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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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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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Heart palpitations
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- You may get:
- chest pain
- a pounding or fluttering heart (palpitations)
- shortness of breath
- dizzy or light-headed
- confused
- more tired than usual.
- Tell your doctor if you have any heart problems or are on any heart medications.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the symptoms listed above.
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Heart problems
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- You may get:
- chest pain or tightness
- shortness of breath
- swelling of your ankles
- an abnormal heartbeat.
- Heart problems can occur months to years after treatment.
- Tell your doctor if you have a history of heart problems or high blood pressure.
- Before or during treatment, you may be asked to have a test to see how well your heart is working.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the symptoms listed above.
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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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Diarrhoea
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- You may get bowel motions (stools, poo) that are more frequent or more liquid.
- You may also get bloating, cramping or pain.
- Take your antidiarrhoeal medication as directed by your doctor.
- Drink plenty of fluids (unless you are fluid restricted).
- Eat and drink small amounts more often.
- Avoid spicy foods, dairy products, high fibre foods, and coffee.
- Ask your doctor or nurse for eviQ patient information - Diarrhoea during cancer treatment.
- Tell your doctor or nurse immediately, or go to your nearest hospital Emergency Department if your diarrhoea is not controlled, you have 4 or more loose bowel motions per day, and if you feel dizzy or light-headed.
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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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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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Fever
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- You may feel warm.
- Tell your doctor or nurse if you get this symptom.
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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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Bleeding (haemorrhage)
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- Tell your doctor or nurse if you have a wound that does not heal.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the following signs or symptoms:
- unusual bleeding or bruising
- bright red or black, tarry bowel motions (stools, poo)
- stomach pain
- slurred speech
- shortness of breath
- a fast heartbeat.
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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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High blood pressure (hypertension)
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- You may not have any signs or symptoms if you have high blood pressure.
- If it is severe you may get headaches, shortness of breath or feel dizzy.
- Your blood pressure will be taken regularly during your treatment.
- Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get any of the signs or symptoms listed above.
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Mouth pain and soreness (mucositis)
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- You may have:
- bleeding gums
- mouth ulcers
- a white coating on your tongue
- pain in the mouth or throat
- difficulty eating or swallowing.
- Avoid spicy, acidic or crunchy foods and very hot or cold food and drinks.
- Try bland and soft foods.
- Brush your teeth gently with a soft toothbrush after each meal and at bedtime. If you normally floss continue to do so.
- Rinse your mouth after you eat and brush your teeth, using either:
- 1/4 teaspoon of salt in 1 cup of warm water, or
- 1/4 teaspoon of bicarbonate of soda in 1 cup of warm water
- Ask your doctor or nurse for eviQ patient information - Mouth and throat problems during cancer treatment.
- Tell your doctor or nurse if you get any of the symptoms listed above.
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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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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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Eye problems
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- You may get:
- blurred vision
- changes in your eyesight
- flashes of light
- floating spots.
- These may be especially noticeable when you move from a light area to a dark area.
- If you notice any of these symptoms, do not drive or operate machinery.
- Tell your doctor or nurse if you get any of these symptoms.
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