking about inflammatory foci - gingivitis, periodontitis). The dentist will also advise you on ways to prevent stomatitis. Secondly, during treatment, it is advisable to examine your mouth daily for redness, swelling, soreness, white plaque, and bleeding.

Adviсe

• Brush your teeth gently after every meal; at night for sure.


• You need to brush your teeth for at least three minutes. Firstly, chemical reactions occurring with the participation of substances contained in the paste require at least some time. Secondly, this way you will actually remove the bacterial film covering the teeth. The tongue also needs to be gently cleaned.


• The use of floss (dental floss) is contraindicated (!!!) if you have low platelets. If there are more than 100 thousand platelets per microliter, it is possible and desirable.


• The brush should have a small head and soft bristles. Brushes vary in bristle stiffness. Yours should say “soft”. "Medium" and "firm" are not suitable. The best option is a baby brush. Electric brushes with soft bristles are highly effective.


• The paste must contain fluorides and silicon dioxide. Silicon dioxide is an abrasive substance that is the main component of the paste. Many pastes are made with coarser abrasives (calcium carbonate, chalk). They don't fit. It is desirable that the paste contains an antiseptic drug. Pastes containing sodium lauryl sulfate can be dangerous: there is evidence that this substance itself can cause stomatitis. Be that as it may, it is better to play it safe and not use them. So, when buying a paste, you will have to study its composition.


• If brushing your teeth hurts, rinse your mouth vigorously. A teaspoon of baking soda per glass of water is fine. Consult your doctor. There are now a large number of liquid oral care products. They are divided into elixirs, balms and rinses. Elixirs and balms are aqueous-alcohol solutions. Rinse aids usually do not contain alcohol or contain only small amounts of it. We need rinses containing antiseptic substances - chlorhexidine (chlorhexidine solution, eludril, peridex, corsodil). Usually they rinse your mouth 2-3 times a day, after meals. Long-term use leads to darkening of teeth. When you stop taking the mouthwash, the color of your teeth will return.


• Lubricate your lips with Vaseline and hygienic lipstick.


• The development of stomatitis is promoted by strong alcoholic drinks, smoking, hot sauces, vinegar, garlic, onions, and salty foods.


• Keep your mouth moist. For example, carry a bottle of water with you.


• Don't eat dry food. Non-spicy sauces and gravies are what you need. You need to drink at least 1.5 liters of liquid per day - water, tea, weak coffee, juices (for example, apple). Sour juices are not recommended - orange, grapefruit, lemon. Warm herbal teas are good. To keep your mouth fresh, you can eat pieces of pineapple in juice, berries, and other things of this kind.

What to do if stomatitis still appears - treatment of stomatitis

Need a doctor. Even if you want to rinse your mouth with herbal preparations, consult your doctor. The following are the main means in the treatment of stomatitis.

Herbal preparations

• sage, St. John's wort, calendula, chamomile, oak bark help with stomatitis.

Rinse aids

• Rinses with chlorhexidine (chlorhexidine solution, eludril, peridex, corsodil). Numerous preparations containing biclotymol

To fight the pain

• You can rinse your mouth with anesthetics (lidocaine, benzocaine, trimecaine, colanchoe juice).


• Some people rinse their mouths with aspirin and say that it is very effective. Just don’t swallow it, it’s dangerous, especially if your body temperature is high. Aspirin can lead to a critical drop in temperature. Very often, the only sign that the antibiotic has worked is a decrease in temperature. If you use aspirin and other antipyretics, you are not allowing the effect to be seen. In addition, aspirin is strictly contraindicated if platelets are low. Be sure to tell your doctor if you are going to take aspirin.


• Preparations containing benzydamine (tantum verde) Complex preparations with chlorhexidine and anesthetics (chlorhexidine X tetracaine)

Nausea and vomiting after chemotherapy

Chemotherapy can cause nausea and vomiting. Most often it develops on the day of chemotherapy administration, but it can occur or recur a day or two later.

How to deal with nausea:

• Tell your doctor about nausea. We have an arsenal of effective drugs at our disposal (ondansetron (Zofran, Latran), granisetron (Kytril), dolasetron (Navoban), aprepitant (emend) has recently been registered). Nausea has ceased to be the scourge of chemotherapy departments.


• Before administering chemotherapy, take an antiemetic drug beforehand.


• On the day of chemotherapy administration, do not eat fatty or fried foods.


• In the morning, food should be liquid, for example, drink broth.


• During the day you can drink water and juices. No milk.


• Ventilate the room you are in; fresh air reduces nausea, but strong odors increase it.


• If nausea is associated with stomatitis, drink through a straw.


• Drink carbonated drinks in small sips.


• Eat crackers in the morning, before you get up.


• Eat little and often. Drink between meals, not with meals.


• Prepare cold foods: Hot food gives off a strong smell.


• Rinse your mouth frequently with solutions of salt, soda (a teaspoon per glass of water), or just water. After every meal, be sure.


• Products that make it easier to tolerate nausea and stomatitis:
  
  
  • nausea is reduced by foods and drinks containing ginger
  
  
  • main dishes - chicken fillet, eggs, lean fish, rice
  
  
  • from fruits and vegetables - baby food products (all kinds of purees), jelly cookies, crackers
  
  
  • drinks - tea without sugar, water
  
  




If you experience vomiting, you must remember that it is dangerous due to dehydration.

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European clinic

One of the main treatment methods in oncology. The mechanisms of action of chemotherapy drugs vary, but they all boil down to one principle: the drugs damage and destroy rapidly multiplying cancer cells.

Since chemotherapy drugs are most often administered intravenously, they spread throughout the body and attack not only tumor cells, but also healthy, actively dividing cells, in particular in hair follicles, red bone marrow, and mucous membranes (mouth, digestive tract, reproductive system). This causes side effects. Some chemotherapy drugs can damage cells of the heart, kidneys, bladder, nervous system, and lungs.

If you are about to undergo chemotherapy, you are likely worried about serious side effects. Here's what you need to know about it:

• There is no reliable way to predict how the body will respond to chemotherapy. Some patients have almost no side effects, while others have very severe side effects.
• There is a rule in oncology: the dose of chemotherapy should be high enough to effectively kill cancer cells, but low enough to cause minimal side effects. The doctor always looks for the “golden mean”.
• Over the past 20 years, doctors have learned to effectively prevent and treat many of the side effects of chemotherapy drugs.

Maintenance therapy helps you endure chemotherapy comfortably. This is important because reducing the dose or stopping chemotherapy reduces the chances of successful treatment and increases the risk of relapse. Doctors at the European Clinic know how to keep side effects under control.

What color is chemotherapy? How is “red” different from “white”?

The division of chemotherapy in oncology “by color” was invented by patients and is largely arbitrary. The main criterion is the color of the drug solution:

• Red chemotherapy: doxorubicin, epirubicin, idarubicin. Cause the most severe side effects.
• Yellow chemotherapy: methotrexate, fluorouracil, cyclophosphamide. In terms of toxicity, these drugs can perhaps be placed in second place after the “red” ones.
• Blue Chemotherapy: mitomycin, mitoxantrone.
• White chemotherapy: taxol, taxotel.

