Condition after chemotherapy. From the immune system. Urinary incontinence during chemotherapy

Cancer cells are capable of rapidly dividing, so the tumor grows rapidly into both neighboring and distant intraorganic structures.

Chemotherapy can slow down or stop the growth and development of cellular structures, and sometimes even leads to their destruction. But it has not yet been possible to create such a drug that would simultaneously destroy cancer and not have such serious side effects on the body.

The patient's condition after chemotherapy

The condition after chemotherapy is even included in the list of diseases, where it is assigned the code Z54.2.

After a chemotherapy course, the condition of cancer patients is usually regarded as moderate or severe.

Cancer patients tolerate such treatment differently, because each of them has a different stage, degree of malignancy of oncology and the state of the immune status.

Symptoms

There are also common symptoms of a post-chemotherapeutic state, which include:

• All indicators of organic activity are decreasing;
• There is a change in the blood;
• Falls immunity;
• Increased susceptibility to infections;
• The cellular structures of the bone marrow, hair follicles and mucous membranes are killed;
• Toxins from drugs affect the lungs and heart, kidney and liver, urinary and gastrointestinal, skin and other structures.

Also, in patients after chemotherapy, the nervous system suffers, polyneuropathy develops, depression and excessive fatigue, general organic weakness, etc.

Baldness

They begin to fall out about a couple of weeks after the start of the chemotherapy course. But not all drugs cause characteristic baldness.

When using some of them, only a small amount of hair falls out, and the main hair can be saved. A few months after the treatment, the hair will grow back.

Hair loss is observed not only on the head, but also throughout the body - eyelashes, eyebrows, hairline on the legs and armpits, in the groin and on the chest.

To minimize alopecia, it is recommended to use mild baby shampoos and comb the hair with a soft massage brush. But it is better to refuse the aggressive effect of a hair dryer, thermal curlers and curling irons, various irons and other devices.

Anemia

Chemotherapeutic anticancer drugs cause a decrease in the number of red blood cells. As a result, anemia of the hypochromic type develops.

The body receives oxygen supply precisely from erythrocytes, therefore, with their shortage, oxygen starvation develops.

Patients are concerned about the following symptoms:

1. dizziness;
2. Dyspnea;
3. Constant weakness;
4. Chronic fatigue;
5. tachycardia manifestations.

To eliminate anemia, bone marrow functions of hematopoiesis are necessary. Why is the reception of stimulators of the division of bone marrow cell structures that accelerate the formation of red blood cells.

These include Erythropoietin and its derivatives like Recormon, Epogen, Prokrit and Erythrostim, Epoetin, etc.

Weakness and fatigue

In all cancer patients, after chemotherapeutic exposure, adverse reactions such as excessive fatigue and weakness are observed.

This sign accompanies such complications of anticancer therapy as anemia, general organic intoxication, material exchange disorders, sleep disorders, depressive states, infections and pain syndrome.

To save the body, on the day of chemotherapy, it is necessary to take a day off and spend the whole day in rest mode. In the following days, a diet to increase hemoglobin and leukocytes, regular moderate physical activity, 9 hours of sleep at night and a mandatory daytime owl for at least 1 hour are recommended.

Violation of the gastrointestinal tract

The mucous membranes of the gastrointestinal tract structures are constantly being updated, their cells are constantly in the process of dividing, so chemotherapy often leads to violations of these cellular changes, and causes constipation, diarrhea and other consequences.

To reduce side effects of this nature, a diet therapy specially designed for cancer patients is recommended.

• For constipation, increase fluid and fiber intake. Whole grains, bran and all kinds of vegetables are recommended.
• With diarrhea, it is necessary to abandon fatty foods and alcohol, caffeinated drinks. It is better to eat cereals and light broths, rice and bananas.

In addition, the doctor will prescribe the necessary medications.

Stomatitis

After chemotherapy, almost all cancer patients develop stomatitis after about a week and a half - ulcers begin to appear actively in the oral cavity, causing dryness and burning. When the patient takes food, its taste changes markedly with stomatitis.

To avoid the formation of stomatitis, experts recommend to perform oral hygiene with increased care:

• Use a soft toothbrush;
• Brush your teeth after every meal.

If the first signs of stomatitis began to appear in the mouth, it is necessary to abandon products that irritate the mucous membrane - from alcohol, soda, citrus fruits and smoking.

Palmar-plantar syndrome

After some types of chemotherapy, patients may develop hand-foot syndrome, which is characterized by swelling, soreness, and redness of the feet and hands.

A similar reaction is observed if the antitumor drug leaks out of the capillaries on the extremities. As a result, tissue damage occurs, which manifests itself in the form of redness, irritation and soreness.

To prevent this side effect, it is recommended to avoid prolonged exposure to hot water on the palms and feet, for example, when bathing or washing dishes. Avoid contact with household chemicals, work with tools that require hand pressing, etc.

Cough

For a number of reasons, cancer patients may develop a cough after chemotherapy. Provoke it:

1. Taking medication. Drugs cause active overdrying of the mucous membranes. As a result of overdrying, irritation of the respiratory structures occurs, which is expressed in a dry cough;
2. Reduced immunity. The body after chemistry, due to a pathologically low immune barrier, easily passes infectious pathogens that cause respiratory pathologies of the respiratory system. Cough indicates the penetration of just such an infection, which must be fought through antibiotic therapy.

Mucositis

This complication develops in about 40% of cancer patients receiving chemotherapy. The specificity of the disease is associated with the formation of wounds and sores in the mouth, often spreading to the mucous throats.

Most often, mucositis develops during treatment with drugs like 5-fluorouracil, etc. Analgesics or anesthetics are recommended to relieve pain in myositis. It is recommended to rinse your mouth with saline-soda solution (½ a small spoonful of salt and soda per 200 ml of water).

Nausea

A symptom such as nausea after chemotherapy worries many patients. It is impossible to avoid such a side effect, although there are many ways to eliminate it with the help of drugs, for example, Cerucal, Dexamethasone, Ondansetron, etc.

With adequate and correct selection of drugs, nausea disappears in about 90% of cases.

In addition, a diet that eliminates salty and sweet, fatty and fried foods alleviates nausea. Nausea relieves a little grape juice or cranberry juice, Regidron, tea with mint and lemon, jelly, bananas.

Folk remedy for nausea

Widely used against post-chemotherapeutic nausea and folk remedies, which are even more effective than drugs. But they should be used only on the recommendation of an oncologist.

An effective remedy that reduces nausea and vomiting and restores gastrointestinal function is an infusion of lemon balm. The raw materials are crushed and brewed like tea, keeping under the lid for about 2 hours. The daily norm is 2 glasses, taken during the day.

Neutropenia

The bone marrow constantly produces leukocytes - white blood cells, which are represented by several varieties: neutrophils, lymphocytes and monocytes.

