Adverse reactions and complications of chemotherapy of tumor diseases. Always wash your hands. Weakness and fatigue

Of all the methods of treating cancer, chemotherapy is developing most rapidly in our time. New drugs are being developed, various schemes for their combination, however, it is very difficult to completely prevent or predict in advance the side effects of this type of treatment. They may develop in the early stages of treatment or be absent altogether. may be more or less pronounced. But in a situation where it is a “lifeline”, the doctor and the patient need to do everything together to make the treatment as effective as possible.

According to the time of occurrence, complications are divided into three groups:

• Directly arising from the first administration of the drug: nausea, vomiting, headache, allergic reactions.
• Early complications that occur during the course of chemotherapy itself or in a short time after completion: dysfunction of the gastrointestinal tract, hematopoiesis suppression, liver dysfunction, neurological disorders.
• Late complications usually occur after the end of chemotherapy treatment. These include inhibition of the function of the thyroid gland, other endocrine organs and severe changes in hematopoiesis.

It is very important in the treatment of the oncological process to treat the underlying disease and the complications of chemotherapy as two pathological processes occurring in parallel. It is impossible not to highlight the fact that sometimes complications can lead to a catastrophic ending, even with victory over the main cause - a tumor. This group of patients needs to be monitored by specialists, both generalists and those with a narrow specialization, due to the need for careful dynamic monitoring of the functioning of all organs and systems of the body.

What do patients need to know when starting chemotherapy treatment?

• To combat the possible toxic effects of this group of drugs, inpatient treatment may be necessary to carry out detoxification organism after the administration of chemotherapy drugs.
• An important point is suppression of the immune system. Patients may need to use immunostimulating drugs. This therapy also requires inpatient treatment and specialist supervision.
• allergic reactions may manifest as hives, spotty rashes, itching, and sometimes fever. In severe situations, when the reaction occurs during the administration of the drug, the administration of the drug may be suspended.
• This group of drugs causes dry skin and brittle nails. The sensitivity of the skin to sunlight increases. With minor skin problems, you can deal with them yourself - protecting the skin from the sun's rays, using soft creams that are gentle on the skin and do not contain perfume components.
• Nausea and vomiting are the most common symptoms of complications encountered with chemotherapy. In recent years, the arsenal of antiemetic drugs has increased. They control nausea and vomiting well. From non-drug remedies, ginger is recommended; it has a spicy flavor and is used both as a condiment and when added to tea. Sometimes you should reduce the amount of food and eat more snacks, juices. With nausea, a meditative practice is also possible, which involves imagining a pleasant relaxing place to relax or chat with friends, visit a theater or a friendly company. Positive emotions can block negative physical sensations.
• For complaints of constipation the attending physician must be notified. In such a situation, it is recommended to introduce more fiber into the diet - fresh and boiled vegetables, whole grain bread, fruits (fresh and dried fruits), seeds, brown and wild rice, oats, boiled legumes.
• In case of occurrence diarrhea- exclude dairy products, various types of cabbage, coffee, muffins from the diet. If loose stools and colic last more than a day, or blood appears in the stool, you should consult a doctor.
• During chemotherapy, there may be hair loss. This usually occurs after several weeks or months of treatment. Sometimes the hair does not fall out, but becomes thinner and dryer. Chemotherapy damages hair follicles, i.e. the process of hair growth is disrupted. But, as a rule, this does not lead to irreversible consequences. At the end of the treatment, the hair will grow back as it did before the treatment. In this situation, it is recommended to cut your hair short, use mild shampoos so as not to irritate the skin and hair follicles. To restore hair color, it is better to use natural henna. For the effectiveness of hair growth, it is recommended to use all kinds of vegetable oils - grape, nettle, olive, burdock. It is most effective to use the listed oils by rubbing into the scalp or in the form of a massage in combination with essential oils - jasmine, ylang-ylang, rose oil. It must be remembered that masks and massage can be prescribed only after the end of chemotherapy. The use of mineral-vitamin complexes should be approached with caution: during the acute period of the disease and treatment, they are contraindicated. It is required to protect the scalp from sunlight and cold, do not wear a hat made of synthetic materials. Hair loss is a very difficult psychological situation that requires the understanding and help of relatives and friends.
• Anemia. Chemotherapy drugs can inhibit the work of the hematopoietic organs and thereby reduce the number of red blood cells. As a result, the tissues of the body receive less oxygen. Patients begin to complain of lethargy, dizziness, shortness of breath. Our recommendations are to save energy, find time for rest during the day, and keep at least 8 hours of sleep at night. You need to eat right and balanced. The diet should have enough protein, foods high in iron - red meats, greens, spinach, beans. Control of the blood test according to the prescription of the attending physician.
• Decreased appetite- a frequent complaint in the treatment of drugs of this group. You need to control your weight. Frequent, fractional nutrition is shown. You need to try to maintain interest in food - cook new dishes, watch TV while eating, eat in company or with family people. In the diet, high-calorie and protein foods are preferred. You can use various types of spices to improve the taste of food. The liquid is best drunk one hour before meals. It is useful to use soups, milkshakes. Foods that are high in calories are recommended: chicken, beef, eggs, fish, nuts, cereals, sprouted wheat, dairy products, whole milk, lentils, red and black beans, ice cream, muffins, puddings, butter and vegetable oils, cheeses.
• Weakness and fatigue in patients directly depends on the use of chemotherapy drugs. It is associated with anemia, insomnia, pain and depression. You should try to do only the most urgent things. Take care of yourself and do not refuse the help of relatives and friends. One should not endure pain, no matter what localization and intensity it is; take medications recommended by your doctor. Caution is required when moving, lifting objects, since falls, numbness of the limbs, and convulsive readiness are not excluded. Try not to rush when doing anything. Try to do the highest priority things in your life. No need to waste energy on unimportant things.
• When taking these drugs, you may experience urination disorders. There are frequent urge to urinate, pain, change in color and smell of urine. It is necessary to talk about these symptoms with your doctor, he will help to cope with such disorders.
• Chemotherapy often causes a decrease in the number of platelets in the blood. Platelets are an important component of blood that promotes clotting. The risk of bleeding dictates that patients be careful in all their actions. Close people should provide them with a life without injuries. In such a situation, it is necessary to systematically monitor general clinical blood counts with platelet count, data from the coagulation system and follow all the recommendations of the attending physician.
• Against the background of this group of drugs, patients may be disturbed limb edema. The edematous syndrome develops for many reasons: with heart failure, with impaired respiratory function, and renal pathology. Some types of tumors can also cause swelling. Edema tends to grow rapidly and spread not only to the limbs. All concerns should be directed to the attending physician; to alleviate the condition, it is recommended to follow all his advice - do not stay in one position for a long time, while sitting it is better to take a moderately elevated position for the legs. With swelling of the lower extremities, it is indicated to wear elastic stockings, moreover, they need to be put on in the morning without getting out of bed. We recommend wearing loose clothing and shoes. From the diet, we recommend the exclusion of foods containing a lot of salt - you can not take ham, salted and pickled vegetables, chips and smoked meats; daily monitoring of the patient's weight is extremely important!
• After several weeks of chemotherapy treatment, a complication such as oral mucositis, gingivitis- the symptoms of which are manifested by burning, pain, ulceration in the oral cavity. Difficulty eating and swallowing. Our recommendations are to maintain oral hygiene; rinse your mouth after every meal; brush your teeth with a soft toothbrush or cotton swab. After rinsing the mouth, it is better to use sprays with an analgesic effect, as well as antifungal sprays to reduce the growth of fungal flora on the mucous membrane, which your doctor will prescribe.
• The effect of drugs on fertility in women. Pregnancy in this situation is undesirable. This group of drugs adversely affects the fetus, so contraceptive methods should be discussed with a gynecologist. Oncological disease, chemotherapy affect the reproductive function of a woman, in view of this, one should consult with the attending physician on all issues and be regularly observed by a gynecologist. There may be menstrual irregularities, hot flashes, complaints of dryness of the vaginal mucosa, infections of the genital organs. There must be a frank relationship between you and your sexual partner. In the intimate sphere, the main thing is love and mutual understanding, tenderness and care.
• Chemotherapy and its effect on fertility in men. Advice to male patients is to always use a condom in intimacy, as chemo drugs can be contained in semen. If you have complaints that you have not noted before, a consultation of the attending physician and a sexologist is necessary.
• Some patients may experience memory disorders, attention disorders, depression. The reason for such disorders is associated not only with the toxic effects of drugs, but also with the stress that a person experiences. Contact your doctor, he can prescribe you drugs that eliminate depression, psychotherapeutic treatment. Currently, Pet therapy is used - treatment with the help of animals. Pets are human friends and healers at the same time. They help a person in difficult situations, reducing depression and fatigue, switching those who suffer to positive emotions. This is a new branch in medicine, dogs or other animals help people cope with a serious illness.
• Prevention and control of complications of chemotherapy contributes to its effective use, as well as the possibility of achieving the desired results in the treatment of cancer. With the joint efforts of highly qualified specialists, confidence in the victory over a serious illness of the patient himself, with the support of the love and care of relatives and friends, victory over the disease will be achieved.
• The team of our clinic are professionals who understand that patients with oncological pathology are very unprotected, emotionally and mentally fragile and vulnerable people, so we are always ready to be by your side in the most extraordinary and responsible situations.

