Early (onset days to weeks)
|
Neutropenia
|
Abnormally low levels of neutrophils in the blood. This increases the risk of infection. Any fever or suspicion of infection should be investigated immediately and managed aggressively.
|
Thrombocytopenia
|
A reduction in the normal levels of functional platelets, increasing the risk of abnormal bleeding.
|
Arthralgia and myalgia
|
Generalised joint pain or and/or stiffness and muscle aches, often worse upon waking or after long periods of inactivity. Can improve with movement. May be mild or severe, intermittent or constant and accompanied by inflammation.
|
Diarrhoea
|
|
Dizziness
|
Feeling faint or lightheaded, weak or unsteady. Advise patients to stand up slowly from sitting down or lying down positions and increase fluid intake if dehydrated.
|
Fluid retention and oedema
|
An excess amount of fluid around the cells, tissues or serous cavities of the body, leading to swelling.
|
Hypertension
|
High blood pressure is commonly associated with many anti-cancer drugs. Pre-existing hypertension should be controlled prior to initiation of drugs capable of causing hypertension.
|
Nausea and vomiting
|
|
Side effects of corticosteroids
|
Insomnia, oedema, increased risk of infection e.g. oral thrush, gastric irritation, worsening of peptic ulcer disease, increased blood sugar levels, loss of diabetic control, mood and behavioural changes - including anxiety, euphoria, depression, mood swings, increased appetite and weight gain, osteoporosis and fractures (long term use), bruising and skin fragility are associated with corticosteroid use.
|
Skin rash
|
Anti-cancer drugs can cause a number of changes in the skin with maculo-papular rash the most common type of drug-induced skin reaction.
|
Thromboembolism
|
Thromboembolic events, including pulmonary embolism, deep vein thrombosis and cerebrovascular accidents can occur. Thromboprophylaxis should be considered based on an individual benefit/risk assessment and at clinician discretion.
|