Under the influence of chemotherapy, there is a sharp decrease in all types of leukocytes. A decrease in neutrophils is called neutropenia. These cells are essential in resisting infections, so their reduction leads to a high risk of their development.

With a deficiency of neutrophils, microbes that have entered the body are not destroyed, but begin to multiply rapidly. That is why neutropenia is considered the main cause of infectious complications after chemotherapy.

For the treatment of neutrophil deficiency, the colony-stimulating granulocyte factor G-CSF is used, which promotes the accelerated formation of neutrophils.

Pain in the legs, head, bones, stomach

Often, after anti-cancer treatment, cancer patients experience severe pain in various organs and parts of the body. This may mean that there is a high risk of damage to these structures.

In addition, the cause of pain is the action of chemotherapy drugs.

• Soreness in the stomach occurs when cytostatics reach the digestive tract. The cause of pain in the stomach is toxic gastritis.
• Headache occur against the background of toxic damage to certain brain areas. There is a similar soreness periodically, manifesting itself with different intensity and character.
• Pain in the legs also not uncommon after anti-cancer treatment. The cause of the syndrome may be polyneuropathy, bone marrow disorders, or severe arterial and venous lesions.
• Pain in the bones are caused by damage to the bone marrow structures by anticancer drugs.

Treatment of any post-chemotherapeutic pain is carried out symptomatically, i.e., with the use of painkillers prescribed by the oncologist.

Edema

Many cancer patients after chemotherapy begin to complain of edema that occurs both throughout the body and in its individual areas - on the limbs, face, in the abdomen.

The cause of post-chemotherapeutic hyperedema is a violation of renal activity.

It is useful to include greens and other products with a diuretic effect in the menu, such as dill and parsley, watermelons and melons, blackberries and strawberries, tomatoes and cucumbers, apples, etc.

Numbness

A fairly common consequence of chemotherapy is numbness due to damage to peripheral nerve fibers. Numbness is manifested by loss of sensation in the limb. Begins at the tips of the fingers, spreads up the arms and legs, and then along the spine.

In addition, numbness can be manifested by painful sensations, a feeling of tightness and burning, tingling, etc.

Some patients find it difficult to cope with buttons or laces, their balance is disturbed, they often fall, stumble. Numbness usually indicates the development of polyneuropathy.

How to treat veins after chemotherapy?

Against the background of chemotherapy, patients often experience extensive damage to the veins, develop phlebosclerosis and phlebitis.

Phlebosclerosis is a thickening of the vascular walls against the background of degenerative changes, and phlebitis is an inflammatory lesion of the venous walls. Typically, such lesions are observed in the area of ​​the shoulders and elbows.

• Anticoagulants (Gumbiks);
• NSAIDs;
• Local ointments like Hepatrombin, Troxevasin or Indovazin.

To avoid such complications, it is necessary to infuse anticancer antibiotics and cytostatics slowly, and finish the administration with a 5% glucose solution.

Allergy

A fairly common complication is postchemotherapeutic allergy. Such reactions are manifested by a variety of symptoms - from mild minor rashes to severe symptoms such as anaphylaxis and swelling of the lung or brain.

Such reactions often only aggravate the patient's condition, but specialists often do not associate these manifestations with chemotherapy treatment.

Haemorrhoids

One of the unpleasant complications after anti-cancer treatment is hemorrhoids. Its causes can be both damage to the veins by the components of chemotherapy drugs, and damage to the gastrointestinal tract.

If the patient has previously suffered from hemorrhoids, then after chemotherapy it will definitely worsen.

Stroke

Strokes after chemotherapy occur as a result of complications such as thrombocytopenia - this condition is associated with a low platelet count, which is manifested by a decrease in blood clotting.

With thrombocytopenia, there is a high probability of internal hemorrhages in various internal organs, including the brain.

A cerebral hemorrhage can lead to a stroke, after which the patient needs a long rehabilitation.

Temperature

Hyperthermia after chemotherapy is caused by a decrease in immune defense, in which a variety of infections begin to freely enter the body.

A similar symptom indicates that infectious foci have formed in the body of a cancer patient, for the neutralization of which it is necessary to carry out antibacterial therapy.

Treatment should begin at the first sign of hyperthermia. If the temperature is constantly elevated, then the patient's body can no longer cope with infectious processes and he needs urgent help.

Usually, broad-spectrum antibiotics are prescribed for treatment. For the correct choice of the drug, the patient is given a laboratory blood test to identify the type of infection that is supposed to be fought.

Complications in men

The consequences of anticancer treatment for patients of both sexes are the same, but there are some differences.

Anti-cancer drugs seriously affect a man's sexual functions, significantly reducing reproduction, activity, and sperm count. In other words, a man experiences temporary infertility.

With a positive outcome, over time, the fertility of a man is restored. Although there are exceptions when infertility becomes irreversible.

Suffering from chemotherapy and male erection, libido can be catastrophically reduced. But these problems are resolved over time, all functions are returned.

But in the process of chemotherapy treatment and within a year after its completion, a man needs to be protected in order to exclude the conception of a partner. Such a measure is necessary, because the risk that the child will have serious deviations is as high as possible.

Complications in women

In women, in addition to the general chemotherapeutic consequences, dysfunctional ovarian disorders are observed. Against this background, menstrual irregularities occur, bleeding becomes irregular, and may disappear for a while.

In fact, a woman temporarily loses the ability to become pregnant. After a certain time, all childbearing functions gradually return. Like men, women should not become pregnant during the year because of the risk of having a sick child with serious developmental disabilities.

How to alleviate the patient's condition?

Chemotherapy seriously impairs liver function, so to maintain it, cancer patients need to take hepatoprotectors.

With the development of infection against the background of suppressed immunity, antibiotic therapy is prescribed.

The principles of nutrition of a cancer patient are also important, assuming a balanced diet enriched with vitamins and minerals.

To alleviate the chemotherapeutic consequences, experts recommend taking sorbents. These drugs absorb the toxic components of chemicals and remove them from the body through the urinary system.

Due to this effect, the aggressiveness and severity of complications are significantly reduced. Enterosgel paste has proven itself well in terms of reducing the effects of anticancer drugs. It is taken orally with plenty of water.

Chemotherapy deals a merciless blow to the body, but this technique saves lives by destroying cancer cells. Therefore, one should not refuse such treatment because of the fear of side effects, because life is much more important.

Video about nausea and vomiting during chemotherapy:

For the treatment of cancerous tumors in modern medicine, two types of anticancer drugs are used: cytostatics and cytotoxins. Having a different mechanism of action on the infected cell, they have the same detrimental effect on the entire body. Complications after chemotherapy: decreased immunity, general weakness and body aches, hair loss and other complications. But more serious relapses such as thrombocytopenia, anemia, and neutropenia can also occur. Consider what are the dangerous consequences of chemotherapy. Chemo drugs cannot only affect cancer cells, they also affect healthy cells of the body, thereby causing negative outcomes of varying severity.