Main side effects of chemotherapy drugs

Hair loss (alopecia) due to chemotherapy

This side effect of chemotherapy is not harmful to health, but is often very distressing for many patients. Hair falls out because chemotherapy drugs damage the roots where cell division occurs. Alopecia does not occur in all patients. Sometimes the hair simply becomes thinner.

Hair loss usually begins a few weeks after starting chemotherapy. Sometimes they fall out quickly, in bunches, sometimes gradually. Most often, this side effect is temporary. Hair grows back 3-6 months after treatment is completed. Their color and appearance may vary slightly.

The European Clinic uses Orbis cooling caps to help prevent hair loss. When the scalp cools, the blood vessels constrict, reducing the flow of blood, which contains the chemotherapy drug, to the hair roots.

What to ask your doctor?

• Will my hair fall out during treatment?
• How to properly care for your hair?
• Is it possible to use a cooling cap to protect your hair?
• How quickly will hair grow back after chemotherapy?
• Where can I buy a wig?
• Where can I get psychological help?

Anemia during chemotherapy

Oxygen is delivered to the tissues of the body by red blood cells - erythrocytes. Each of them lives only 3-4 months, so new ones must constantly form in the red bone marrow. Chemotherapy drugs attack red bone marrow cells, the content of red blood cells and hemoglobin in the blood decreases, and anemia develops.

Manifestations of anemia:

• weakness;
• dizziness;
• shortness of breath, feeling of lack of air;
• cardiopalmus.

Tell your doctor if you begin to experience these symptoms. Anemia requires immediate treatment. There are drugs that increase the activity of red bone marrow. In severe cases, red blood cell transfusion is indicated.

Changes in appetite during chemotherapy

Typically, chemotherapy causes two types of changes in appetite:

1. Decreased appetite, up to complete absence.
2. Changing the taste of foods.

It is important for cancer patients to continue to eat and drink enough fluids. Some tips will help with this:

• Train yourself to always eat around the same time. Even if you are not hungry, take some food.
• Often 5-6 small meals throughout the day are best than 3 big ones.
• Try new dishes.
  If you don't feel like eating, eat socially with family and friends while watching TV.
• Seasonings can improve the taste of food. Ask your doctor which ones may be appropriate for you.
• Sometimes patients feel a metallic taste in the mouth. In this case You can change the spoon and fork to plastic ones.
• Food should be high in calories and rich in protein.
• Move more. Physical activity will help increase your appetite.
• Eat liquid food(broths, cocktails) that is easy to swallow.
• Don't drink while eating.
• Keep a food diary, write down everything you ate in it, mark the time. This will help you and your doctor monitor how well you are eating.

• Soups: bean, lentil, cream soups.
• Beverages: whole milk, fruit smoothies, milkshakes, drinking yoghurts.
• Snacks: beans (black and red), chicken, fish, eggs, cereals, nuts, wheat germ.
• Dessert: muffins, ice cream, custard, yoghurt, puddings.
• Other products: margarine, sunflower and butter, soft cheese, sour cream, cottage cheese, milk powder, liquid meal replacements.

If you are losing weight, be sure to tell your doctor about it!

What to ask your doctor?

• What foods can you eat?
• Should I take vitamin complexes and protein shakes?
• How much fluid should you drink every day?
• What physical exercises can you do to increase your appetite?
• How to properly keep a food diary, what to write down there?
• In what cases do you need to urgently contact a doctor?

Changes in skin and nails during chemotherapy

During chemotherapy courses you may experience: dryness, itching, redness, pain of the skin, increased sensitivity to sunlight. Hives may appear on the skin. Nails become brittle and brittle. All these symptoms should be reported to your doctor.

• Take short showers and baths with warm water. Do not use hot water.
• When washing, do not rub the skin with a washcloth; gently stroke it.
• When using lotions and creams, ask your doctor or nurse how to use them correctly.
• The cream should be soft and gentle on the skin. Never use products that contain perfume or alcohol.
• Sometimes in the area of ​​​​skin folds (in the armpits, under the mammary glands, in the popliteal hollows) it is worth applying corn starch. This will help prevent irritation and itching.
• If shaving causes discomfort or irritation, then you should shave less often, or not shave at all.
• Protect your skin from sun rays. When leaving the house, wear long sleeves and long pants, use sunscreen and chapstick.
• Do not visit the solarium.

• Keep your nails short.
• When washing dishes and cleaning, wear rubber gloves.

What should you ask your doctor?

• How to properly care for your skin and nails? What products are best to use?
• What soaps, shampoos and lotions should you not use?
• Which sunscreen and chapstick should you buy?
• What products should you use to treat your nails?
• Is it possible to get a manicure?
• What to do if your skin itches a lot?
• How to care for your skin and nails after treatment? How long will it take to do this?

Changes in memory during chemotherapy

About one in five patients who receive chemotherapy experience problems with memory and thinking. They can be caused by two reasons:

1. side effects of chemotherapy drugs;
2. fatigue, anxiety, stress due to illness and treatment.

The doctor must understand the causes and prescribe treatment. Sometimes memory impairment is not severe and does not cause any special problems, in other cases it interferes with everyday activities.

• Plan ahead. Write them down in a diary or on colored sticky notes placed in a visible place.
• The hardest tasks should be done when you feel good and you can concentrate as much as possible.
• Get more rest.
• Notes will help you take your medications on time and correctly, special boxes, marks in a calendar or diary.
• Don't be shy to ask family and friends for help, if you can’t handle things on your own.
• Ask your family or nurse to remind you about taking medications and procedures.
• If you feel that your condition has worsened or your consciousness is confused, you need to call a doctor and ask that someone close to you be with you at all times.

What should you ask your doctor?

• Why did my memory deteriorate?
• What medications can improve it?
• How long will these violations last?

Constipation during chemotherapy

Constipation is a condition when stool becomes rarer, denser, difficult to pass, and you have to push hard and for a long time in the toilet.

When to see a doctor?

Tell your doctor if you are concerned about the following symptoms:

• There was no stool for more than 2 days.
• I'm worried about pain in my stomach.
• The belly has increased in size.
• Appetite has decreased, nausea and vomiting occur periodically.

How to deal with constipation?

These simple tips help many people:

• Drink enough fluids- at least 8 glasses per day. Plain water, compote, juices from fruits and vegetables, tea, coffee will do. Water will help soften the stool and make it easier to pass.
• Eat more fiber-rich foods: seeds, nuts, vegetables, fruits, whole grain bread.
• Move more. Physical activity helps strengthen intestinal motility. Walk or bike for 15-30 minutes every day. Ask your doctor what exercises may be appropriate for you.

What to ask your doctor?

• What medications will help relieve constipation?
• What's better to eat and drink?
• How much fluid should you drink daily?
• What physical exercises can you do?
• When do you need to see a doctor urgently?

Fatigue and weakness during chemotherapy

Increased fatigue can be associated with chemotherapy, anemia, stress and depression, insomnia, and chronic pain. Sometimes fatigue occurs only at certain times, other times it lasts all day. Be sure to tell your doctor if this makes it more difficult for you to cope with daily activities or if your fatigue does not go away even after resting.

