Side effects can occur with any type of treatment for melanoma, but not everyone has them or experiences them in the same way. Side effects of regional chemotherapy will depend mainly on:
Chemotherapy kills cancer cells, but it can also damage healthy cells. Different cells and tissues in the body tolerate chemotherapy differently. Regional chemotherapy is applied to a specific area of the body, such as a limb or extremity. The drugs do not circulate through the rest of the body in high enough amounts to cause systemic side effects. Side effects are generally related to the treatment area.
Side effects can happen any time during, immediately after, or a few days or weeks after chemotherapy. Most side effects go away after chemotherapy is over. Late side effects can occur months or years after chemotherapy. Some side effects may last a long time or be permanent. It is important to report side effects to the healthcare team.
Pain in the limb and stiffness of the muscles and joints are common after limb perfusion or infusion. The healthcare team may prescribe pain medications if needed. Check with the doctor if pain does not go away or pain medications do not relieve the pain. Higher doses or a different type of pain-relieving medicine may be necessary.
Redness and swelling may occur in the treated limb, often a few days after treatment. Swelling will gradually go away over a few months. The redness of the skin will gradually fade to brown. The limb may be quite dark brown at first but will become lighter and is usually back to normal after about 6 months. It is possible for a permanent change in skin colour to occur.
Blisters or peeling of the skin may occur on the sole of the foot or palm of the hand, depending on the limb affected. This usually occurs in the first few weeks after treatment and gradually heals. Changes to the nails, such as lines or a nail coming off, may occur a few weeks after treatment.
Hair loss (alopecia) will occur on the treated limb. Hair will usually grow back again.
Symptoms of nerve damage, or peripheral neuropathy, include numbness or tingling in the toes or fingers. Nerve damage may occur due to the high dose of chemotherapy drug given to the limb. Most people experience temporary nervous system problems. In a few people, nervous system damage can become a long-term problem. Nervous system damage can develop months or years after treatment and may take months to go away.
Lymphedema, or swelling of the limb, is a possible long-term effect that can occur due to damage from the chemotherapy drugs.
Note: Other side effects may occur. For more detailed information on specific drugs, go to sources of drug information.
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.