Thrombocytopenia - a complication after chemotherapy

Let's start with thrombocytopenia. Thrombocytopenia is a disorder characterized by low levels of platelets (platelets) in the blood. Platelets are small, irregularly shaped blood cells that are produced by red bone marrow cells.
The main function of platelets is blood clotting. Platelets clog the damaged surface of the vessel, thereby protecting against severe bleeding and significant blood loss. Without the presence of platelets in the blood, a person can die from even the smallest cut. Therefore, patients with thrombocytopenia need to be careful about their safety, since the slightest injury can cause serious consequences.

Hemorrhagic purpura

After chemotherapy, the body's immune system may also produce antibodies that can destroy platelets. Hemorrhagic purpura is a disease characterized by just such a condition. Antibodies that destroy platelets in the blood are called autoantibodies. These antibodies, produced by the spleen, kill all the platelets in the blood in the body. This disease is dangerous because the body kills itself.
In a healthy adult, there are 150,000 to 400,000 platelets per milliliter of blood. There were cases when there were practically no platelets in thrombocytopenia. A low platelet count increases the chance of a stroke.

Acute thrombocytopenia

Another complication after chemotherapy, this is thrombocytopenia - an ailment in which small hematomas can occur on the skin, as well as on the internal organs. In half of the cases, this disease is the result of previous diseases such as measles, rubella, and a number of other viral infections.
Thrombocytopenia is characterized by a difficult and lengthy recovery process. Also, treatment can be expensive. Very often, patients suffering from this disease experience profuse bleeding from the nose, as well as hemorrhages of internal organs. Serious consequences can bring hemorrhages in the brain. After all, hemorrhages in the brain inevitably lead to a stroke, the treatment after which may require a lot of time and money.
With thrombocytopenia, the occurrence of small hemorrhages occurs spontaneously. Indeed, in addition to the lack of platelets, there is a violation of the integrity of the walls of blood vessels. Therefore, red blood cells can seep into body tissues. As mentioned earlier, this may result in profuse hemorrhage even from a minor scratch or wound. In addition, visual impairment may occur, as hemorrhages are possible even in the eye.
Abundant bleeding is observed in the first days of the manifestation of the disease, over time, they decrease.
To cure acute thrombocytopenia, hospitalization of the patient is necessary. As drugs, glucocorticosteroids are used, the course of treatment of which can be from 3 to 6 weeks.
Recently, treatment with immunoglobulin has been popular. Such treatment is most often used before operations, childbirth, when it is necessary to increase the number of platelets in the blood. Although the result, from such treatment, is short-lived.
A hemostatic sponge impregnated with thrombin is used for nosebleeds. Also, with anemia, you may need a transfusion of red blood cells or platelets. The overwhelming majority of cases of such treatment bring a speedy recovery, but in 10-15% of patients the disease either recurs or becomes chronic.

Anemia

As a result of chemotherapy treatment, the main damage is done to the bone marrow, which is responsible for the formation of blood cells. This leads to a decrease in the number of red blood cells (erythrocytes). Red blood cells contain hemoglobin, which is necessary for delivering oxygen from the lungs to other internal organs and tissues of the body. Chemotherapy drugs cause a number of side effects, including a decrease in the numerical value of red blood cells in the blood, which can also cause a decrease in hemoglobin levels. As a result, oxygen enrichment of the internal organs and tissues of the body decreases, which prevents their normal operation. This is the main danger of anemia as an undesirable side effect of chemotherapy, that is, treatment with chemotherapy drugs.
The consequence of anemia can be dizziness, increased heart rate and breathing, chills. These symptoms should be reported to your doctor right away. It is also worth remembering and following these recommendations:
. A long night's sleep is needed. If possible, daytime sleep is also desirable, at least an hour and a half.
. It is necessary to reduce activity to a minimum.
. Ask friends and family for help if possible. They can do household chores or look after children.
. It is advisable to contact a nutritionist so that he prescribes a balanced diet for you.
. Do not make sudden movements in order to avoid the possibility of dizziness.

Blood clotting as a consequence of chemotherapy

Chemotherapy drugs have a number of side effects. In addition, the number of red blood cells decreases, which also affects the number of platelets in the blood. Due to a violation of the functionality of the bone marrow, the production of platelets decreases, which leads to a deterioration in blood clotting.
These cells exist for a relatively short time, so the bone marrow must constantly create them. But with complications after chemotherapy, this can be problematic. Platelets are responsible for blood clotting, stop bleeding in case of any damage to tissues and blood vessels. This can be attributed to both large and small blood vessels, which can be damaged quite by accident. When the integrity of the walls of the blood vessel is violated, platelets easily disintegrate. At the same time, biologically active substances gain freedom, which begin the process of successive reactions that create a blood clot. This clot blocks the damaged area of ​​the vascular wall, thus stopping the bleeding.
After treatment with chemotherapy drugs, the slightest injury causes prolonged bleeding, which is directly related to a significant decrease in the number of platelets in the blood. Therefore, it is worth protecting yourself from the possibility of getting any injuries. The unreasonable appearance of small bruises and subcutaneous hemorrhages on the body may be a sign of a decrease in blood clotting. Very often, bleeding gums, as well as bleeding from the nose, can also be observed. There are cases when blood impurities occur in the urine or feces. In such cases, the urine acquires a reddish tint, and the feces become tarry. If you have at least a few of the symptoms described above, you should immediately inform your doctor. To avoid such complications after chemotherapy, it is necessary to carefully monitor the level of platelets in the blood. When the level of platelets drops to a critical value, the doctor will prescribe a blood transfusion.
The following are tips to reduce the likelihood of bleeding, as well as to reduce their randomness:
. You should not take any other medicines unless you have consulted your doctor and he has prescribed them for you. Remember that self-medication can do more harm than good. Even the most harmless drugs, such as analgin, can have negative consequences.
. It is worth limiting yourself in taking alcoholic beverages, and it is advisable to completely exclude it for the duration of treatment.
. Handkerchiefs should be exclusively made of soft natural fabrics, so as not to irritate the nasal mucosa.
. Handle knives and other sharp objects with extreme caution. Remember that even a minor injury is dangerous for you.

Neutropenia and neutrophils

The human bone marrow continuously produces white blood cells called leukocytes. There are three types of leukocytes: neutrophils, monocytes and lymphocytes.
Neutropenia is a sharp decrease in the number of granulocytes. Agranulocytosis is a type of neutropenia in which there is a very dramatic decrease in neutrophils in the blood. This is the most dangerous type of neutropenia.
Neutrophils are responsible for fighting infections. Reducing their number increases the risk of contracting serious infections, for the treatment of which it will be necessary to hospitalize the person and prescribe a course of massive antibiotic therapy.
The tissue that makes up blood is immature cells called hematopoietic stem cells and progenitor cells. These cells have the ability to divide into a wide variety of blood cell types. Anemia is one of the most serious complications after undergoing chemotherapy. It has three very dangerous even individually factors: 1) The number of red blood cells that carry oxygen decreases; 2) Decreased blood clotting; 3) Reducing the number of neutrophils. Neutropenia is considered the most common complication after chemotherapy.