• Plan ahead. Do the most important ones first when you feel good.
• Ask your family for help if you can't handle it on your own.
• If you plan to continue working during treatment - take time off early, take fewer working hours.
• It is useful to keep a diary. Write down how you feel every day. This will help your doctor better monitor your condition and prescribe the best treatment.
• Eat well. Cook meals when you feel good and freeze for later.
• Better 5-6 small meals throughout the day than 3–4 solid ones.
• Drink at least 8 glasses of liquid per day. You can take small sips throughout the day.
• Try to exercise at least 15 minutes a day.
• Rest often. If you feel tired, don’t force yourself and continue working.
• Train yourself to take a nap. It should last at least an hour.
• Always go to bed at the same time.
• Before going to bed, try to relax. For example, pleasant music helps.
• Your night's sleep should last at least 8 hours.

What should you ask your doctor?

• What medications will help cope with fatigue?
• What should I eat and drink?
• How much fluid should I drink every day?
• What physical exercises can make me feel better?
• How can I properly control my well-being? What information should you write down in your diary?
• In what cases should you urgently consult a doctor?

Nausea and vomiting during chemotherapy

Nausea and vomiting usually occur on days when chemotherapy is not administered. Medicines and some recommendations can help cope with these side effects:

• Limit spicy, sweet, salty, fried, fatty foods.
• If you can't stand the smell of raw food, ask your loved ones to cook it for you.
• Allow food to cool, do not eat it hot.
• Eat little, but more often. 5-6 small meals throughout the day are better than three “big” ones.
• If you find it difficult to drink a lot, take small sips of liquid throughout the day.
• During the administration of chemotherapy, you should try to relax and breathe deeply. Your loved ones can help and distract you.
• Find the best meal time for you. Some people feel fine if they eat a little before the procedure. Others are better off not eating anything.
• It is not recommended to eat or drink anything for at least an hour after the administration of chemotherapy drugs.
• Acupuncture helps some people cope with nausea.

Foods and drinks that will help improve your condition:

• Transparent broths: beef, chicken, vegetable.
• Grape or cranberry juice.
• Soda.
• Rehydron and other salt solutions for rehydration.
• Rice flakes.
• Semolina.
• Skinless chicken, boiled or baked.
• Oatmeal.
• Cookies, crackers.
• Boiled potatoes.
• Pasta, noodles.
• Croutons (from white bread).
• White rice.
• Yogurts.
• Applesauce.
• Canned peaches and pears.
• Bananas.
• Sherbet.
• Fruit ice.
• Kissel.

What should you ask your doctor?

• What foods are recommended for me to eat?
• What foods should you limit?
• What foods should you completely avoid?
• How much fluid should you drink daily?
• Can physical therapy and acupuncture be helpful in my case? Where can you find specialists?
• Where can I find a nutritionist who can create an optimal diet?

The effect of chemotherapy on female fertility

Chemotherapy can lead to decreased levels of female sex hormones and premature menopause. Symptoms such as:

• Dryness, itching in the vagina, pain and discomfort during sexual intercourse.
• Hot flashes.
• Decreased sexual desire.
• Weakness, emotional instability, tendency to depression.
• Irregular periods or absence of them.
• Sweating at night.

Hormonal therapy, relaxation techniques, and artificial vaginal lubricants help to cope with these manifestations. If hot flashes are a concern, carry a fan with you. Wear light clothing under warm clothing so that it can be removed during high tide.

During chemotherapy, you need to use contraception because chemotherapy drugs damage the cells of the embryo and fetus. If you are planning to have a child in the future, you need to inform your oncologist in advance and consult with a reproductive health specialist.

The effect of chemotherapy on male fertility

Some chemotherapy drugs cause a decrease in testosterone levels in the body in men. This leads to some symptoms:

• Erectile dysfunction: difficulty getting and maintaining an erection.
• Decreased sexual desire.
• Increased fatigue.
• Irritability, tendency to depression.
• Sometimes - hot flashes, sweating.

Some medications help combat these disorders.

When a man is undergoing chemotherapy, he must use a condom during sexual intercourse, even if his partner uses other forms of contraception. Chemotherapy drugs can penetrate sperm and enter the woman’s body with it.

Oral cavity and throat

Cells in the mucous membrane of the mouth and digestive tract are constantly multiplying and renewing themselves, so chemotherapy drugs can damage them. In some patients, 7–10 days after the start of treatment, an inflammatory process occurs in the mouth - oral mucositis. The burning sensation is disturbing, like after a burn with boiling water, ulcers may appear.

Tell your doctor if you experience any of these symptoms:

• It became difficult to eat and swallow.
• Painful spots and ulcers appeared on the oral mucosa.
• Sores appeared on the inside of the lips and cheeks.
• You began to taste and smell food and objects differently.
• Saliva production has almost ceased, and my mouth is constantly dry.
• When you eat hot or cold food, pain occurs.

• Take care of your teeth regularly. Brush your teeth and tongue after every meal and before bed.
• Use a toothbrush with soft bristles or cotton swabs.
• Toothpaste must contain fluoride- it helps strengthen teeth.
• Rinse your mouth with baking soda solution(¼ teaspoon) and salt (1/8 teaspoon) diluted in a glass of water. After this, you need to rinse your mouth with plain water.
• Moisturize your lips with chapstick.
• Drink in small sips or through a straw.
• Give preference to soft foods which is easy to swallow.
• If you have pain in your mouth, You can eat scrambled eggs, porridge, mashed potatoes.
• Broths will help soak solid foods, gravies, sauces.
• Don't eat hot food, let it cool.
• Avoid drinking citrus and tomato juice.
• Don't drink alcoholic beverages.
• Don't drink sweet soda, limit foods that contain sugar.
• If you smoke, try to quit.

You should visit your dentist 2 weeks before starting chemotherapy. If you are having dental treatment, the treatment must be completed. Take a statement from your dentist and show it to your oncologist.

What should you ask your doctor?

• What foods and drinks should I consume?
• Can I rinse my mouth with a solution of salt and soda?
• How can you reduce pain when brushing your teeth?
• Which toothpaste is best to use?
• What medications can reduce my symptoms?
• In what cases should you urgently consult a doctor?

Diarrhea (loose stools) during chemotherapy

Chemotherapy may cause your stool to become loose and frequent. During diarrhea, the body loses fluid, which can lead to serious complications. Some tips will help improve your condition and replenish fluid loss:

• Eat more often: 5-6 small meals a day instead of 3 large ones. Give preference to foods that are easy to digest.
• Drink more- 8–12 glasses of water per day.
• Clear broths, jelly, and Regidron solution help to replenish fluid loss.

Avoid foods that make diarrhea worse:

• Any alcoholic drinks.
• Caffeine, including in black and green tea.
• Fatty, spicy, fried foods.
• Dairy products. Instead, it is better to buy lactose-free products.
• Cabbage, broccoli and other foods that increase gas formation.
• Muesli, whole grain bread and other high fiber foods.
• Raw vegetables and fruits. It is better to eat canned ones instead.
• Some medications make diarrhea worse. Before taking any drug, consult your doctor.

When should you call a doctor?

If diarrhea is accompanied by some symptoms, this indicates serious problems. Contact your doctor if:

• Diarrhea and colic have been bothering me for more than a day.
• Stool frequency more than 6–7 times a day.
• My head is spinning.
• The temperature rose above 38°C.
• There was pain in the rectum, blood in the stool.

