When people think of cancer, the side effects that cause physical changes to the body typically provoke the most fear. But not everyone experiences these effects, and even if you experience one or more of them, they’re often short-lived.
Fluid retention
Cancer and its treatments may cause an abnormal buildup of fluid in the body, a condition your oncologist may refer to as edema when the fluid collects in the extremities (legs, arms, feet, hands) or face; ascites when it collects in the abdomen; and pleural effusion when it collects around the lungs.
Other causes of fluid retention may include nutritional deficiencies (such as low protein levels); inactivity; cancer-related vein or lymph system blockages; removal of the lymph nodes; and problems with the kidneys, liver, or heart. Symptoms may include swelling, a feeling of heaviness or tightness, rapid weight gain, decreased urination, difficulty breathing, and stiffness of the joints.
Fluid retention from medications or malnutrition is generally reversible, but when it’s caused by cancer or by other health problems, the swelling may be more difficult to treat and may be permanent. Your oncologist may also prescribe a diuretic (which increases the production of urine).
If you notice you’re retaining fluid, it’s important to speak with your healthcare team as soon as possible, particularly if you become short of breath, you’ve gained 5 pounds or more in a week, your hands or feet are cold to the touch, or you’re rarely urinating.
Hair loss
Hair loss is probably one of the most feared side effects among people receiving chemotherapy, particularly among women who may struggle with perceptions of being less feminine without hair. Hair loss can also occur in areas exposed to radiation treatments, particularly when administered at higher doses.
Although not all chemotherapeutic agents cause hair loss, many do. But even though hair loss is an undesirable side effect of many chemotherapeutic agents, it isn’t a serious complication. After all, it doesn’t result in the loss of normal body function or pose a risk of death, and hair starts to grow back usually within weeks after treatment ends.
At the same time, it can have a profound emotional impact. You may feel anxiety about how you’ll be perceived by the outside world and whether you’ll be gawked at, particularly because bald heads have become the hallmark of cancer, at least for women.
Pain
Reports indicate that approximately 33 percent to 50 percent of people with cancer will experience pain at some point during their cancer journey. Cancer-related pain can take a variety of forms. It may be mild, moderate, or severe and feel dull, sharp, or achy. It may come and go or be constant, and it may occur at the primary cancer site or at distant sites if the cancer has spread.
Cancer treatments can also contribute to the pain picture. Recovery from major surgery to remove a tumor can be painful, whereas radiation and chemotherapy may cause painful side effects, such as skin irritation and mouth sores.
Generally, treatment-associated pain is short-lived — when the treatment ends, the pain usually resolves not too long thereafter. And if you felt pain before you started treatment, cancer treatments may decrease or eliminate this pain. When this occurs, it can serve as an important indicator that the treatment is working as intended. But even if your pain doesn’t improve or worsens during treatment, this doesn’t indicate that your treatment isn’t working.
People with cancer that has spread to their bones may experience more severe pain. Numerous medications are available that can effectively manage pain (your oncologist may refer to these as analgesics) and permit normal function. These may range from very mild over-the-counter analgesics like acetaminophen (Tylenol) to powerful pain-controlling prescription medicines like morphine.
No matter what’s causing your cancer pain, your oncologist and healthcare team can provide you with medications to alleviate pain and the side effects that directly cause pain. They may also suggest complementary treatments and strategies that may be helpful, such as acupuncture or aromatherapy.
Skin reactions
Skin reactions are quite common and may consist of any of the following symptoms: rashes, itching, dryness, flushing (redness and warmth of an area of the skin), inflammation, or blistering. They may occur with any drugs, but are a side effect of many chemotherapy agents.
Although most skin reactions are mild, some can be life threatening, so it’s always a good idea to mention any skin changes to your oncologist as soon as possible.
Mild skin reactions are simply observed until they improve without a need for specific interventions. For more severe skin reactions, your oncologist will have to consider whether to continue with your treatment. More serious events will require careful local skin care, including efforts to prevent secondary infections because the normal skin barrier has been breached.