Today, in medical practice, such a procedure as chemotherapy is no longer a rarity, the consequences of which are diverse. Chemotherapy is a drug treatment of oncological diseases with special drugs - cytostatics, which, by preventing the growth and reproduction of cancer cells, destroy them. Almost all such drugs are difficult to tolerate by most patients, since they have multiple side effects after treatment. Their severity is purely individual, but at the end of the consequences, these significantly weaken or stop completely.

If earlier the diagnosis of cancer was regarded as a death sentence, today chemotherapy in the vast majority of cases saves human lives. The main advantage of cytostatics is the penetration into the deepest layers of tissues, while when using other methods, the therapeutic effect is achieved only in local areas of the body.

However, chemotherapy drugs affect not only malignant, but also healthy cells. Therefore, this type of treatment is very toxic and is used for vital indications, when the patient faces a tough choice: life or death.

Side effects of cytostatics

The side effects of chemotherapy can be quite varied. The most common consequences of taking cytostatics and the main complications are:

• nausea and vomiting;
• developing anemia;
• infectious diseases;
• polyneuropathy after chemotherapy (dizziness, weakness, loss of strength, the patient has pain in the joints);
• swelling, stomatitis, ulcers on the tongue, oral mucosa;
• effect on the bone marrow, deterioration of blood composition, bleeding;
• complications in the work of internal organs, especially the heart, kidneys, bladder, liver;
• diarrhea and constipation;
• hair loss, brittle nails, skin pigmentation.

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Blood changes

Alas, even modern medicine cannot prevent the effect of cytostatics on the bone marrow, which carries out the process of hematopoiesis. Its intoxication is the most tangible and dangerous consequence of chemotherapy.

The consequences of chemotherapy due to violations in the blood formula are as follows:

• a deficiency of leukocytes leads to a drop in immunity, and then even the most benign infection can become fatal for a cancer patient;
• a decrease in the level of red blood cells and hemoglobin causes a breakdown, fatigue;
• platelet deficiency worsens blood clotting, and even a slight injury leads to the appearance of a hematoma (bruise, bumps).

A decrease in the number of leukocytes is almost inevitable. If there are less than 4 x 109 of them in 1 liter of blood, preventive measures should be taken to prevent infectious diseases, since immunity is practically at zero.

To do this, you need to wear a gauze mask, stay indoors more, avoid drafts, colds, carefully process food. When the level of leukocytes is less than 2.5 x 109, a weekly course of Derinat injections is recommended.

If the hemoglobin level drops to 70 g/l or below, a blood transfusion with the introduction of red blood cells or a course of injections of erythropoietins, substances that stimulate the production of red blood cells in the bone marrow, is necessary. In addition, you need to rest more, extra sleep during the day.

With a low platelet count, there is a risk of bleeding. In this case, it is necessary to avoid injuries, stress, rises in blood pressure, due to which there may be nosebleeds.

With a significant violation of the composition of the blood, anemia develops. She is treated, as a rule, also with blood transfusion and preparations with growth vitamins. But such treatment is not always possible, since it can provoke a recurrence of a cancerous tumor.