What to ask your doctor?

• What medications will help cope with loose stools?
• How much fluid should you drink daily?
• Should I take rehydration solutions?
• Where can I find a nutritionist who can recommend the optimal diet during chemotherapy?

Swelling during chemotherapy

The occurrence of edema can be provoked by chemotherapy drugs, hormonal changes in the body, and general health (in particular, the cardiovascular system). Call your doctor immediately if you experience the following symptoms:

• Difficulty breathing.
• Feeling that the heart is not working properly.
• Rapidly, sharply occurring swelling that quickly increases.
• Unexplained weight gain - This may also be due to swelling.
• Very rare urination, a small amount of urine - this indicates that fluid is retained in the body.

• Wear loose shoes.
• Try not to stand for long periods of time.
• When lying or sitting, try to raise your legs so that they are no lower than the level of your heart.
• Weigh yourself at the same time every day, keep a diary and record your results every day.
• Avoid adding salt and soy sauce to your food.
• Avoid foods that contain a lot of salt: ham, chips, sauerkraut, pickles.
• When you buy foods, be sure to read labels and check how much salt they contain.

What should you ask your doctor?

• How much salt can I consume per day?
• Should I wear compression garments?
• What kind of weight gain should you pay attention to?
• What foods should you not eat?
• How can you reduce swelling and improve the condition?

Nervous system during chemotherapy

Chemotherapy can cause some nervous system side effects. If you notice them, you should immediately tell your doctor:

• Pain while walking.
• Rapid fatigue of the arms and legs, tingling, burning, numbness.
• Loss of balance, falling.
• Dizziness.
• Muscle spasms, cramps, pain.
• Deterioration in hand function: it has become more difficult to lift and hold objects.
• Hearing loss.
• Stomach ache.
• Constipation.

Helpful tips for people with neurological disorders:

• Remove or move carpets in your home to avoid tripping hazards.
• Screw on special grab bars in the bathroom.
• Place a non-slip mat in the bathroom.
• Wear comfortable shoes without high soles.
• Use a cane.
• Buy comfortable shoes for indoors.
• Wear rubber gloves when working in the kitchen or cleaning.
• Regularly examine your feet with a mirror, ask your loved ones for help.
• An ice pack will help reduce pain and discomfort.
• When doing chores around the house, take your time and don't overexert yourself.
• If you find it difficult to do some things, do not hesitate to ask your loved ones for help.

What should you ask your doctor?

• What medications can help treat neurological disorders?
• Should I see a chiropractor?
• What neurological problems might I have and when is it most likely to happen?
• How long will these side effects last?
• In what cases should you consult a doctor?

Urinary dysfunction during chemotherapy

Chemotherapy may change the color and smell of your urine. Ask your doctor what changes may occur. If some symptoms appear, you must inform your doctor about them:

• Chills, fever over 38°C.
• The urine turned red, orange, dark yellow, green, cloudy, and there was blood in it.
• Urination has become difficult, during which there is a burning sensation and pain.
• The urine began to smell sharp.

• Drink enough liquid - at least 8 glasses daily. This can be water, juices (it is better to dilute them with water), fruit drinks, milkshakes, compotes, soups.
• Drink more water, even if you urinate a lot and often - this will help normalize your body's functioning.
• Avoid any drinks that contain alcohol or caffeine.

What should you ask your doctor?

• How much fluid should I drink daily?
• What drinks are best to drink?
• What drinks are undesirable?
• What drinks should you not take?
• In what cases should you urgently consult a doctor?

Bleeding during chemotherapy

Chemotherapy suppresses platelet production in the red bone marrow, causing platelet levels in the blood to decrease and causing increased bleeding. Bleeding may begin due to minor tissue damage caused by everyday activities.

• Don't go barefoot.
• Use a toothbrush with soft bristles (the kind given to patients at the European Clinic).
• Don't blow your nose too much.
• Use only an electric razor.
• Before visiting the dentist, be sure to consult your doctor.
• Don't lift heavy objects.
• Don't drink alcohol.
• Avoid constipation, drink more fluids.
• Don't use enemas.

If there is heavy bleeding, consult a doctor immediately!

What should you ask your doctor?

• What medications will help reduce bleeding?
• What recommendations should you follow?
• May a platelet transfusion be required? In which cases?
• In what cases should you immediately consult a doctor?

Infection during chemotherapy

Tell us immediately if you:

• Temperature 38⁰ C or higher. Ask your doctor how to take your temperature.
• You have chills.
• Cough or sore throat.
• Ear pain.
• Headache and pain in the maxillary and frontal sinuses.
• Pain or stiffness in the neck muscles.
• Skin rash.
• Ulcers, white coating on the tongue or inner cheeks.
• Redness or swelling anywhere. This is especially important if you have a catheter.
• Blood in the urine or cloudy urine.
• Pain or burning when urinating.

If you feel unwell or have symptoms that weren't there before, don't wait. Call your doctor immediately.

Follow these tips to reduce your chance of infection:

Always wash your hands:

• Before preparing and eating food,
• After the toilet,
• After being in public places. Wash your hands with warm water and soap.
• Ask your loved ones to wash their hands thoroughly as well.
• Consult your doctor about using hand sanitizer.

Follow the rules of hygiene:

• Brush your teeth after eating and before going to bed. Use a very soft toothbrush.
• If you have a catheter, try to keep the area dry and clean. Ask your nurse how to care for this area.

Try to avoid injury:

• Use an electric razor, not a regular razor.
• Wash yourself thoroughly and carefully after using the toilet. Tell your doctor if your rectal area hurts or bleeds.
• Do not touch or squeeze pimples.

Avoid contact with germs:

• Stay away from people who are contagious, especially those with a cold or flu. Avoid large crowds of people.
• Wash raw fruits and vegetables thoroughly.
• Wash your hands thoroughly after handling raw meat. Fry the meat thoroughly.
• Try to avoid people who have recently been vaccinated against measles, chickenpox, or polio.
• Have someone clean up after your pets.

Questions to ask your doctor:

1. In what cases should I call a doctor?
2. What else can I do to avoid infection?
3. How often should the temperature be measured?
4. In what cases should you call an ambulance?

Side effects of chemotherapy

What are the manifestations of complications associated with the side effects of chemotherapy, how can these complications be overcome or their severity reduced?

Patients prescribed chemotherapy, as well as their relatives, are often interested in complications that may be associated with treatment with anticancer drugs. In particular, they are interested in whether chemotherapy is always accompanied by such complications, how they manifest themselves and what their likelihood is. Answers to these and other questions are given in subsequent sections. In addition, this section provides specific recommendations that will allow you to reduce the severity to a certain extent.
various manifestations of side effects of chemotherapy.

If you read this section before starting chemotherapy, you may be unpleasantly surprised that chemotherapy is associated with a number of complications caused by the side effects of anticancer drugs. However, it should be borne in mind that such complications do not occur in every patient. Most patients experience chemotherapy with only minor complications, and many experience no complications at all. What kind of side effect may occur during your treatment and what its severity may be - all this largely depends on what anticancer drugs will be used in your case and what your body's response to treatment will be. Be sure to ask your doctor about what complications of chemotherapy are most likely in your case, what their duration may be, how dangerous they are, and what you personally can do to minimize the manifestations of such complications.

