Early (onset days to weeks)
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Infection risk (neutropenia)
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- This treatment lowers the amount of white blood cells in your body. The type of white blood cells that help to fight infection are called neutrophils. Having low level of neutrophils is called neutropenia. If you have neutropenia, you are at greater risk of getting an infection. It also means that your body can’t fight infections as well as usual. This is a serious side effect, and can be life threatening.
- Wash your hands often.
- Keep a thermometer at home and take your temperature regularly, and if you feel unwell.
- Do your mouth care regularly.
- Inspect your central line site (if you have one) daily for any redness, pus or swelling.
- Limit contact with people who are sick.
- Learn how to recognise the signs of infection.
- Ask your doctor or nurse for eviQ patient information - Infection during cancer treatment.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the following signs or symptoms:
- a temperature of 38°C or higher
- chills, shivers, sweats or shakes
- a sore throat or cough
- uncontrolled diarrhoea
- shortness of breath
- a fast heartbeat
- become unwell even without a temperature.
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Low platelets (thrombocytopenia)
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- This treatment lowers the amount of platelets in your blood. Platelets help your blood to clot. When they are low, you are at an increased risk of bleeding and bruising.
- Try not to bruise or cut yourself.
- Avoid contact sport or vigorous exercise.
- Clear your nose by blowing gently.
- Avoid constipation.
- Brush your teeth with a soft toothbrush.
- Don't take aspirin, ibuprofen or other similar anti-inflammatory medications unless your doctor tells you to.
- Tell your doctor or nurse if you have any bruising or bleeding.
- Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if you have any uncontrolled bleeding.
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Stomach pain
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- You may get:
- dull aches
- cramping or pain
- bloating or flatulence (gas).
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have stomach pain that you are unable to control.
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Appetite loss (anorexia)
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- You may not feel like eating.
- Try to avoid drinking fluids at meal times.
- Try to eat small meals or snacks regularly throughout the day.
- Try to eat food that is high in protein and calories.
- If you are worried about how much food you can eat, or if you are losing weight, ask to speak to a dietitian.
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Tiredness and lack of energy (fatigue)
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- You may feel very tired, have no energy, sleep a lot, and not be able to do normal activities or things you enjoy.
- Do not drive or operate machinery if you are feeling tired.
- Nap for short periods (only 1 hour at a time)
- Prioritise your tasks to ensure the best use of your energy.
- Eat a well balanced diet and drink plenty of fluids (unless you are fluid restricted).
- Try some gentle exercise daily.
- Allow your friends and family to help.
- Tell your doctor or nurse if you get any of the symptoms listed above.
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Skin rash
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- You may get a red, bumpy rash and dry, itchy skin.
- Moisturise your skin with a gentle non-perfumed moisturising cream like sorbolene or aqueous cream.
- Do not scratch your skin.
- Protect your skin from the sun by wearing sun-protective clothing, a wide-brimmed hat, sunglasses and sunscreen of SPF 50 or higher.
- Talk to your doctor or nurse about other ways to manage your skin rash.
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Constipation
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- You may have bowel motions (stools, poo) that are less frequent, harder, smaller, painful or difficult to pass.
- You may also get:
- bloating, cramping or pain
- a loss of appetite
- nausea or vomiting.
- Drink plenty of fluids (unless you are fluid restricted).
- Eat plenty of fibre-containing foods such as fruit, vegetables and bran.
- Take laxatives as directed by your doctor.
- Try some gentle exercise daily.
- Tell your doctor or nurse if you have not opened your bowels for more than 3 days.
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Bleeding into stomach or bowel
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- This side effect is rare, but can be very serious.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of these signs or symptoms:
- severe stomach pain
- swollen and hot skin around your stomach
- bleeding
- nausea or vomiting
- fever or chills
- a fast heartbeat
- you feel short of breath.
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Joint and muscle pain and stiffness
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- You may get muscle, joint or general body pain and stiffness.
- Applying a heat pack to affected areas may help.
- Talk to your doctor or nurse about other ways to manage these symptoms. You may need medication to help with any pain.
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Chest infection
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- You can develop a chest infection whilst receiving this treatment.
- Tell your doctor or nurse as soon as possible if you get any of the following symptoms:
- shortness of breath
- difficulty breathing
- wheezing
- coughing up mucus
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Dizziness or feeling light-headed
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- You may feel dizzy or light-headed.
- These symptoms may be caused by your treatment, or other problems like dehydration.
- If you are feeling dehydrated, drink plenty of fluids (unless you are fluid restricted) as this can be a cause of dizziness.
- If you are feeling dizzy, try lying down until the dizziness passes.
- When you want to get up from a sitting or lying down position, get up slowly to let your body adjust to the new position.
- Tell your doctor or nurse if you get any of the symptoms listed above.
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Shortness of breath
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- You may have a cough.
- You may feel short of breath.
- Tell your doctor or nurse immediately if you feel you have a cough or feel short of breath.
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Liver problems
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- You may get:
- yellowing of your skin or eyes
- itchy skin
- pain or tenderness in your stomach
- nausea and vomiting
- loss of appetite
- You will have regular blood tests to check how well your liver is working.
- Tell your doctor or nurse as soon as possible if you notice that your urine is a dark colour, the whites of your eyes look yellow, or if you have stomach pain.
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Extra fluid in the body (fluid retention)
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- You may gain weight over a short amount of time.
- Your hands and feet may become swollen, appear red or feel hot and uncomfortable.
- Wear loose clothing and shoes that are not too tight.
- Try not to stand up or walk around too much at one time.
- If your ankles or legs get swollen, try raising them.
- Make sure that any cuts or areas of broken skin are treated as soon as possible.
- Tell your doctor or nurse as soon as possible if you get any of the symptoms listed above or gain 1 to 2 kg in a week.
- Tell your doctor or nurse immediately or go to the nearest hospital Emergency Department if you become short of breath.
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High blood cholesterol levels
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- This treatment may increase your blood cholesterol levels. This is not a side effect you will notice.
- Your cholesterol levels will be checked during your treatment.
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