Chemotherapy and neutropenia: what are the risks

Depending on the number of neutrophils in the peripheral blood, neutropenia is divided into 4 degrees. With timely treatment with chemotherapy, it is almost impossible to prevent the occurrence of such complications as neutropenia. With an increase in the dose of chemotherapy drugs, the effectiveness of treatment increases proportionally and, unfortunately, such a complication as neutropenia.
Neutrophils protect our body from various infections. A decrease in their number leads to the fact that nothing prevents the reproduction of infections in the human body. For this reason, neutropenia is considered the root cause of the process of reproduction of infections after a course of chemotherapy treatment. Another negative result of this disease is the need to take long breaks between chemotherapy courses. This is done so that the body can restore required amount neutrophils. In the period between chemotherapy courses, it is often necessary to take a general blood test in order to know the exact level of neutrophils in the blood. Lack of timely provided ambulance can have irreversible disastrous consequences.
If you experience any of the following symptoms after chemotherapy, you should tell your doctor right away:
. heat;
. chills;
. pain in the throat;
. the appearance of a rash;
. diarrhea;
. redness around the wound.
There may be a need to delay the next course of chemotherapy in cases where profound neutropenia has not been cured. This has great negative consequences, since cancer cells develop immunity to chemotherapy drugs during this time, which drastically reduces the effectiveness of treatment.
The normal number of neutrophils in the body of a healthy person is from four to seven million cells per milliliter of blood, he is reliably protected from infections caused by pathogenic bacteria. But if their number falls below 500 thousand per milliliter, there is a risk of developing infectious complications.
Such patients are prescribed antibiotics, which, unfortunately, are not always able to stop the infection. This method of treatment is very expensive and may not have the desired positive effect. Along with it, there is another method. It uses granulocyte colony-stimulating factor (G-CSF) to prevent complications after chemotherapy.

The time in which we live is characterized not only by rapid technological progress, but also by the emergence of more and more deadly ailments. Diseases affect almost all internal organs and systems of a person. Cancer has become a terrible threat hanging over people. This oncological disease has affected millions of people around the world. Literally 10-15 years ago, cancer was considered an incurable disease, the outcome of which in most cases was fatal. However, medicine does not stand still, and scientists have come up with an effective method by which you can completely eliminate it without surgery. As you might guess, we are talking about chemotherapy.

What is this procedure? Why do patients who are about to undergo chemotherapy be interested in the consequences of the treatment? The fact is that the procedure is based on the impact on tumor cells with special toxic substances that completely destroy the formation that negatively affects the human body. That is, the infectious agent, which acts as the causative agent of the disease, is attacked by the full power of toxins. Unfortunately, during chemotherapy, there is a negative impact not only on malignant formation, but also on the body itself. The poison that is used during treatment is commonly called a chemotherapy drug. This is why many people experience adverse effects of chemotherapy. Let's talk in more detail about the types of procedures, side effects and the rehabilitation period.

There are situations when the doctor could not surgically remove everything. The same is considered a local method. That is, it affects a certain area. It often happens that some cancer cells separate from the tumor and travel throughout the body. In such cases, chemotherapy is simply indispensable. Unfortunately, the drugs used during the procedure are extremely toxic and adversely affect human health. The adverse effects of chemotherapy are a reality.

The main side effect of this procedure, which is striking, is the so-called alopecia. In simple words, baldness. Almost all patients experience depression, frustration and other emotional disturbances in this case. That's not all. Complications of chemotherapy can occur both in the early and late stages. Some side effects are life threatening. Here are the most frequent and terrible consequences of chemotherapy: myelosuppression (blood and bone marrow is affected), problems with the gastrointestinal tract (nausea, vomiting), nephrotoxicity (complications associated with the kidneys), cardiotoxicity and infertility.

In order to improve the patient's condition, rehabilitation after chemotherapy comes to the rescue. The procedure is based on the use a large number lactic acid bacteria that stabilize the intestines. For this purpose, bifidophilus or floradophilus is attributed. These drugs restore not only the work of the stomach, but also prevent hair loss on the head. After the course of treatment, patients are prescribed the drug Liver 48. It helps to increase the level of hemoglobin in the blood and has a beneficial effect on the liver.

From the foregoing, it follows that the effects of chemotherapy adversely affect the human body. However, it should be remembered that in most cases, all side effects disappear over time, and the person gets rid of the fatal disease forever and gets a second chance for a happy life.

The condition of an oncological patient after undergoing a course of chemotherapy is quite severe or of moderate severity. Of course, patients with different levels of immunity, with different stages of cancer, as well as with existing other diseases of the body, tolerate treatment differently.

But the general is considered a sharp deterioration in the state of health and well-being of the patient after a course of chemotherapy.

ICD-10 code

Z54.2 Condition of recovery after chemotherapy

body after chemotherapy

After a course of chemotherapy, patients experience a sharp decrease in all indicators of the body's work. First of all, it concerns the state of the hematopoietic system and the blood itself. Sharp changes occur in the blood formula and its composition, which are expressed in a drop in the level of its structural elements. As a result, the immunity of patients is greatly reduced, which is expressed in the susceptibility of patients to any infectious diseases.

All internal organs and systems experience the effects of toxic damage from chemotherapy drugs that contain poisons that kill rapidly growing cells. This type of cells are malignant, as well as cells of the bone marrow, hair follicles, mucous membranes of various organs. They suffer before everyone else, which is expressed in a change in the well-being of patients, exacerbation of various diseases and the appearance of new symptoms, as well as a change in the appearance of the patient. The heart and lungs, liver and kidneys, gastrointestinal tract and genitourinary system, skin and so on are also affected.

After chemotherapy, patients experience allergic reactions, skin rashes and itching, hair loss and baldness.

The peripheral and central nervous system also suffers, which is expressed in the appearance of polyneuropathy.

At the same time, the appearance of general weakness and increased fatigue, depressive states is noted.

Immunity after chemotherapy

The state of human immunity is influenced by many factors, including the composition of the blood and the number of various types of leukocytes in it, including T-lymphocytes. After chemotherapy, the patient's immunity decreases sharply, due to a drop in the level of leukocytes responsible for the body's immune response against various infections and pathological agents of internal and external origin.

Therefore, after a course of chemotherapy, patients are treated with antibiotics so as not to become victims of infectious diseases. This measure, of course, does not improve the general condition of the patient, which is already reduced by the use of chemotherapy.