Most side effects of chemotherapy can be successfully managed

What is the cause of unwanted side effects of anticancer drugs?

Tumor cells are characterized by rapid growth and relatively rapid division. Anticancer drugs not only block these processes, but also cause irreversible damage and death of such cells. However, many normal cells
also grow and divide quickly. These include: cells of the bone marrow, the mucous membrane of the oral cavity and gastrointestinal tract, the reproductive system, and hair follicles. Therefore, anticancer drugs cause damage to these normal cells, which is the cause of a number of complications associated with the side effects of chemotherapy. Manifestations of such complications include: nausea and vomiting, ulceration of the oral mucosa, baldness, anemia, and increased fatigue. The side effects of chemotherapy also explain the high likelihood of bleeding and infectious complications. During treatment, undesirable consequences may also appear, such as dysfunction of the kidneys, bladder, nervous system and other organs.

How long can chemotherapy side effects last?

The process of restoring the function of most normal cells that were damaged during chemotherapy begins soon after chemotherapy is completed.
Since over time the function of such cells is almost completely restored, the side effects of treatment gradually disappear. However, the duration of the body's recovery period after chemotherapy may vary from patient to patient. This depends on a number of factors, including your health before you started chemotherapy, as well as which anticancer drugs you received.

Most chemotherapy side effects go away fairly quickly after treatment is completed.

Most side effects of chemotherapy do go away soon after it is completed. However, some of them can exist for several months or even years. This occurs in particular in cases where, as a result of treatment with anticancer drugs, damage to the heart, lungs, kidneys and reproductive organs has occurred.
organs. However, some manifestations of the side effects of chemotherapy may not appear immediately, but after a long period of time after its completion.

It is important to note that for most patients, chemotherapy is accompanied by only short-term complications. In addition, it should be especially emphasized that modern medicine has made significant progress in the field of prevention and treatment of most of the rather severe complications associated with the unwanted side effects of anticancer drugs. This means that the effectiveness of chemotherapy on tumor cells has increased, and the danger associated with its undesirable effects on normal cells has decreased.

Every patient undergoing chemotherapy must remember that he is receiving effective treatment that can completely destroy tumor cells, and the complications accompanying such treatment are temporary and do not pose a threat to life.

Some patients express dissatisfaction with the fact that chemotherapy lasts too long and is accompanied by a number of complications. If you have such concerns, consult your doctor. In some cases, the doctor may change the regimen for using previously prescribed chemotherapy drugs or replace some anticancer drugs with others. The doctor will tell you how to reduce the severity of side effects of treatment.

Nausea and vomiting during chemotherapy

Nausea and vomiting may occur during chemotherapy. This may be due to unwanted side effects of anticancer drugs
either on the gastric mucosa or on certain structures of the brain. The severity of this reaction to chemotherapy varies from patient to patient and largely depends on which antitumor drugs are used in this particular case. In many patients, nausea and vomiting do not occur at all. Others make complaints
for prolonged moderate nausea, and some report severe nausea occurring over a short period of time both during chemotherapy and after its completion. Nausea and sometimes vomiting may occur immediately after the administration of anticancer drugs or several hours later.

There are cases when nausea bothers patients for several days. If after the administration of anticancer drugs you experience nausea or vomiting, be sure to consult your doctor.

In the arsenal of modern medicine there is a number of medications that can be used to prevent the occurrence of nausea and vomiting during chemotherapy or reduce their severity and duration. These medications belong to the class of antiemetics. However, the effectiveness of these drugs varies from patient to patient, and in some cases it becomes necessary to prescribe several of these drugs simultaneously.
Therefore, only together with your doctor can you find the optimal way to overcome nausea and vomiting.

A number of drugs are known that prevent nausea and vomiting or reduce their severity and duration

Try to eat a little at each meal to avoid feeling full. Eat small meals throughout the day rather than sticking to your usual three meals a day

Try to eat only soft foods

Eat slowly. Drink the liquid in small sips

Avoid including sweet, fatty, spicy or too salty foods in your diet

Food should be at room temperature, not hot

Chew your food well to improve digestion

Maintain good oral hygiene

If you are worried about nausea in the morning, then even before getting out of bed, you should eat some cookies, croutons or corn sticks. However, this is not necessary if there is damage to the oral mucosa and dry mouth.

If nausea is severe, drink cool, clear, sugar-free fruit juice (such as apple or grape). If you want to drink a carbonated drink, you should wait until the gas bubbles stop.

Sometimes you can suck on an ice cube or sour candy. The mouth should be rinsed with water and lemon juice. However, avoid anything sour if there is damage to the oral mucosa.

Foreign odors that usually accompany the cooking process, cigarette smoke, and the smell of perfume should be avoided. Try not to prepare food yourself, and if this is not possible, then knowing on what day the next administration of anticancer drugs is scheduled, prepare it in advance.

After eating, do not go straight to bed, but sit in a chair for at least two hours

When nausea is at its worst, try to sleep

If you feel nauseous, breathe slowly and take a few deep breaths.

Your clothes should be loose

Try to distract yourself from unpleasant feelings, chat with friends, listen to music, watch TV, read

Avoid eating and drinking for 1-2 hours before and after administering anticancer medications.

If nausea or vomiting occurs, especially within 24-48 hours after the next administration of anticancer drugs, do not hesitate to contact your doctor and strive to follow the recommendations given by him

Baldness from chemotherapy

Hair loss (alopecia) is done to try to minimize
undesirable consequences of chemotherapy. During your conversation with your doctor, you should get answers to the following questions:

Why do you need chemotherapy?

What positive effects can chemotherapy have?

What antitumor drugs will you be prescribed?

What is the likelihood of complications associated with the side effects of such drugs?

How will the medications be administered?

Where will the treatment be carried out?

What is the duration of chemotherapy in your case?

What complications may arise during treatment?

What side effects of anticancer drugs should you immediately report to your doctor?

Psychological support of the patient from the attending physician, relatives and friends is one of the most important components of successful treatment

Alopecia is a fairly common side effect of chemotherapy. However, in many patients, baldness may not occur at all. Ask your doctor what the likelihood of baldness is in your particular case, since the intensity of hair loss is directly related to which anticancer medications
will apply. In some cases, hair density may decrease, and in others, complete hair loss may occur. However, after chemotherapy is completed, the hairline is usually completely restored. In many patients, its recovery can begin during chemotherapy. In some cases, newly grown hair takes on a different color and
texture.

Hair loss occurs not only on the head, but also on other parts of the body (on the face, arms, legs, under the arms, on the pubic area).

Hair rarely begins to fall out immediately after the first cycle of chemotherapy. This usually happens after several cycles. Hair can fall out individually or in whole strands. The remaining hair becomes dull and dry.

When caring for your hair during chemotherapy, it is useful to follow these recommendations:

Use shampoos for dry and damaged hair

Brush your hair with a soft brush

When drying your hair, apply only moderate heat

Do not use curlers or curling irons on your hair.

Don't get a perm

Keep your hair short. A short haircut can hide insufficient hair density and make hair care easier

If there is little hair left, you should protect it from exposure to direct sunlight with a hat.