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Digestive disorders

Such complications of chemotherapy are so frequent that diarrhea or constipation has to be fought almost every day. You can stop diarrhea using decoctions of oak bark, calamus, bergenia, cinquefoil. And the preparations Fitolax, Guttalax, Drops of Ogarkov, decoctions of senna, buckthorn, cow parsnip help to get rid of constipation.

After each session of chemotherapy, many malignant cells die, turning into necrotic tissue. Its particles enter the bloodstream, causing severe weakness, nausea, headache, fever. To cleanse the body of dead cancer cells, you need frequent and plentiful drinking of water, chamomile tea, decoction of rose hips, mountain ash, cranberry juice. Symptoms of intoxication are well relieved by a decoction of birch fungus chaga (pharmacy preparation "Befungin"), activated charcoal (12-15 tablets per day), decoctions of flaxseed, angelica, marshmallow.

Stomatitis after chemotherapy is a very common phenomenon. Swelling, inflammation of the mucous membranes of the oral cavity. Therefore, both before and after chemotherapy sessions, her hygiene should be observed. In the morning, you need to clean the tongue from white-yellow necrotic plaque with a sterile pharmacy napkin (16 x 14 cm). In order not to irritate the mucous membrane of the cavity, you should not drink liquids with a sharp, sour taste. After eating, it is advisable to rinse your mouth with a soda solution diluted with chlorhexidine or furatsilina solution.

If Candida fungi settle in the oral cavity, candidiasis (thrush) develops with plaque, which must also be removed. To get rid of this disease help rinsing with a solution of soda, taking the drug "Fluconazole" or "Diflucan".

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Nausea and severe vomiting, anti-infective protection

Concerns about severe vomiting are greatly exaggerated. It really affected patients who were previously treated with drugs that are now outdated and are not used. Another thing is nausea of ​​varying intensity. She hurts many.

But although its symptoms are almost inevitable, they are effectively relieved by Ondansetron and its analogues (alone or in combination with Dexamethasone), and other antiemetics. "Metoclopramide" ("Cerucal") has a very weak effect on many. With an accurate individual selection of drugs, nausea and vomiting are prevented in 90% of cases.

You should know that the risk of death from infectious complications exceeds the risk of death even from a number of cancerous tumors.

A direct danger to the penetration of pathogens is:

• damage to any mucous membranes;
• a sharp decrease in the number of leukocytes;
• diseased teeth;
• congestion of mucus in the lungs;
• poorly processed food, water;
• contact with sick people.

What are the manifestations of complications associated with side effects of chemotherapy, how can these complications be overcome or their severity reduced?

Patients who are prescribed chemotherapy, as well as their relatives, are often interested in the complications that may be associated with treatment with anticancer drugs. In particular, they are interested in whether chemotherapy is always accompanied by such complications, how they manifest themselves and what their probability is. These and other questions are answered in the following sections. In addition, this section gives specific recommendations that will allow you to reduce the severity to a certain extent.
various side effects of chemotherapy.

If you read this section before starting chemotherapy, you may be unpleasantly surprised that it is associated with a number of complications caused by the side effects of anticancer drugs. However, it should be borne in mind that such complications do not occur in every patient. For most patients, chemotherapy has only minor complications, and for many, they do not occur at all. What kind of side effect may occur during your treatment and how severe it may be - all this largely depends on which anticancer drugs will be used in your case and what your body's response to treatment will be. Be sure to ask your doctor about which chemotherapy complications are most likely in your case, how long they can be, how dangerous they are, and what you can do personally to reduce the manifestations of such complications as much as possible.

Most side effects of chemotherapy can be successfully overcome

What is the reason for the unwanted side effects of anticancer drugs?

Tumor cells are characterized by rapid growth and relatively rapid division. Anticancer drugs not only block these processes, but also cause irreversible damage and death of such cells. However, many normal cells
also grow and divide rapidly. These include: cells of the bone marrow, mucous membranes of the oral cavity and gastrointestinal tract, reproductive system, hair follicles. Therefore, anticancer drugs cause damage to these normal cells, which is the cause of a number of complications associated with side effects of chemotherapy. Among the manifestations of such complications include: nausea and vomiting, ulceration of the oral mucosa, baldness, anemia, increased fatigue. The side effect of chemotherapy also explains the high likelihood of bleeding and infectious complications. In the course of treatment, such undesirable consequences as dysfunctions of the kidneys, bladder, nervous system and other organs may appear.

How long can the side effects of chemotherapy last?

The process of restoring the function of most normal cells that have been damaged during chemotherapy begins shortly after it is completed.
Since over time the function of such cells is almost completely restored, the side effects of the treatment gradually disappear. However, the duration of the recovery period of the body after chemotherapy may be different for different patients. It depends on a number of factors, including your state of health prior to starting chemotherapy, as well as which anticancer drugs you received.

Most of the side effects of chemotherapy disappear fairly quickly after it is completed.

Most of the side effects of chemotherapy do disappear soon after it is completed. However, some of them can exist for several months and even years. This is particularly the case when treatment with anticancer drugs has caused damage to the heart, lungs, kidneys, and reproductive organs.
organs. At the same time, some manifestations of the side effects of chemotherapy may not appear immediately, but after a long period of time after its completion.

It is important to note that in most patients, chemotherapy is accompanied by only short-term complications. In addition, it should be emphasized that modern medicine has made significant progress in the prevention and treatment of the majority of rather severe complications associated with undesirable side effects of anticancer drugs. This means that the effectiveness of chemotherapy on tumor cells has increased, while the danger associated with its undesirable effect on normal cells has decreased.

Each patient undergoing chemotherapy should remember that he is receiving effective treatment that can completely destroy tumor cells, and the complications that accompany such treatment are temporary and do not pose a threat to life.

Some patients express dissatisfaction with the fact that chemotherapy lasts too long and is accompanied by a number of complications. If you have such concerns, then consult your doctor. In some cases, the doctor may change the regimen for the use of previously prescribed chemotherapeutic agents or replace one anticancer drug with another. The doctor will tell you how to reduce the severity of side effects of the treatment.