The following measures contribute to the increase in immunity after the end of treatment:

1. Taking antioxidants - vitamins that stimulate the immune system. These include vitamins C, E, B6, beta-carotene and bioflafonides.
2. It is necessary to eat a lot of fresh vegetables, fruits, herbs and berries with food, which contain antioxidants - currants, strawberries, bell peppers, lemons and other citrus fruits, raspberries, apples, cabbage, broccoli, brown rice, germinated wheat, parsley, spinach, celery and so on. There are antioxidants in grains and legumes, in unrefined vegetable oils, especially olive.
3. It is necessary to include in preparations rich in selenium, as well as products in which this trace element is contained. This element helps to increase the number of lymphocytes, and also improves the production of interferon and stimulates immune cells to produce more antibodies. Selenium is rich in garlic, seafood, black bread, offal - duck, turkey, chicken cow and pork liver; beef, pork and veal kidneys. Selenium is found in brown rice and corn, wheat and wheat bran, sea salt, wholemeal flour, mushrooms and onions.
4. Small, but regular physical activity improves immunity. These include morning exercises, outdoor walks, cycling, swimming in the pool.
5. Chamomile tea is a simple remedy for boosting immunity. A tablespoon of dried chamomile flowers is brewed with a glass of boiling water, cooled and filtered. The minimum amount of chamomile infusion is two to three tablespoons three times a day before meals.
6. Echinacea tincture or Immunal preparation is an excellent tool for strengthening immunity. Alcohol infusion should be drunk with a small amount of liquid. The initial dose is considered to be forty drops, and then the tincture is consumed in the amount of twenty drops every hour or two. The next day, you can take forty drops of tincture three times a day. The longest course of treatment is eight weeks.

Liver after chemotherapy

The liver is one of the most important human organs, while performing many different functions. It is known that liver cells are most susceptible to the negative consequences of the introduction of chemotherapy of all other organs. This is due to the fact that the liver takes an active part in metabolic processes, as well as excretion from the body along with bile and neutralization of various harmful and toxic substances. It can be said that from the very beginning of chemotherapy, the liver is a conductor of the drug, and after treatment it begins to function in the mode of protecting the body from the toxic effects of drug components.

Many chemotherapy regimens have a strong toxic effect on the liver. In some patients, the effect of drugs, expressed in eighty percent of liver damage, is observed.

The liver after chemotherapy can have several degrees of damage, there are four main degrees - mild, moderate, high and severe. The degree of damage to this organ is expressed in the level of changes in the biochemical parameters of its functioning.

With liver damage, there is a violation of metabolic processes in the cells of the organ, toxic changes in cell structures, impaired blood supply to liver cells and exacerbation of previously existing liver diseases. In this case, the immune abilities of this organ are violated. It is also possible the occurrence of carcinogenesis - the appearance of tumor processes in the liver.

After chemotherapy, it is mandatory to undergo a biochemical blood test, the decoding of which shows how damaged the liver is. This takes into account the level of bilirubin and enzymes in the blood. Patients who have not abused alcohol, have not had hepatitis, and have not worked in hazardous chemical plants may have normal blood counts. Sometimes, in patients, biochemical analysis data can worsen by three to five times relative to the norm.

You can reassure patients that the liver is an organ that regenerates quickly and successfully. If, at the same time, an appropriate diet and drug therapy is applied, this process can be significantly accelerated and facilitated.

Hepatitis after chemotherapy

Hepatitis is a group of inflammatory diseases of the liver, which is predominantly viral (infectious) in nature. The cause of hepatitis can also be toxic substances that are found in excess in cytostatics.

Hepatitis after chemotherapy occurs against the background of damage to liver cells. Moreover, the more affected this organ, the greater the likelihood of hepatitis. Infections penetrate into the weakened liver, which lead to the development of inflammatory processes.

The possibility of hepatitis is also associated with a low level of immunity after chemotherapy, which causes poor resistance of the body to diseases of an infectious nature.

The symptoms of hepatitis are:

1. Appearance of fatigue and headache.
2. The occurrence of loss of appetite.
3. Appearance of nausea and vomiting.
4. The occurrence of elevated body temperature, up to 38.8 degrees.
5. The appearance of a yellow skin tone.
6. Change in the color of the whites of the eyes from white to yellow.
7. Appearance of brown urine.
8. Discoloration of feces - they become colorless.
9. The appearance of sensations in the right hypochondrium in the form of pain and tightness.

In some cases, hepatitis can come and go without symptoms.

Hair after chemotherapy

Hair falls out after chemotherapy, and some patients become completely bald. Chemotherapy drugs damage the follicles from which hair grows. Therefore, hair loss can be observed all over the body. This process begins two to three weeks after the transfer of chemotherapy is called alopecia.

If the course of oncoprocesses in the body has slowed down, there is an increase in the patient's immunity and an improvement in his general condition and well-being. There are good hair growth trends. After a while, the follicles become viable and the hair begins to grow. Moreover, this time they become thicker and healthier.

However, not all chemotherapy drugs cause hair loss. Some anti-cancer drugs only partially dehair the patient. There are drugs that have a targeted effect only on malignant cells, and allow you to keep the patient's hairline intact. In this case, the hair becomes only thin and weakened.

After completing the course, experts advise using the following recommendations:

1. Use the drug "Sidil". But you should not buy the drug yourself, because it has a number of side effects. It is best to consult your doctor about the use of this drug.
2. Do a daily head massage using burdock oil. Oil is applied to the scalp, massage is done, then a cellophane cap is put on the head, and a towel is wrapped on top. After an hour, the oil is washed off with a mild shampoo. Burdock oil can be replaced with hair growth products containing vitamins and ceramides.

Stomach after chemotherapy

Chemotherapy drugs damage the lining of the stomach, causing patients to experience a number of unpleasant symptoms. Appears nausea and vomiting, heartburn and acute burning pain in the upper abdomen, flatulence and belching, weakness and dizziness. These symptoms are signs of gastritis, that is, an inflammatory or degenerative change in the gastric mucosa. In this case, there may be a deterioration in the tolerance of certain foods, as well as a lack of appetite and weight loss.

To restore the proper functioning of the stomach, it is necessary to follow the diet recommended by specialists and take prescribed medications.

Veins after chemotherapy

The patient's veins after chemotherapy experience the consequences of exposure to toxic drugs. The early (immediate) complications include the appearance of phlebitis and phlebosclerosis of the veins.

Phlebitis is an inflammatory process of the walls of the veins, and phlebosclerosis is a change in the walls of the veins of a degenerative nature, in which the walls of the vessels thicken.

Such manifestations of vein changes are observed in the elbow and shoulder of the patient after repeated injections of chemotherapy drugs - cytostatics and / or antitumor antibiotics.

To avoid such manifestations, the above drugs are recommended to be injected into a vein at a slow pace, and also to finish the infusion of the drug by injecting a full syringe of a five percent glucose solution through the needle left in the vessel.

In some patients, chemotherapy drugs have the following side effect on the veins - inflammatory processes begin in them, which lead to the formation of blood clots and the appearance of thrombophlebitis. Such changes, first of all, concern patients whose circulatory system is prone to the formation of blood clots.