Many patients who have experienced complete or partial baldness as a result of chemotherapy use wigs. Men prefer to wear a hat or go bareheaded. In such cases, it is impossible to give general recommendations, since much depends on how comfortable you feel in the new “look” and how your relatives and
Friends.

If you plan to use a wig, it is better to start getting used to it gradually, when your hair just begins to fall out.

Baldness causes difficult experiences for many patients. Such patients especially need the sympathy of others, relatives and friends. The main thing is to console yourself with the thought that baldness is a temporary phenomenon.

Hair lost during chemotherapy is subsequently restored

Anemia and associated general weakness and fatigue

Chemotherapy leads to dysfunction of the bone marrow, the main hematopoietic organ. This manifests itself, in particular, in the fact that the number of red blood cells (erythrocytes) decreases. Red blood cells contain hemoglobin, which easily combines with oxygen and transports it from the lungs to various organs and tissues of the body. When, as a result of the side effects of anticancer drugs, the number of red blood cells in the blood decreases significantly, this leads to a decrease in the level of hemoglobin in the blood, and, consequently, organs and tissues do not receive oxygen in quantities sufficient for their normal functioning. This is the essence of anemia caused by an unwanted side effect of chemotherapy.

This anemia is accompanied by general weakness and increased fatigue. Its other manifestations are dizziness, increased heart rate and breathing, and chills. Be sure to inform your doctor that you have experienced the above symptoms during chemotherapy.

If signs of anemia appear, the following recommendations may be helpful:

Try to increase the amount of sleep you get at night. Try to rest more during the day and, if possible, get some sleep during the day

Limit your daily activities. Do only what is absolutely necessary at the moment

Do not hesitate to ask your relatives and friends for help with housework and child care.

Your diet should be well balanced

To avoid dizziness, rise slowly from a sitting or lying position.

’ Chemotherapy is often accompanied by severe!
general weakness and increased fatigue

Infections during chemotherapy

As a result of the side effects of chemotherapy, the body's susceptibility to various infections increases. This is because most anticancer drugs have a negative effect on bone marrow function. In particular, its ability to form white blood cells (leukocytes), with which the body fights infections, is inhibited. Due to the fact that chemotherapy reduces the body’s resistance to the effects of various infectious agents (infectious agents), the “entry gate” of infection can be the oral cavity, skin, lungs, urinary tract, intestines, and genitals.

During chemotherapy, the attending physician will periodically monitor the number of leukocytes in the blood, since maintaining their normal level is extremely important both for continuing treatment and for preventing the development of infectious complications. If the level of leukocytes in the blood decreases, the doctor will prescribe appropriate
medicines. Until the level of white blood cells in the blood returns to normal, the dosage of anticancer drugs should be reduced, and in some cases the start of the next cycle of chemotherapy should be delayed.

If it is discovered that the number of leukocytes in your blood is below normal, then to prevent infectious complications it is very important to follow the following recommendations:

Be sure to wash your hands before eating and after using the toilet

When visiting the toilet, use soft toilet paper, and when washing, use mild soap. If you suffer from concomitant hemorrhoids, ask your doctor about additional measures that should be taken during care. Before using hemorrhoidal suppositories, also consult your doctor.

Avoid contact with people who have obvious signs of colds (cough, runny nose), as well as with measles, chickenpox and other infectious diseases that are transmitted by airborne droplets. Try not to visit places with large crowds of people (shops, markets, etc.)

Avoid contact with children who have recently been vaccinated for rubella, measles, mumps, or polio.

Use caution when trimming fingernails and toenails

To avoid accidental injury, be careful when using a knife, scissors, or needle

Use an electric razor rather than a straight or safety razor to avoid cuts and
skin irritation

Use a soft toothbrush to prevent damage to your gums

Don't squeeze pimples

Take a bath or shower every day, remembering that the water should be warm, not hot. Use a soft sponge, do not rub the skin with a washcloth.

For dry skin, use special moisturizing creams and lotions

If a cut or scratch appears, wash it with warm water and soap and use an antiseptic (for example, brilliant green)

Use protective gloves when working around the house, in the garden and when caring for pets

You should not be vaccinated for any reason without the permission of your attending physician.

Most infectious complications that occur during chemotherapy can be caused by bacteria that usually live on the skin, mouth, gastrointestinal tract and genital area, although under normal conditions they are harmless to the body. If, as a result of a side effect of chemotherapy, the number of leukocytes in the blood decreases significantly compared to the normal level, then the body loses its ability to resist infections and infectious complications caused by such bacteria may occur during treatment. Moreover, sometimes this can happen even with careful personal hygiene.

Pay special attention to the fact that the “entry gates” of infection can be the eyes, nose, mouth, external genitalia, and anus. Remember the signs of infectious complications and be prepared to recognize them in a timely manner. These signs include:

Increased temperature (above 38°C)

Sweating

Severe cough, sore throat and pain when swallowing

Diarrhea (however, it should be noted that diarrhea can also be an independent manifestation of a side effect of chemotherapy)

Burning sensation when urinating

Unusual vaginal discharge and itching

Redness, itching, and the appearance of a lump around a wound, scratch, pimple, or IV site
injections. Tell your doctor immediately if you notice any of the above signs of infectious complications. This is especially important in cases where you know that the number of white blood cells in the blood is significantly below normal levels. If you have a fever, do not take aspirin or other medications that help lower your temperature until you talk to your doctor.

If you have signs of infection (infectious complication), be sure to inform your doctor about this, as it may be necessary
urgent prescription of antibiotics

Bleeding disorders during chemotherapy

The side effects of anticancer drugs can cause another dysfunction of the bone marrow, namely, reduce its ability to form platelets (blood platelets) and to constantly renew their number in the blood.
The latter is especially important since the lifespan of these cells is relatively short. Platelets play an important role in the process of blood clotting and in stopping bleeding that occurs when the wall of a blood vessel is damaged. This applies to both large and small blood vessels, which can be damaged even in
as a result of the most minor injury, and often accidental. When the wall of a blood vessel is damaged, platelets are easily destroyed. In this case, biologically active substances are released, which trigger a series of sequential reactions,
ultimately leading to the formation of a dense blood clot covering the damaged area of ​​the vascular wall. Such a clot helps to quickly stop bleeding.

If during chemotherapy the number of platelets in the blood decreases significantly compared to the normal level, then bleeding that occurs after the slightest injury can continue for quite a long time. As a result, the body may experience
bruising or minor subcutaneous hemorrhages may occur. It is not uncommon to experience nosebleeds or bleeding gums. Sometimes blood may appear in the urine or stool. In this case, the urine becomes reddish and the feces become tarry. Tell your doctor immediately if you notice any of the above signs of bleeding. During chemotherapy, your doctor will periodically check your blood platelet count.
and if it drops to a critical level, he may prescribe a blood or platelet transfusion.

Do not take any medications without first talking to your doctor. This applies to aspirin and other antipyretics, as well as to those medications that can be purchased without a prescription, since even such seemingly harmless
drugs may adversely affect platelet function

Don't drink alcoholic beverages

When caring for your nasal cavity, use handkerchiefs made of soft fabric.

Take special care when using a knife, scissors, needle and other piercing or cutting objects.

Be careful when ironing clothes and cooking to avoid burns. Wear heat-protective gloves when using the oven.