Nausea and vomiting during chemotherapy

During chemotherapy, nausea and vomiting may occur. This may be due to unwanted side effects of anticancer drugs.
either on the mucous membrane of the stomach, or on certain structures of the brain. In different patients, the severity of such a reaction to chemotherapy is not the same and, to a large extent, depends on which antitumor drugs are used in this particular case. In many patients, nausea and vomiting do not occur at all. Others are complaining
on prolonged moderate nausea, and some note severe nausea that occurs over a short period of time both during chemotherapy and after it is completed. Nausea and sometimes vomiting may occur immediately after the administration of anticancer drugs or several hours later.

There are cases when nausea worries patients for several days. If you experience nausea or vomiting after the administration of anticancer drugs, be sure to consult your doctor.

In the arsenal of modern medicine, there are a number of drugs that can prevent nausea and vomiting during chemotherapy or reduce their severity and duration. Such drugs belong to the class of antiemetics. However, the effectiveness of these drugs is not the same in different patients, and in some cases it becomes necessary to simultaneously prescribe several of these drugs.
Therefore, only together with your doctor can you find the best way to overcome nausea and vomiting.

A number of drugs are known that prevent nausea and vomiting or reduce their severity and duration.

At each meal, try to eat a little, so that there is no feeling of fullness in the stomach. Eat small meals throughout the day rather than the usual three meals a day

Try to eat only soft foods

Eat slowly. Drink liquid in small sips

Avoid including sugary, fatty, spicy or overly salty foods in your diet

Food should be at room temperature, not hot

Chew food well to improve digestion

Practice good oral hygiene

If you are bothered by nausea in the morning, then even before you get out of bed, you should eat some cookies, toast or corn sticks. However, it is unnecessary to do this in the presence of damage to the oral mucosa and dry mouth.

If nausea is severe, drink cool, clarified, sugar-free fruit juice (such as apple or grape juice). If you want to drink a carbonated drink, you should wait for the gas bubbles to stop emitting

Sometimes you can suck on an ice cube or sour candy. The mouth should be rinsed with water with the addition of lemon juice. However, avoid anything acidic in case of damage to the oral mucosa.

Foreign odors that usually accompany the cooking process, cigarette smoke, and perfume should be avoided. Try not to prepare food yourself, and if this is not possible, then knowing what day the next administration of anticancer drugs is due, prepare it in advance.

After eating, do not go to bed immediately, but sit in a chair for at least two hours

Try to sleep during the period of the most severe nausea.

If you feel nauseous, breathe slowly, take a few deep breaths

Your clothes must be loose

Try to distract yourself from unpleasant sensations, chat with friends, listen to music, watch TV, read

Avoid food and liquids for 1-2 hours before and after the administration of anticancer drugs

If you experience nausea or vomiting, especially within 24-48 hours after the next injection of anticancer drugs, do not hesitate to contact your doctor and strive to follow their recommendations.

Baldness from chemotherapy

Baldness (alopecia) to do in order to try to minimize
unwanted side effects of chemotherapy. During the conversation with your doctor, you should get answers to the following questions:

Why do you need chemotherapy?

What are the benefits of chemotherapy?

What anticancer drugs will you be prescribed?

What is the likelihood of complications associated with the side effects of such drugs?

How will the drugs be administered?

Where will the treatment take place?

What is the duration of chemotherapy in your case?

What complications can arise during the treatment?

What manifestations of side effects of antitumor drugs should you immediately inform your doctor about?

Psychological support of the patient by the attending physician, relatives and friends is one of the most important components of successful treatment.

Alopecia is a fairly common side effect of chemotherapy. However, in many patients, baldness may not occur at all. Ask your doctor what is the likelihood of baldness in your particular case, since the intensity of hair loss is directly related to which anticancer drugs
will apply. In some cases, the density of the hairline may decrease, while in others, complete hair loss may occur. However, after the completion of chemotherapy, the hairline, as a rule, is completely restored. In many patients, its recovery can begin during chemotherapy. In some cases, newly grown hair takes on a different color and
texture.

Hair loss occurs not only on the head, but also on other parts of the body (on the face, arms, legs, under the arms, on the pubis).

Hair rarely begins to fall out immediately after the first cycle of chemotherapy. This usually happens after a few cycles. Hair can fall out both singly and in whole strands. The remaining hair becomes dull and dry.

When caring for hair during chemotherapy, it is useful to follow these recommendations:

Use shampoos for dry and damaged hair

Comb your hair with a soft brush

Only moderate heat is used to dry the hair

Do not use curlers and tongs to style your hair

Don't do a perm

Keep your hair short. A short haircut can hide the lack of density of the hairline and facilitate hair care

If there is little hair left, then you should protect them from exposure to direct sunlight with a hat.

Many patients who have undergone complete or partial baldness as a result of chemotherapy use wigs. Men prefer to wear a headdress or go bareheaded. In such cases, it is impossible to give general recommendations, since a lot depends on how comfortable you feel in the new “image” and how your relatives and
friends.

If you plan to use a wig, it's best to start getting used to it gradually, when the hair is just starting to fall out.

Baldness causes many patients severe experiences. Such patients especially need the sympathy of others, relatives and friends. The main thing is to console yourself with the thought that baldness is a temporary phenomenon.

Hair lost during chemotherapy is later restored

Anemia and associated general weakness and fatigue

Chemotherapy leads to dysfunction of the bone marrow, the main hematopoietic organ. This is manifested, in particular, in the fact that the number of red blood cells (erythrocytes) decreases. Red blood cells contain hemoglobin, which easily combines with oxygen and carries it from the lungs to various organs and tissues of the body. When, as a result of side effects of antitumor drugs, the number of red blood cells in the blood decreases significantly, this leads to a decrease in the level of hemoglobin in the blood, and, consequently, organs and tissues do not receive oxygen in an amount sufficient for their normal functioning. This is the essence of anemia caused by an unwanted side effect of chemotherapy.

Such anemia is accompanied by general weakness and increased fatigue. Its other manifestations are dizziness, increased heart rate and respiration, chills. Be sure to tell your doctor if you experience any of the above symptoms during chemotherapy.

If signs of anemia appear, the following recommendations may be helpful:

Try to get more sleep at night. Try to rest more during the day and, if possible, get some sleep during the day

Limit your daily activities. Do only what is absolutely necessary this moment

Feel free to ask for help with housework and childcare from your relatives and friends.

