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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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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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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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 changes
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- Your skin may become dry, and you may notice changes to areas of your skin that have been exposed to the sun.
- Keep your skin moisturised with a cream such as sorbolene or aqueous cream.
- Avoid direct sunlight.
- Protect your skin from the sun by wearing a wide-brimmed hat, sun-protective clothing, sunglasses and sunscreen of SPF 50 or higher.
- Tell your doctor or nurse if you notice any skin changes.
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Eye problems
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- You may get:
- eye pain
- red, sore or swollen eyes
- blurred vision
- watery or gritty eyes
- changes in your eyesight
- sensitivity to sunlight.
- Protect your eyes from the weather (sun and wind) by wearing sunglasses, especially if you have lost your eyelashes.
- Tell your doctor or nurse if you get any of the symptoms listed above. Eye drops may help with your symptoms.
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Hand-foot syndrome (palmar-plantar erythrodysaesthesia)
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- The palms of your hands and soles of your feet may become:
- red and hot
- swollen
- painful and tender
- blistered.
- The skin in the area may also peel.
- Moisturise your hands and feet daily with sorbolene or aqueous cream.
- Keep your hands and feet clean and dry.
- Avoid hot water, instead use lukewarm water to bathe.
- Avoid direct sunlight.
- Avoid unnecessary walking, jogging or exercise.
- Wear cotton socks and avoid tight-fitting shoes.
- Tell your doctor or nurse as soon as possible if you notice any skin changes on your hands or feet.
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Skin that is more sensitive to the sun (photosensitivity)
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- After being out in the sun you may develop a rash like a bad sunburn.
- Your skin may become red, swollen and blistered.
- Avoid direct sunlight.
- Protect your skin from the sun by wearing sun-protective clothing, a wide-brimmed hat, sunglasses and a sunscreen of SPF 50 or higher.
- Tell your doctor or nurse if you get any of the symptoms listed above.
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Nerve damage (peripheral neuropathy)
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- You may notice a change in the sensations in your hands and feet, including:
- tingling or pins and needles
- numbness or loss of feeling
- pain.
- You may find it difficult to do everyday activities, such as doing up buttons or picking up small objects.
- Test water temperature with your elbow when bathing to avoid burns.
- Use rubber gloves, pot holders and oven mitts in the kitchen.
- Wear rubber shoes or boots when working in the garden or garage.
- Keep rooms well lit and uncluttered.
- Ask your doctor or nurse for eviQ patient information – Nerve problems during cancer treatment.
- Tell your doctor or nurse if you get any of the symptoms listed above.
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