Do not engage in physical activities that could cause injury.

Violation of the integrity of the mucous membrane of the gums of the oral cavity and pharynx during chemotherapy

During chemotherapy, it is very important to carefully maintain oral hygiene. Side effects of anticancer drugs can cause dry mouth, irritation and ulceration of the oral mucosa and pharynx. As a result of violation of the integrity of the mucous membrane and its damage, bleeding can easily occur, including bleeding gums. In addition to the fact that mucosal ulcerations are quite painful, they can become an “entry gate” for infection by bacteria that usually live in the oral cavity. Under normal conditions, these bacteria are harmless, but when the body's resistance decreases, they can become a source of infection. Since during chemotherapy the likelihood of infectious complications occurring is quite high, and it is very difficult to combat them, it is very important to do everything possible to eliminate any potential sources of infection.

Visit your dentist before starting chemotherapy to treat carious teeth, inflammation, and gum disease. A complete sanitation of the oral cavity must be carried out. Talk to your dentist about how best to care for your teeth during chemotherapy, and what type of toothpaste and toothbrush is best to use during treatment. Since chemotherapy can accelerate the development of caries, you should use fluoride paste or gel daily, as well as use a special mouthwash.

Brush your teeth after every meal. Use only a soft toothbrush. When brushing your teeth, the movements of the brush should be as gentle as possible so as not to cause damage to the gums and mucous membrane of the oral cavity. If your gums are sensitive, consult your dentist who will help you choose a special toothbrush and paste.

Rinse your toothbrush thoroughly after each use.

Do not rinse your mouth with liquids that contain alcohol or salt.

Avoid getting substances into the oral cavity that may cause irritation to the mucous membrane. Do not smoke.

If, during chemotherapy, ulcers (ulcerations) appear on the oral mucosa, be sure to inform your doctor about this, since
This complication of chemotherapy requires additional treatment. If such ulcers are painful and cause discomfort while eating, then use the following recommendations:

Ask your doctor how you can treat the sites of such mucosal injuries. Ask your doctor to prescribe pain medication for you.

Eat food only at room temperature, as hot food can cause additional irritation to damaged areas of the oral mucosa and pharynx.

Try to eat mostly soft foods that do not cause irritation to the mucous membrane: dairy products, baby food, mashed potatoes, soft-boiled eggs, pasta, puddings, soft fruits (for example, bananas), mashed apples, etc.

Avoid eating any food that can irritate the mucous membrane (spicy, salty, sour, as well as dry and rough). You should not eat tomatoes, citrus fruits or drink orange, lemon or grapefruit juices.

If dry mouth makes it difficult to swallow food, the following recommendations may be helpful:

Use special means to irrigate the oral cavity after consulting your doctor.

Drink more fluids. In some cases, chewing sugar-free gum or sucking on hard candies can help relieve dry mouth.

Add animal or vegetable oil to main courses or use mild sauce.

Wash down dry crunchy foods with liquid.

Eat soft, crushed, pureed food.

If your lips are extremely dry, use a softening lipstick.

Diarrhea during chemotherapy

As a result of the side effects of anticancer drugs, damage to the cells of the intestinal mucosa occurs. This may cause diarrhea (diarrhea). If the duration of diarrhea exceeds 24 hours or bowel movements are accompanied by pain or
painful spasms, then tell your doctor. In severe cases, your doctor may prescribe medication to help stop the diarrhea. However, you should not take these medications without a doctor's prescription.

In addition, it is useful to use the following recommendations:

Eat less food at one time, it is better to eat more often, but little by little.

Avoid including fiber-rich foods in your diet, as this may cause intestinal spasms and diarrhea. These products include: wholemeal bread, fresh vegetables and
fruits, dried fruits, legumes (peas, beans), nuts. Instead, eat foods with
low fiber content (white bread, noodles, refined rice, cottage cheese, yogurt, eggs,
hard-boiled, mashed potatoes, peeled vegetables, baked apples without peel, ripe bananas).

Avoid drinking coffee, tea and alcoholic drinks, and eating sweets. Avoid fried, fatty and spicy foods as this can cause intestinal irritation, cramping and diarrhea.

You should not drink milk, as this may cause more diarrhea.

Use more foods high in potassium on your pizza (potatoes, bananas, oranges, peach and apricot juices), as diarrhea removes a large amount of potassium from the body.

Drink plenty of fluids to compensate for fluid lost due to diarrhea. It is best to drink clarified apple juice, weakly brewed tea, non-concentrated broth, and boiled water. Any liquid should be at room temperature and should be drunk slowly, in small sips. Try not to consume highly carbonated drinks
drinks.

Be sure to tell your doctor if you have severe diarrhea. Consult with him whether you should switch to drinking only clarified liquids. Since such liquids do not contain the entire complex of substances necessary for the body, they should be used as a strict diet for no more than 3-5 days. If diarrhea stops and general condition improves, you can gradually include foods containing
small amount of fiber

With severe diarrhea, which continues despite following a strict diet, it may be necessary to administer intravenous infusions of medicinal solutions to replace fluid and certain minerals lost by the body.

Carefully observe anal hygiene (install a hygienic shower or watering can in the toilet at home, use wet toilet paper).

Constipation during chemotherapy

Some patients may experience constipation during chemotherapy. The causes of constipation may be a side effect of treatment, decreased physical activity, or a decrease in the amount of food compared to the usual diet. If you haven't had a bowel movement for more than 1-2 days, please let me know.
Talk to your doctor about this, as it may be necessary to prescribe laxatives or an enema.

However, you should not take any medications on your own without consulting your doctor. It is especially important to follow this rule if the number of leukocytes in the blood is significantly lower than the normal level.

If you have constipation, you can use the recommendations below:

Drink plenty of fluids to normalize bowel function. In this case, it is best to drink warm or slightly warmed drinks.

Eat more foods high in fiber (whole bread, fresh vegetables and fruits, dried fruits, nuts).

Try to walk outside more. Do light exercise regularly. However, before increasing physical activity and physical activity, consult your doctor.

Dysfunction of the nervous and muscular systems during chemotherapy

Some antitumor drugs that stop the growth of tumor cells (i.e., have a cytotoxic effect) also have undesirable side effects on the cells and fibers of the nervous system. This may lead to the development
peripheral neuropathies - toxic damage to individual or several peripheral nerves. This may result in a feeling of numbness in the fingers.
hands, burning and weakness in the arms and/or legs. In addition, there may be a lack of coordination of movements, which is manifested by clumsiness and clumsiness of movements, difficulties when fastening buttons and when manipulating small objects. In some cases
Balance problems may occur when walking. Sometimes hearing acuity decreases. Some anticancer drugs can also have unwanted side effects on the muscular system. The result is pain
in a number of muscles, weakness in them and rapid fatigue.

This side effect of chemotherapy may cause some inconvenience in daily life, but it does not pose any danger. However, in some cases, neuromuscular disorders are more serious and may require medical intervention. Therefore, any of the above signs of such disorders should be reported to your doctor immediately.