Your diet should be well balanced

To avoid dizziness, rise slowly from a sitting or lying position.

’ Chemotherapy is often accompanied by severe!
general weakness and increased fatigue

Infections during chemotherapy

As a result of the side effects of chemotherapy, the body's susceptibility to various infections increases. This is due to the fact that most anticancer drugs adversely affect bone marrow function. In particular, its ability to form white blood cells (leukocytes), with which the body fights against infections, is inhibited. Due to the fact that chemotherapy reduces the body's resistance to exposure to various infectious agents (causative agents of infection), the mouth, skin, lungs, urinary tract, intestines, and genitals can become the “entrance gates” of infection.

During the period of chemotherapy, the attending physician will periodically monitor the number of leukocytes in the blood, since maintaining their normal level is extremely important both for continuing treatment and for preventing the development of infectious complications. If the level of leukocytes in the blood drops, the doctor will prescribe appropriate
medicines. Until the level of leukocytes in the blood returns to normal, the dosage of anticancer drugs should be reduced, and in some cases it is necessary to delay the start of the next cycle of chemotherapy.

If it is found that the number of leukocytes in your blood is below normal, then for the prevention of infectious complications it is very important to follow these recommendations:

Be sure to wash your hands before eating and after using the toilet

When visiting the toilet, use soft toilet paper, and when washing, use mild soaps. If you suffer from concomitant hemorrhoids, then ask your doctor about additional measures that should be observed in care. Before using hemorrhoidal suppositories, also consult your doctor.

Avoid contact with people who have obvious signs of colds (cough, runny nose), as well as with measles, chickenpox and other infectious diseases that are transmitted by airborne droplets. Try not to visit crowded places (shops, markets, etc.)

Avoid contact with children who have recently been vaccinated for rubella, measles, mumps, polio

Be careful when trimming fingernails and toenails

To avoid accidental injury, be careful when using a knife, scissors, needle

Use an electric razor, not a straight or safety razor, to avoid cuts and
skin irritation

Use a soft toothbrush to prevent gum damage

Don't pop pimples

Take a bath or shower every day, remember that the water should be warm, not hot. Use a soft sponge, do not rub the skin with a washcloth

For dry skin, use special moisturizers and lotions.

If there is a cut or scratch, wash them with warm soapy water and use an antiseptic (for example, brilliant green)

Use protective gloves when doing housework, gardening, and pet care.

You should not be vaccinated for any reason without the permission of your doctor

Most infectious complications that occur during chemotherapy can be caused by bacteria that normally live on the skin, in the mouth, in the gastrointestinal tract, and in the genital area, although under normal conditions they are harmless to the body. If, as a result of a side effect of chemotherapy, the number of leukocytes in the blood is significantly reduced compared to the normal level, then the body loses its ability to resist infections, and infectious complications caused by such bacteria may occur during treatment. And sometimes this can happen even with careful personal hygiene.

Pay special attention to the fact that the eyes, nose, oral cavity, external genital organs, and the anus can become the “entrance gates” of the infection. Remember the signs of infectious complications and be prepared to recognize them in a timely manner. These signs include:

Temperature rise (above 38°C)

sweating

Severe cough, sore throat and pain when swallowing

Diarrhea (however, it should be noted that diarrhea can also be an independent manifestation of a side effect of chemotherapy)

Burning sensation when urinating

Unusual vaginal discharge and itching

Redness, itching, and induration around a wound, scratch, pimple, or IV site
injections. Tell your doctor right away if you have any of the above signs of infection. This is especially important if you're aware that your white blood cell count is well below normal levels. If you have a fever, do not take aspirin or other fever-lowering medications until you have talked to your doctor about it.

If you have signs of an infection (infectious complication), then be sure to tell your doctor about it, as it may be necessary
urgent prescription of antibiotics

Blood clotting disorders during chemotherapy

Side effects of anticancer drugs can cause another violation of the function of the bone marrow, namely, to reduce its ability to form platelets (platelets) and to constantly renew their number in the blood.
The latter is especially important, since the duration of the existence of these cells is relatively short. Platelets play an important role in the process of blood clotting and in stopping bleeding that occurs when the wall of a blood vessel is damaged. This applies to both large and small blood vessels, which can be damaged even in
the result of the most insignificant injury, and, often, accidental. When the wall of a blood vessel is damaged, platelets are easily destroyed. At the same time, biologically active substances are released, which trigger a series of successive reactions,
leading, ultimately, to the formation of a dense blood clot that covers the damaged area of ​​the vascular wall. Such a clot contributes to the rapid cessation of bleeding.

If, during chemotherapy, the number of platelets in the blood is significantly reduced compared to the normal level, then bleeding that occurs after the slightest injury can continue for quite a long time. As a result, on the body for no apparent reason,
bruising or small subcutaneous hemorrhages occur. It is not uncommon for nosebleeds or bleeding gums to occur. Sometimes an admixture of blood may appear in the urine or feces. In this case, the urine becomes reddish, and the feces become tarry. Tell your doctor immediately if you experience any of the above signs of bleeding. During chemotherapy, your doctor will periodically check the number of platelets in the blood,
and if it drops to a critical level, he may prescribe a blood or platelet transfusion.

Do not take any medication without first talking to your doctor. This also applies to aspirin and other antipyretics, as well as to those medicines that can be purchased without a prescription, since even such seemingly harmless
drugs can adversely affect platelet function

Do not drink alcoholic beverages

When caring for the nasal cavity, use soft tissue handkerchiefs

Take special care when using a knife, scissors, needle and other piercing and cutting objects.

Be careful when ironing and cooking to avoid burns. Wear heat protection gloves when using the oven.

Do not do physical exercises that can cause injury.

Violation of the integrity of the mucous membrane of the gums of the oral cavity and pharynx during chemotherapy

During chemotherapy, it is very important to carefully observe oral hygiene. Side effects of anticancer drugs can cause dry mouth, irritation and ulceration of the oral mucosa and pharynx. As a result of violation of the integrity of the mucous membrane and its damage, bleeding can easily occur, including bleeding gums. In addition to being quite painful, mucosal ulcerations can become a gateway for infection by bacteria that normally live in the oral cavity. Under normal conditions, these bacteria are harmless, but when the body's resistance decreases, they can become a source of infection. Since the likelihood of infectious complications during chemotherapy is quite high, and it is very difficult to deal with them, it is very important to do everything possible to eliminate any potential sources of infection.