Lymph nodes after chemotherapy

After chemotherapy, some patients may become inflamed and enlarge the lymph nodes. This is due to the increased sensitivity of the follicles of the lymph nodes to the toxic effect of cytostatics.

This happens for a number of reasons:

1. Due to damage to the cells of the lymph nodes.
2. By reducing the number of blood elements (leukocytes and lymphocytes), which are responsible for the body's immune response.
3. Due to the reaction of the body to the penetration of the infection into the body.

Kidneys after chemotherapy

During chemotherapy, kidney damage occurs, which is called nephrotoxicity. This consequence of treatment is manifested in necrosis of cells of the renal tissue, which is the result of accumulation in the tubules of the parenchyma of the drug. First of all, there is a lesion of the tubular epithelium, but then the processes of intoxication can penetrate deep into the glomerular tissue.

A similar complication after chemotherapy has another name: tubulo-interstitial nephritis. At the same time, this disease can develop in an acute form, but then, after long-term treatment, move into a chronic stage.

Damage to the kidneys, as well as kidney failure, affects the occurrence of long-term anemia, which appears (or worsens) due to a violation of the production of renal erythropoietin.

After chemotherapy, there is the presence of varying degrees of renal failure, which can be established after laboratory tests of blood and urine. The degree of this dysfunction is affected by the level of creatine or residual nitrogen in the blood, as well as the amount of protein and red blood cells in the urine.

Feeling good after chemotherapy

After chemotherapy, patients experience a sharp deterioration in well-being. There is severe weakness, increased fatigue and fatigue. The psycho-emotional state of the patient changes for the worse, depression can be observed.

Patients complain of constant nausea and vomiting, heaviness in the stomach and burning in the epigastric region. Some patients experience swelling of the hands, face, and legs. Some of the patients feel severe heaviness and dull pain in the right side in the area of ​​the liver. Pain can also be observed in the entire abdomen, as well as in the joints and bones.

There is numbness of the arms and legs, as well as impaired coordination during movement, changes in tendon reflexes.

After chemotherapy, bleeding of the mucous membranes of the mouth, nose and stomach increases sharply. Patients have manifestations of stomatitis, which are expressed in severe dryness of the soreness of the oral cavity.

Consequences after chemotherapy

After undergoing a course of chemotherapy, patients begin to feel the various consequences of the treatment they have undergone. Patients are faced with a deterioration in well-being, the occurrence of general weakness, lethargy and increased fatigue. There is a loss of appetite and a change in the taste of foods and dishes, diarrhea or constipation occurs, severe anemia is detected, patients begin to worry about nausea and even vomiting. The patient may be disturbed by oral mucositis (pain in the mouth and throat) and stomatitis, as well as various bleeding.

The appearance of the patient also undergoes changes. Hair usually falls out after chemotherapy. The appearance and structure of the skin changes - it becomes dry and painful, and the nails become very brittle. There is severe swelling, especially of the limbs - arms and legs.

The mental and emotional processes of the patient also suffer: memory and concentration of attention deteriorate, periods of clouding of consciousness are observed, difficulties with the thinking process appear, the general emotional state of the patient is destabilized, depressive states are observed.

The peripheral nervous system is also heavily affected by drugs. Feelings of numbness, tingling, burning or weakness are observed in various parts of the body. First of all, such transformations concern the hands and feet of the patient. When walking, pain in the legs and the whole body can occur. There may be loss of balance and falls, dizziness, cramps and muscle twitching, difficulty holding or lifting objects. Muscles constantly feel tired or sore. There is a decrease in hearing acuity.

The transferred chemotherapy affects the decrease in sexual desire, as well as the deterioration of the patient's reproductive functions. There is a disorder of urination, the occurrence of pain or burning, as well as a change in the color, smell and composition of urine.

Complications after chemotherapy

Complications after chemotherapy are associated with general intoxication of the body through the use of drugs. There are local and general complications, as well as early (immediate) and late (long-term) consequences of chemotherapy.

Examination after chemotherapy

Examination after chemotherapy is done for two purposes:

1. Determine the success of the treatment.
2. Find out the degree of damage to the patient's body by the toxic effect of drugs and prescribe the appropriate symptomatic treatment.

The examination procedure includes a laboratory study of blood tests: general, biochemical and leukocyte formula. It is also necessary to pass a urine test to determine the level of protein.

Additional examination after chemotherapy may include ultrasound diagnostics and x-rays.

Tests after chemotherapy

During the course of chemotherapy, patients undergo tests at least twice a week. This concerns, first of all, a blood test and its research. This measure is due to the need to monitor the patient's condition during chemotherapy. If the results of the tests are satisfactory, the course of treatment can be continued, and if the results are poor, the doses of the drugs can be reduced or the treatment should be stopped altogether.

After chemotherapy, patients also undergo tests that are aimed at monitoring the patient's condition after chemotherapy. First of all, a general blood test, a biochemical blood test and a leukocyte formula are performed. This group of analyzes allows you to fix the level of damage to the body after chemotherapy, namely, vital organs and systems, and take appropriate measures to normalize the patient's condition.

Common after chemotherapy is a change in all blood parameters. The level of leukocytes, erythrocytes and platelets decreases. ALT and AST levels rise, as do bilirubin, urea, and creatine levels. The level of total protein in the blood decreases, the amount of cholesterol, triglycerides, amylase, lipase and GGT changes.

Such changes in the composition of the blood show damage to all organs and systems of varying severity after a course of chemotherapy.

What to do after chemotherapy?

Many patients who have been treated with cytostatics begin to wonder: “What should I do with my health after chemotherapy?”

First of all, it is necessary to determine what symptoms bother the patient after the completion of chemotherapy. They need to be told to specialists who monitor the patient's condition after chemotherapy. The attending physician, having familiarized himself with certain symptoms, may refer the patient to a narrower specialist for advice and appropriate treatment.

Specialists of a narrower profile, as a symptomatic treatment, may prescribe the intake of certain medications, as well as vitamin-mineral complexes and immunity-supporting therapy.

Along with alleviating the patient's condition with the help of medicines, it is necessary to set the goal of restoring the functions of damaged organs and systems. First of all, this concerns the function of hematopoiesis, the immune system, the work of the digestive system of the stomach, intestines, liver, as well as the function of the kidneys. It is very important to restore the microflora in the intestine, thereby stopping the course of dysbacteriosis. In this case, it is necessary to pay attention to the elimination of symptoms of general intoxication of the body, as well as weakness, depression, pain, swelling and loss of appetite.

Restorative therapies include:

• The transition to proper nutrition, which includes the whole range of products useful for the body.
• Feasible physical activity - hiking in the fresh air, morning exercises.
• The use of massages, physiotherapy and so on to improve health.
• Using the methods of traditional medicine and herbal medicine to restore the body.
• The use of psychotherapy methods to improve the psycho-emotional state of the patient.

