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Potential side effects of systemic chemotherapy for melanoma
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 chemotherapy will depend mainly on:
- the type of drug(s)
- the dose
- how the drug is given
- the person’s overall health
Chemotherapy kills cancer cells, but it can also damage healthy cells. Different cells and tissues in the body tolerate chemotherapy differently.
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. Doctors may also grade (measure) how severe certain side effects are. Sometimes chemotherapy treatments need to be adjusted if side effects are severe.
The following are the most common side effects that people tend to experience with chemotherapy for melanoma. Some people may experience all, some or none of these side effects. Others may experience different side effects.
Bone marrow suppression is a condition in which one or more of the main types of blood cells are decreased.
- A low white blood cell count (neutropenia) increases the risk of infection.
- A low platelet count (thrombocytopenia) increases the risk of bruising and bleeding.
- A low red blood cell count (anemia) causes fatigue, paleness and malaisemalaiseA general feeling of discomfort or illness..
Low blood cell counts occur because of chemotherapy’s effect on the bone marrow, where blood cells are made. Blood cell counts often reach their lowest level about 7–14 days after chemotherapy. Bone marrow suppression is a serious side effect of chemotherapy. When it happens, the dose of chemotherapy is adjusted right away or chemotherapy may have to be stopped temporarily. A stem cell transplant may be used to replace bone marrow severely damaged by high-dose chemotherapy or radiation.
Fatigue makes a person feel more tired than usual and can interfere with daily activities and sleep. It occurs for a variety of reasons. Fatigue may be caused by anemia, specific drugs, poor appetite or depression. It may also be related to toxic substances that are produced when cancer cells break down and die. Fatigue can occur days after a chemotherapy treatment cycle and can continue long after the person has finished their cancer treatment. It will get better as time goes by.
Nausea and vomiting
Not all chemotherapy drugs cause nausea and vomiting. Individual drugs vary in their effects, but nausea and vomiting are more likely when combinations of chemotherapy drugs are given.
Nausea and vomiting can occur within the first few hours after chemotherapy drugs are given and usually last about 24 hours. However, delayed nausea and vomiting may continue for a few days after treatment. Some people may have anticipatory nausea after having a few treatments, where they feel nauseated even before treatment is given because they expect to be sick.
A sore mouth (also called stomatitis or oral mucositis) occurs because of chemotherapy’s effect on cells inside the mouth. Many drugs can cause a sore mouth. It occurs more often when higher doses of drugs are used. A sore mouth occurs about a week (anywhere from 5–14 days) after chemotherapy is started. It often improves on its own a few weeks after treatment is finished.
Painful mouth sores, ulcers in the mouth and mouth infections can also develop. Thorough, regular mouth care can help prevent a sore mouth and reduce infection. The healthcare team will give instructions about how often to clean and rinse the mouth and what to use. Pain medicines or special oral solutions may be needed to relieve pain.
Diarrhea is an increase in the number and looseness of stools. It occurs because chemotherapy drugs often affect the cells that line the gastrointestinalgastrointestinalReferring to or having to do with the digestive organs, particularly the stomach, small intestine and large intestine. tract. Many factors increase the risk of diarrhea, including the type and dose of chemotherapy drug used. Diarrhea is often worse when combinations of drugs are given. Diarrhea occurs soon after chemotherapy starts and can continue up to 2 weeks after treatment has ended. People who have radiation at the same time as chemotherapy are at an increased risk of experiencing diarrhea.
Hair loss (alopecia) is a common side effect of many, but not all, chemotherapy drugs. Hair follicles are sensitive to chemotherapy drugs because they grow fast. The extent and duration of hair loss is unpredictable. It depends on the type and dose of drugs used, as well as personal factors. Hair loss can occur on all parts of the body, including the face and scalp. Hair loss can begin within a few days or 2–3 weeks after chemotherapy starts. Hair usually grows back once chemotherapy treatments are over.
Hair should not be permed, straightened, dyed or coloured during treatment. These products contain chemicals that can damage hair. It is best to wait until new hair growth becomes established and hair returns to its original state. This may take 6 months or more after treatment. Talk to the healthcare team about when you can use these products again.
Loss of appetite
Nausea and vomiting, fatigue or a buildup of waste products as cancer cells break down and die can cause loss of appetite. Some chemotherapy drugs can cause temporary changes in taste and smell, which can make foods seem less appetizing. Some people lose interest in food completely and don’t eat even though they know they need to. This can lead to weight loss and malnutrition. Maintaining good nutrition during and after chemotherapy is important to help a person recover from their treatment.
Some chemotherapy drugs used to treat skin cancer can affect the function of the sexual organs. Some men may stop producing sperm and some women may have premature menopause (treatment-induced menopause). These side effects can result in fertility problems (infertility). Whether or not a person will have fertility problems depends on the type and dose of chemotherapy drugs given to treat skin cancer.
Infertility is sometimes permanent. People concerned about having children in the future should discuss the effects chemotherapy treatment may have on their fertility with their doctor. It is important to discuss fertility options before treatment begins.
Note: Other side effects may occur. For more detailed information on specific drugs, go to sources of drug information.
Establishing a national caregivers strategy
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.