Visit the dentist before starting chemotherapy to treat carious teeth, inflammation, and gum disease. Should be carried out a complete sanitation of the oral cavity. Ask your dentist how best to care for your teeth during chemotherapy, what type of toothpaste and toothbrush is best to use during treatment. Since chemotherapy can accelerate the development of caries, you should use a daily fluoride paste or gel, as well as use a special mouthwash.

Brush your teeth after every meal. Use only a soft toothbrush. When brushing your teeth, brush movements should be as gentle as possible so as not to cause damage to the gums and oral mucosa. If your gums are sensitive, ask your dentist to help you choose a special toothbrush and toothpaste.

Rinse your toothbrush thoroughly after each use.

Do not rinse your mouth with liquids containing alcohol or salt.

Avoid getting into the oral cavity substances that can cause irritation of the mucous membrane. Do not smoke.

If sores (ulcerations) appear on the oral mucosa during chemotherapy, be sure to inform your doctor about this, as
This complication of chemotherapy requires additional treatment. If such sores are painful and cause discomfort while eating, then use the following recommendations:

Ask your doctor how you can treat the places of such damage to the mucous membrane. Ask your doctor to prescribe pain medication for you.

Eat food only at room temperature, as hot food can cause additional irritation of damaged areas of the oral mucosa and pharynx.

Try to eat predominantly soft foods that do not cause irritation of the mucous membrane of dairy products, baby food, mashed potatoes, soft-boiled eggs, pasta, puddings, soft fruits (for example, bananas), pureed apples, etc.

Avoid eating any food that can irritate the mucous membrane (spicy, salty, sour, as well as dry and rough). You should not eat tomatoes, citrus fruits and drink orange, lemon or grapefruit juice.

If dry mouth makes swallowing difficult, the following suggestions may be helpful:

Use special means for irrigating the oral cavity, after consulting with your doctor.

Drink more fluids. In some cases, chewing sugar-free gum or sucking on hard candies can help overcome dry mouth.

Add animal or vegetable oil to main dishes or use mild sauce.

Drink dry crunchy foods with liquid.

Eat soft, crushed, pureed foods.

For dry lips, use an emollient lip balm.

Diarrhea with chemotherapy

As a result of side effects of anticancer drugs, damage to the cells of the intestinal mucosa occurs. This can cause diarrhea (diarrhea). If the duration of diarrhea is more than 24 hours or the bowel movements are painful or
painful spasms, then inform your doctor. In severe cases, a doctor may prescribe medication to help stop the diarrhea. However, you should not take these drugs without a doctor's prescription.

In addition, the following tips are helpful:

Eat less food at one time, it is better to eat more often, but little by little.

Avoid including fiber-rich foods in your diet, as this can cause intestinal cramps and diarrhea. These foods include: Wholemeal bread, fresh vegetables and
fruits, dried fruits, legumes (peas, beans), nuts. Instead, eat foods with
low fiber content (white bread, noodles, peeled rice, cottage cheese, yogurt, eggs,
hard-boiled, mashed potatoes, peeled vegetables, peeled baked apples, ripe bananas).

Avoid drinking coffee, tea and alcoholic beverages, eat sweets. Avoid fried, fatty, and spicy foods, as these can cause intestinal irritation, cramps, and diarrhea.

You should not drink milk, as this can lead to increased diarrhea.

Eat more foods high in potassium in pizza (potatoes, bananas, oranges, peach and apricot juices), as diarrhea removes a large amount of potassium from the body.

Drink plenty of fluids to compensate for fluid loss due to diarrhea. It is best to drink clarified apple juice, weakly brewed tea, non-concentrated broth, boiled water. Any liquid should be at room temperature and should be drunk slowly, in small sips. Try not to consume highly carbonated
drinks.

Be sure to tell your doctor if you have severe diarrhea. Ask him if you should switch to drinking only clarified liquids. Since such liquids do not contain the entire complex of substances necessary for the body, they should be used as a strict diet for no more than 3-5 days. If diarrhea stops and the general condition improves, you can gradually include foods containing
a small amount of fiber

With severe diarrhea that persists despite a strict diet, intravenous infusions of medicinal solutions may be necessary to replace lost body fluids and some minerals.

Carefully observe the hygiene of the anus (install a hygienic shower or watering can in the toilet at home, use wet toilet paper).

Constipation during chemotherapy

Some patients may develop constipation during chemotherapy. The causes of constipation may be a side effect of treatment, a decrease in physical activity, or a decrease in the amount of food compared to the usual diet. If there was no stool for more than 1-2 days, then report
about this to your doctor, as it may be necessary to prescribe laxatives or enemas.

However, without consulting your doctor, you should not take any medication on your own. It is especially important to observe this rule if the number of leukocytes in the blood is significantly below the normal level.

If you have constipation, you can use the following recommendations:

Drink plenty of fluids to keep your bowels normal. It is best to drink warm or slightly warm drinks.

Eat more foods high in fiber (wholemeal bread, fresh vegetables and fruits, dried fruits, nuts).

Try to get outdoors more. Do light exercise regularly. However, before increasing physical activity and physical activity, consult your doctor.

Violation of the functions of the nervous and muscular systems during chemotherapy

Some antitumor drugs that stop the growth of tumor cells (ie, have a cytotoxic effect) also have undesirable side effects on the cells and fibers of the nervous system. This may lead to the development
peripheral neuropathies - toxic damage to individual or several peripheral nerves. As a result, there may be sensations of numbness in the fingers.
hands, burning and weakness in the arms and/or legs. In addition, there may be violations of coordination of movements, which is manifested by awkwardness and clumsiness of movements, difficulties in fastening buttons and in manipulating small objects. In some cases
imbalance may occur when walking. Sometimes hearing loss is reduced. Some anticancer drugs can have unwanted side effects on the muscular system as well. The result is pain
in a number of muscles, weakness in them and fatigue.