The following recommendations may be useful in overcoming problems associated with dysfunction of the nervous and muscular systems. For example, if numbness in your fingers occurs, then take special care when using hot, sharp, piercing and other dangerous objects. If muscle weakness or body imbalance occurs, be careful when walking to avoid accidentally falling. When going up or down stairs, be sure to hold on to the railing. Take special care when leaving the bathroom or shower room. Do not wear shoes with slippery soles.

Side effects of chemotherapy on skin and nails

During chemotherapy, redness, dryness, flaking of the skin, and acne may appear. Nails may darken, become brittle and brittle. In addition, longitudinal stripes may appear on them,

You can overcome some of these undesirable consequences of treatment yourself. When acne appears on your face, you should wash your face especially carefully, using special types of soap. When drying your face, you should not wipe it, but blot it, then
use moisturizing creams. If skin itching occurs, you can use baby powder. To prevent dry skin, take a warm shower or a warm, but not hot, bath. Use moisturizing creams for your hands and body, and do not use cologne, perfume or aftershave that contains alcohol. Take good care of your nails.
Wear rubber gloves when washing dishes and protective gloves when doing housework. If redness or pain appears around the nail plates, be sure to notify your doctor.

When a number of anticancer drugs are administered intravenously, the color of the skin may change (pigmentation may appear) along one or more veins. However, such pigmentation usually gradually disappears over several months after completion of treatment. The undesirable effects of anticancer drugs on the skin may be enhanced by direct sunlight. Consult with your doctor which protective creams are best to use in case of short-term exposure to the sun. Cotton clothing with long sleeves and a wide-brimmed hat will provide you with reliable sun protection.

Some cancer patients who received radiation therapy before starting chemotherapy report that associated skin changes reappear after starting treatment with anticancer drugs. Immediately after the administration of such drugs, the skin in the area of ​​​​previous irradiation turns red again, burning and itching appear. The duration of such a reaction can reach several hours or days. Relief can come from applying cold, damp compresses to areas of the skin with the above
manifestations. However, in any case, the development of a skin reaction to treatment must be reported to the attending physician.
doctor. Most skin complications associated with side effects of chemotherapy are not dangerous. However, some of them deserve special attention. For example, when chemotherapy drugs are given intravenously, the drug may accidentally enter the tissue surrounding a blood vessel and cause damage. If you
If you feel pain or burning at the intravenous injection site, tell your nurse or doctor immediately.

You should also immediately inform your doctor that, immediately after the administration of anticancer drugs, a rash (such as hives) appeared on your skin or you experienced difficulty breathing. These signs may
indicate the development of an allergic reaction and require urgent medical intervention.

Side effects of chemotherapy on kidney and bladder function

Some cancer drugs can irritate the bladder and cause temporary or long-term damage to kidney function. You should ask your doctor if the prescribed medications have these side effects. If such treatment-related effects are likely, promptly notify your doctor if the following symptoms occur:

Pain or burning when urinating

Increased urination

Feeling the need to urinate immediately when the urge to urinate occurs

Red urine or blood in the urine

Fever

If there is a high risk of side effects from chemotherapy on the bladder and kidneys, it may be helpful to drink more fluids, including fruit juices. You can include jelly and ice cream in your diet. Increasing the amount of fluid will also increase the volume of urine, which may prevent or reduce the irritating effects of chemotherapy drugs on the bladder or kidneys. However, only a doctor can decide to what extent you can exceed the usual
amount of liquid consumed.

In addition, you should be aware that some anticancer drugs may change the color of your urine. For example, the urine may turn orange or red. Sometimes you may notice an increase in urine odor. If you experience these symptoms, ask your doctor if they could be caused by the medications you are taking.

Flu-like symptoms during chemotherapy

Hours or days after receiving anticancer drugs, many patients may experience flu-like symptoms. These include muscle pain, headache, increased fatigue, fever, chills, nausea, and poor appetite. Such manifestations can exist for 1-3 days. They can be
caused by concomitant infection or the tumor process itself. Therefore, if you experience flu-like symptoms, it is extremely important to notify your doctor.

Fluid retention in the body during chemotherapy

During chemotherapy, the body may retain excessive amounts of fluid. Such a delay may be due to several reasons: hormonal changes occurring in the body during treatment, water disturbances,
salt balance, arising both as a result of the side effects of antitumor drugs and under the influence of the tumor itself. If you notice swelling of the face or the appearance of swelling in the arms and legs, then inform your doctor, who will either
may recommend limiting fluid and salt intake, or prescribing diuretics. However, you should not take these medications on your own, without a doctor’s prescription.

How does chemotherapy affect sexuality?

Chemotherapy can have a negative effect on the genital organs and their function in both men and women, but this does not always happen. Moreover, the severity of such side effects of chemotherapy depends on the patient’s age, his general condition and on
which antitumor drugs are used in this particular case.

Side effects of chemotherapy on genital function in men

As a result of chemotherapy, the number of germ cells (sperm) may decrease and their motility may decrease. These changes can cause temporary or long-term infertility. Although chemotherapy is a cause of male infertility, it does not have a significant effect on sex life.

The possibility of infertility should be discussed with your doctor before starting chemotherapy. Men undergoing chemotherapy should use effective contraception, as some anticancer drugs are known to
cause genetic disorders in germ cells. Discuss with your doctor how long after
After completing treatment, you can stop using contraceptives.

Side effects of chemotherapy on genital function in women

Antitumor drugs can cause dysfunction of the ovaries and lead to hormonal changes. As a result, many women experience irregularities in the rhythm of menstruation, and in some cases, menstruation stops altogether.

The hormonal effects of chemotherapy can cause a number of symptoms reminiscent of menopause: hot flashes, burning sensation, itching and dryness in the genital area. Local manifestations can be alleviated with the help of special water-soluble vaginal lubricants (vaginal lubricants). Irregularities in the genital area increase the risk of infection. To prevent such complications, you should not use oil-based vaginal lubricants. It is recommended to wear only cotton underwear as
it is not an obstacle to free air circulation. Do not wear tight underwear or pants. In addition, to reduce the risk of developing infectious complications, the doctor may recommend special vaginal creams or suppositories.

Impaired ovarian function caused by side effects of chemotherapy can lead to temporary and sometimes long-term infertility. The duration of infertility depends on a number of factors, including the type of medications used, their dosage, and the woman’s age.

During chemotherapy, pregnancy is undesirable, since many anticancer drugs can cause the development of congenital defects in the fetus. Therefore, women of childbearing age during chemotherapy should
use effective contraceptives.

If pregnancy occurs before the tumor is diagnosed, then in some cases the start of treatment is postponed until childbirth. If there is a need to carry out chemotherapy during pregnancy, then treatment begins, as a rule, after the 12th week of pregnancy, that is, at a time when the risk of developing congenital defects in the fetus decreases. IN
In a number of cases, there is a need for artificial termination of pregnancy.

Throughout treatment with anticancer drugs, cancer patients should use effective contraception.

Avoid pregnancy not only during chemotherapy, but also for several months after its completion.

The effect of chemotherapy on libido and sex life

For many patients, changes in this area are insignificant or absent. Some patients
note a decrease in sexual desire due to a number of psychological, emotional and physical factors accompanying chemotherapy. Therefore, it is so important to maintain mutual understanding between spouses (sexual partners) on this delicate issue.

Chemotherapy has only a short-term effect on sexual desire and habitual sexual activity