Treatment after chemotherapy

Treatment after chemotherapy is based on the appearance of the most disturbing symptoms in patients. The choice of therapy, as well as the appropriate drug treatment, can only be made after the results of laboratory blood tests and, if necessary, other tests.

The means that improve the patient's condition after a course of chemotherapy include:

1. Changing the diet of the patient and following a certain diet.
2. Being at rest, the ability to restore strength.
3. Walks in the fresh air, feasible physical activity, for example, therapeutic exercises.
4. Getting positive emotions and positive impressions from others, working with a psychologist.
5. Certain physiotherapy procedures.
6. Drug treatment of side effects.
7. The use of traditional medicine.
8. Spa treatment.

Pregnancy after chemotherapy

Pregnancy after chemotherapy is considered a controversial issue. If chemotherapy is accompanied by medical protection of the ovaries, then this increases the chances of a woman becoming a mother in the future. But many patients remain infertile, even despite enhanced treatment for this problem. This is because after each course of chemotherapy, the chances of pregnancy are reduced several times.

The toxic effect of drugs affects the ovaries and inhibits their functioning. Such an effect is felt the more clearly, the closer the area of ​​​​influence of chemotherapy is to the ovaries.

During chemotherapy, two methods of surgical protection of the ovaries can be used:

1. Displacement of the ovaries from the area of ​​action of the drugs.
2. With general chemotherapy, the ovaries can be removed from the body and preserved until the woman is healthy. After that, the ovaries return to their original place.

Experts recommend starting pregnancy planning at least one year after the end of the course of chemotherapy. This is due to the need to restore the body of a woman after intoxication and the removal of toxic substances. Otherwise, if the terms of conception are not observed, irreversible changes in the fetus may occur even in the prenatal period and the birth of a child with deviations in health and development.

Sex after chemotherapy

Sex after chemotherapy is a rather difficult act. This is caused, first of all, by the deterioration in the general state of health and well-being of patients. Hormonal changes lead to a decrease in the strength of sexual desire, and in many cases, its temporary absence.

Women may experience changes in the microflora of the vagina, which is expressed in the appearance of thrush, which is accompanied by unpleasant symptoms. In this case, sexual intercourse will cause discomfort and pain, which negatively affects the desire to have sex.

In men, as a result of chemotherapy, there are difficulties with the onset and maintenance of an erection, as well as anorgasmia - the absence of orgasms.

Despite the fact that many women do not have periods after chemotherapy, it is necessary to follow the rules of contraception when having sex. Since there is always a risk of getting pregnant, and this would be undesirable immediately after the end of chemotherapy.

In men, toxic products of chemotherapy drugs penetrate the semen and can affect the conception and birth of a child with developmental anomalies that will have congenital malformations.

Periods after chemotherapy

The toxic effect of chemotherapy drugs inhibits the activity of the ovaries. This is manifested in the violation of the menstrual cycle, the occurrence of its instability. Some patients may experience a complete cessation of menstruation. This leads to the appearance of temporary infertility in women.

In order to restore reproductive functions after chemotherapy, the patient must undergo appropriate hormonal treatment so that menstruation reappears. In some cases, the body never restores its reproductive functions, which means an early entry into menopause (menopause) and the complete absence of menstruation forever.

Life expectancy after chemotherapy

It is impossible to accurately predict how long a patient will live after undergoing chemotherapy. These assumptions depend on many factors, including:

• Stage of the oncological process.

At the first or second stage of the disease, a complete recovery of the body after chemotherapy and the absence of relapses of the disease are possible. At the same time, patients can lead a full life and twenty, and thirty years after the end of treatment.

The third and fourth stages of oncological diseases do not give bright forecasts: patients after chemotherapy in this case can live from one to five years.

• The degree of damage to the body after chemotherapy.

The consequences after the transferred treatment are of unequal severity for all patients. There are complications from zero to fifth degree of toxic damage to the patient's body.

With mild to moderate effects, patients can recover sufficiently to continue a full life for a long time. At the same time, of course, it is necessary to radically change your lifestyle, making it healthy from the physical and psychological aspects.

Severe degrees of damage to the body can cause serious consequences for the health of the patient. In this case, a lethal outcome can occur within a short time after chemotherapy, as well as within one year after treatment.

• Changing the patient's lifestyle.

Those patients who really intend to live long begin to take care of their health. They change their diet towards wholesome and healthy food, change their place of residence to more environmentally friendly areas, begin to engage in physical activity, resort to methods of strengthening immunity and hardening. Bad habits - alcohol, smoking and others are also ostracized. Those wishing to lead a full-fledged lifestyle may resort to a change in professional activity and place of work if this greatly affects the patient's quality of life. All of the above measures can lead not only to an increase in life expectancy after chemotherapy up to ten - twenty - thirty years, but also to complete elimination of the signs of the disease.

• The psychological attitude of the patient to recovery is very important. It has been noticed that those patients who really tune in to a full life after undergoing chemotherapy live a long time without observing relapses of the disease. The psychological attitude towards recovery is very important for the life expectancy of the patient. After all, not in vain, it is believed that many diseases, including cancer, are of a psychosomatic nature.
• A huge role is played by a change in the psychological situation in the place of residence of the patient and his work. It is known that negative emotions are one of the main causes of somatic diseases, including cancer. Immune and recovery processes in the body are directly related to the mental state of the patient. Therefore, being in an atmosphere of positive emotions, support, participation and attention is one of the factors for increasing the duration after chemotherapy. It is important to change the atmosphere in the patient's home and work in such a way that it has a positive effect on his condition.

It is also of great importance to enjoy life and bright, pleasant impressions. Therefore, it is necessary to think about such activities and hobbies for the patient that would give patients pleasure and fill their life with meaning.

Disability after chemotherapy

Disability after chemotherapy is issued in case of establishing an uncertain prognosis for the patient's condition. In this case, the high risk of recurrence, for example, the possibility of metastases, is of great importance.

If, after the surgical treatment, no further radiation treatment and chemotherapy are prescribed, this means that the patient's prognosis for recovery is high. At the same time, there are no complications that lead to persistent violations of the functioning of the body and limit the life of the patient. In this case, disability is not issued due to lack of grounds.

If the patient needs to undergo severe treatment for a long period, he may be assigned a group II disability for a period of one year. Chemotherapy can be of varying severity, this affects the disability group, which can be the third.

It should be noted that disability is not assigned immediately after the surgical intervention, but after three to four months from the initial moment of treatment and longer. This applies to working patients, and pensioners, and the non-working category of patients. Registration of disability cannot be longer than four months after the chemotherapy treatment of the disease.

At the same time, the patient passes a medical commission, which issues a conclusion about the obvious unfavorable clinical and labor prognosis for the patient. This does not depend on the timing of the patient's temporary disability, but must be done no later than four months from its occurrence. Only citizens who have permanent disabilities and who need social protection are sent to the commission.

The patient's condition after chemotherapy is a determining factor for taking further actions to improve health, improve the quality of life and social protection of the patient's rights.