This side effect of chemotherapy can cause some discomfort in Everyday life, it does not pose any danger. However, in some cases, neuromuscular disorders are more serious and may require medical intervention. Therefore, any of the above signs of such disorders should be reported to the attending physician immediately.

In overcoming problems associated with dysfunction of the nervous and muscular systems, the following recommendations may be useful. For example, if there is numbness of the fingers, then take extra care when using hot, sharp, piercing and other dangerous objects. When muscle weakness and body imbalance occur, be careful when walking to avoid accidental falls. When climbing or descending stairs, be sure to hold on to the railing. Take special care when leaving the bathroom or shower room. Do not wear shoes with slippery soles.

Side effects of chemotherapy on the skin and nails

During chemotherapy, redness, dryness, peeling of the skin, as well as acne may appear. Nails can darken, become brittle and brittle. In addition, longitudinal stripes may appear on them,

You can overcome some of these undesirable effects of treatment yourself. When acne appears on the face, you should wash yourself especially carefully, using special grades of soap. When drying the face, it should not be wiped, but blotted, after which
use moisturizers. When skin itching occurs, baby powder can be used. To prevent dry skin, take warm showers or warm, but not hot, baths. Use moisturizing creams for hands and body, do not use cologne, perfumes and aftershaves that contain alcohol. Take good care of your nails.
Wear rubber gloves when washing dishes and protective gloves when doing chores. If redness or soreness appears around the nail plates, be sure to inform your doctor about this.

With intravenous administration of a number of anticancer drugs, skin color (pigmentation) may change along one or more veins. However, this pigmentation usually disappears gradually over several months after treatment is completed. Undesirable effects of anticancer drugs on the skin may be aggravated by exposure to direct sunlight. Talk to your doctor about which protective creams are best for short-term sun exposure. Long-sleeved cotton clothing and a wide-brimmed hat will provide you with reliable protection from the sun.

Some cancer patients who received radiation therapy prior to chemotherapy report that radiation-related skin changes reappear after starting treatment with anticancer drugs. Immediately after the introduction of such drugs, the skin in the area of ​​the previous irradiation turns red again, burning and itching appear. The duration of such a reaction can reach several hours or days. Relief can come from the application of cold, wet compresses to the areas of skin indicated above.
manifestations. However, in any case, the development of a skin reaction to treatment must be reported to the attending physician.
doctor. Most skin complications associated with side effects of chemotherapy are harmless. However, some of them deserve special attention. For example, when chemotherapeutic agents are administered intravenously, the drug may accidentally enter the tissues surrounding the blood vessel and cause damage to them. If you
If you feel pain or burning at the injection site, tell your nurse or doctor immediately.

It is also necessary to tell the doctor immediately that immediately after the administration of anticancer drugs you have developed rashes on your skin (such as urticaria) or you have felt difficulty in breathing. These signs may
indicate the development of an allergic reaction and require urgent medical intervention.

Side effects of chemotherapy on kidney and bladder function

Some cancer medicines can irritate the bladder and cause temporary or long-term kidney damage. You should ask your doctor if the prescribed medications have exactly this side effect. If such a treatment-related action is very likely, inform your doctor in a timely manner of the following symptoms:

Pain or burning when urinating

Increased urination

Feeling the need to urinate immediately when the urge to urinate occurs

Redness of the urine or blood in the urine

Fever

If there is a high chance of side effects of chemotherapy on the bladder and kidneys, it is helpful to drink more fluids, including fruit juices. You can include jelly and ice cream in the diet. Increasing the amount of fluid will also increase the volume of urine, which may prevent or reduce the irritant effect of chemotherapy drugs on the bladder or kidneys. However, only a doctor can decide to what extent you can exceed your usual
the amount of liquid used.

In addition, you should be aware that some anticancer drugs can change the color of your urine. For example, urine may turn orange or red. Sometimes you may experience an increased smell of urine. If you experience these symptoms, ask your doctor if they may be caused by the medications you are taking.

Flu-like symptoms with chemotherapy

Several hours or days after the administration of anticancer drugs, many patients may develop flu-like symptoms. These include muscle pain, headache, fatigue, fever, chills, nausea, poor appetite. Such manifestations can exist for 1-3 days. They can be
due to concomitant infection or the tumor process itself. Therefore, if flu-like symptoms appear, it is extremely important to inform your doctor about it.

Fluid retention in the body during chemotherapy

During chemotherapy, an excessive amount of fluid may be retained in the body. Such a delay may be due to several reasons: hormonal changes that occur in the body during treatment, disorders of water
salt balance, arising both as a result of the side effects of anticancer drugs, and under the influence of the tumor itself. If you notice swelling of the face, the appearance of edema on the arms and legs, then inform your doctor who will either
may recommend limiting fluid and salt intake, or prescribing diuretics. However, these drugs should not be taken on their own, without a doctor's prescription.

How does chemotherapy affect the sexual sphere?

Chemotherapy can have a negative effect on the genital organs and their function in both men and women, but this does not always happen. At the same time, the severity of such side effects of chemotherapy depends on the age of the patient, his general condition and on
what kind of anticancer drugs are used in this particular case.

Side effects of chemotherapy on the function of the genital organs in men

As a result of chemotherapy, the number of germ cells (spermatozoa) may decrease and their mobility may decrease. These changes can cause temporary or long-term infertility. Although chemotherapy is the cause of male infertility, it does not significantly affect sexual life.

The possibility of infertility should be discussed with your doctor before starting chemotherapy. Men undergoing chemotherapy should use effective contraceptives, as some anticancer drugs are known to
cause genetic disorders in germ cells. Discuss with your doctor when
completion of treatment, you can stop using contraceptives.

Side effects of chemotherapy on the function of the genital organs in women

Anticancer drugs can cause ovarian dysfunction and lead to hormonal changes. As a result, many women experience menstrual irregularities, and in some cases, menstruation stops altogether.

The hormonal effects of chemotherapy can cause a number of menopause-like symptoms: hot flashes, burning sensation, itching, and dryness in the genital area. Local manifestations can be alleviated with the help of special water-soluble vaginal lubricants (vaginal lubricants). Violations in the genital area increase the risk of their infection. To prevent such complications, oil-based vaginal lubrication should not be used. It is recommended to wear only cotton underwear as
it is not an obstacle to the free circulation of air. Do not wear tight underwear or trousers. In addition, to reduce the risk of developing infectious complications, the doctor may recommend special vaginal creams or suppositories.

Ovarian dysfunction caused by a side effect of chemotherapy can lead to temporary and sometimes long-term infertility. The duration of infertility depends on a number of factors, including the type of drugs used, their dosage, and the age of the woman.

During chemotherapy, pregnancy is undesirable, since many anticancer drugs can cause birth defects in the fetus. Therefore, women of childbearing age during chemotherapy should
use effective contraceptives.

If pregnancy has occurred even before the diagnosis of the tumor, then in some cases the start of treatment is postponed until childbirth. If there is a need to conduct chemotherapy during pregnancy, then treatment is usually started after the 12th week of pregnancy, that is, at a time when the risk of congenital malformations in the fetus decreases. AT
In a number of cases, there is a need for artificial termination of pregnancy.

Throughout the course of treatment with anticancer drugs, cancer patients should use effective contraceptives.

Avoid pregnancy not only during chemotherapy, but also for several months after it is completed

Effects of chemotherapy on sex drive and sex life

In many patients, changes in this area are insignificant or absent. Some patients
note a decrease in sexual desire due to a number of psychological, emotional and physical factors that accompany chemotherapy. Therefore, it is so important to maintain mutual understanding between spouses (sexual partners) on this delicate issue.

Chemotherapy has only a short-term effect on sexual desire and the habitual nature of sexual activity.

Cancer is characterized by the appearance of a malignant tumor in one of the organs of the human body. Treatment of this disease includes not only surgery, but also the use of chemotherapeutic procedures. Side effects after chemotherapy occur in most cases and it is important to respond to certain manifestations in a timely manner and take appropriate measures.

Consequences of a patient undergoing chemotherapy

Doctors note that most side effects after undergoing chemotherapy pass within a few minutes. However, the most dangerous side effects of chemotherapy can persist for a long period of time and significantly spoil a person's normal life.

Mild or relatively benign is hair loss in the patient. This is due to the fact that the drugs have a negative effect on the hair follicle and weaken it. In addition, potent drugs can adversely affect the tissues of the upper and lower extremities.

Doctors also note that mild side effects of chemotherapy are divided into certain subgroups depending on the organ in which they are localized:

1. Complications in the digestive system lead to the following unpleasant symptoms:

• to the development of such diseases as stomatitis, esophagitis, gastritis and enterocolitis;
• to the appearance of dysbiosis with the presence of fungal cells;
• to the presence of such unpleasant symptoms in the patient as nausea, vomiting, fever, the development of signs of general intoxication of the body, the appearance of weakness and edema in the lower extremities.
• to the development of anorexia and diseases in the liver.

1. Complications in the circulatory system lead to:

• to the development of diseases such as anemia, leukopenia and neutropenia or febrile fever.

1. Complications in the immune system:

• the occurrence of frequent infectious diseases in the patient in the respiratory system;
• the presence of recurrent herpes;
• development of a fungal infection.

1. Complications in the liver area lead to the appearance of such signs as:

• frequent urination;
• an increase in protein, the level of leukocytes and erythrocytes in the urine.

1. Complications in the reproductive system lead to the following symptoms:

• disorders of the ovaries and changes in the menstrual cycle;
• to the appearance of problems with the formation of seminal fluid.

1. Complications in the nerve fibers lead to the following symptoms:

• the development of polyneuropathy and disturbances in consciousness;
• violations of the activity of the cardiac system and respiratory organs.

1. The consequences of chemotherapy also lead to a violation of the skin.

Often, therapy leads to the appearance of dermatitis in the patient and an exacerbation of an allergic reaction, which is expressed in the occurrence of itching, burning and redness on the skin. In addition, the patient may develop acne, a feeling of numbness in the lower extremities, and a sharp drop in blood pressure.

Doctors note that even young women can develop early menopause, thrush and cystitis. Also, the patient may be disturbed by depression and sleep disturbances, an increase in the size of the lymph nodes and the appearance of frequent bleeding.

Serious side effects after chemotherapy include:

• development of osteoporosis and leukemia;
• increased flow of tear fluid from the eyes;
• development of problems in the cardiac system and rapid hair loss.

It is important to note that complications after chemotherapy can appear in different forms and this depends on the strength of the action, the composition and form of the disease, as well as on the general condition of the patient.

Also, doctors all the side effects that occur after chemotherapy are divided into several stages depending on the severity of the disease:

• Stage 0: it is characterized by the absence of external and internal disorders in the patient. Also, violations cannot be detected during diagnostic studies. This stage is very rare.
• Stage I: with it, the patient has minimal health problems that do not have an overall negative impact on the patient's health. It is noteworthy that these changes usually do not require the patient to undergo therapeutic procedures.
• Stage II: it is characterized by moderate disturbances in the patient's state of health and the level of his activity. Also, violations are manifested in the work of internal organs. When conducting a diagnostic study, all violations become more noticeable. In this case, the doctor prescribes a number of corrective procedures to stabilize the patient's health.
• Stage III: with it, the patient has serious disorders in the state of health and in the work of internal organs. In this case, somatic treatment should be carried out by a doctor. With the development of this stage, the patient should cancel or postpone chemotherapy sessions.
• Stage IV: it is characterized by the appearance of serious disorders in the patient, which can pose a serious threat to the patient's health. In this case, the doctor must cancel chemotherapy completely.

Despite the fact that therapy causes a huge number of complications in the patient, it is considered by doctors to be the most effective way to get rid of a cancerous tumor. Often patients ask a specialist a question about the likelihood of side effects, but, unfortunately, the doctor cannot give an exact answer to this question.

This is due to the fact that he cannot predict the response of the human body to the introduction of potent drugs into it. Currently, all drugs are designed in such a way that the risk of side effects and complications in a patient after undergoing chemotherapy is reduced to the minimum.

What is chemotherapy

Usually this method is used when the disease has passed into an advanced stage, and there are metastases spreading in the lymphatic and circulatory system.

Chemotherapy is based on the introduction into the patient's body of potent drugs that have a negative effect on the cancerous tumor and on metastases localized in neighboring organs. The introduction is carried out intravenously.

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