The use of antitumor chemotherapy is often accompanied by adverse reactions. Chemo drugs primarily damage the rapidly renewing cells of the digestive tract, bone marrow, hair follicles, etc. In addition, anticancer drugs can damage almost all normal body tissues.

There are 5 degrees of severity of side effects of chemotherapy drugs - from 0 to 4.

At grade 0, there are no changes in the patient's well-being and research data. At grade 1, there may be minor changes that do not affect the general activity of the patient and do not require the intervention of a doctor.

At grade 2, moderate changes are noted that disrupt the normal activity and vital activity of the patient; laboratory data are significantly changed and require correction.

At grade 3, there are severe disorders that require active treatment, delay or cessation of chemotherapy.

Grade 4 is life-threatening and requires immediate withdrawal of chemotherapy.

Toxic effect of chemotherapy drugs on hematopoiesis is the most common side effect of chemotherapy and is manifested by the inhibition of all hematopoietic sprouts. Particularly often damaged cells are the progenitors of leukocytes and platelets, and less often the cells responsible for the development of erythrocytes.

Risk factors for the development of the toxic effect of chemotherapy drugs on the bone marrow include: previous chemotherapy and radiation therapy, the age of patients over 60 years and younger than 1 year, the general condition of the patient, exhaustion.

Inhibition of hematopoiesis is usually noted in the next few days after the appointment of chemotherapy (on the 7-12th day). Some drugs cause a delayed toxic effect.

A sharp and prolonged decrease in the number of leukocytes can lead to an increased incidence of infectious complications. In the last 20 years, there has been an increase in cases of fungal and viral infections.

With a significant decrease in the number of platelets, nasal, gastrointestinal bleeding, cerebral hemorrhages, etc.

Toxic effect of chemotherapy on the gastrointestinal tract can lead to nausea, vomiting, stomatitis, enteritis and diarrhea (loose stools) as a result of damage to the mucous membranes of the oral cavity and intestines, toxic liver damage.

Nausea and vomiting are not the most dangerous, but the most common and most painful manifestation of the toxic effects of chemotherapy drugs. In some cases, these reactions can even lead to refusal of treatment.

Toxic damage to the liver more often detected in patients who have previously had hepatitis or who have impaired liver function before starting chemotherapy.

Cardiotoxicity(damage to the heart muscle) occurs mainly with the use of anthracyclines (adriamycin, rubomycin) and less often with the use of other drugs (cyclophosphamide, 5-fluorouracil, etoposide, etc.).

Early manifestations of cardiotoxicity include: lowering blood pressure, palpitations, rhythm disturbance, pain in the heart. Later symptoms of cardiotoxicity occur due to damage to the heart muscle, rhythm disturbance. Sometimes a myocardial infarction may occur.

Signs of myocarditis (damage to the heart muscle) are: palpitations, shortness of breath, an increase in the size of the heart, circulatory disorders.

The development of cardiotoxicity is more often observed in people over 60 years of age, in the presence of heart disease, with irradiation of the lungs or mediastinum, with previous chemotherapy with drugs that have cardiotoxicity.

Toxic effect of chemotherapy drugs on lung function noted infrequently. When using bleomycin, the frequency of such a complication (pulmonitis) is 5-20%. The timing of the onset of pulmonitis is different: from several weeks with the use of bleomycin to 3-4 years with the treatment with cyclophosphamide and myelosan.

More often, this complication is detected in elderly patients, in patients with lung diseases and in previous chemotherapy or radiation.

Damage to the urinary system due to the fact that most chemotherapy drugs are excreted by the kidneys. The degree of toxicity of drugs depends on their dose and concomitant kidney disease, as well as on the age of the patient. Kidney dysfunction during chemotherapy is most pronounced when using platinum.

Uric acid nephropathy. With a high sensitivity of the tumor to chemotherapy, the rapid shrinkage of the tumor (lysis syndrome) may be accompanied by an increase in the content of uric acid in the blood serum and the development of a serious complication from the kidneys - uric acid nephropathy. The initial signs of this complication include: a decrease in the amount of urine, the appearance of a large number of uric acid crystals in the urine sediment, etc.

allergic reactions may occur in 5-10% of patients with the use of various chemotherapy drugs. In patients receiving paclitaxel, docetaxel and L-asparaginase, allergic reactions are most common. When using L-asparaginase, allergic reactions are detected in 10-25% of cases.

Neurotoxicity can manifest itself in various parts of the nervous system. In most cases, it is mild, varied and observed in the treatment of many chemotherapy drugs (vincristine, etoposide, prospidin, natulan, platinum, taxol, etc.).

Symptoms of central neurotoxicity most often manifest themselves in the form of impaired attention, memory, emotional disorders, and a decrease in general tone. Serious complications should be considered the appearance of hallucinations and arousal.

Peripheral neurotoxicity manifests itself as mild tingling in the fingers, dysfunction of the upper and lower extremities, bloating, vision and hearing impairment.

Neurotoxicity can be observed with the introduction of chemotherapy drugs into the spinal canal or the use of high doses. In this case, patients may experience headaches, dizziness, nausea, vomiting, impaired orientation and consciousness.

Toxic effect of chemotherapy drugs on the skin may manifest as redness, rash, itching, fever and decreased sensitivity.

Later, these phenomena can be aggravated and turn into persistent skin changes with the development of infection, hyperpigmentation of the skin, nails and mucous membranes.

Many toxic skin and nail reactions go away on their own soon after chemotherapy is stopped.

Baldness(alopecia) occurs when certain chemotherapy drugs are used that damage the hair follicles (follicles). Alopecia is reversible, but is a severe mental trauma, especially for young patients and women. E

This complication often occurs during treatment with doxorubicin, epirubicin, etoposide, taxanes, and other drugs.

Full hair restoration occurs 3-6 months after the end of chemotherapy.

Toxic fever most often observed in 60-80% of patients receiving bleomycin. An increase in body temperature also occurs during treatment with L-asparaginase, cytosar, adriamycin, mitomycin C, fluorouracil, etoposide.

The temperature quickly normalizes and, as a rule, does not serve as a reason for the abolition of chemotherapy.

Toxic phlebitis(inflammation of the veins) develop more often after several injections of drugs and are manifested by: severe pain along the veins during the administration of a chemotherapy drug, thrombosis and blockage of the veins.

Most often, toxic phlebitis develops during treatment with embichin, cytosar, vinblastine, dactinomycin, doxorubicin, rubomycin, epirubicin, dacarbazine, mitomycin C, taxanes, nevelbin, and with repeated injections of drugs into the same vein.

Local toxic effects of chemotherapy drugs occurs when some of them (nitrosourea derivatives, doxorubicin, rubomycin, vincristine, vinblastine, mitomycin C, dactinomycin, etc.) get under the skin during intravenous administration. As a result, necrosis (necrosis) of the skin and deeper tissues is possible. Late complications of chemotherapy