Soft tissue sarcoma

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Side effects of chemotherapy for soft tissue sarcoma

Side effects can happen with any type of treatment for soft tissue sarcoma, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it damages healthy cells as it kills cancer cells. Side effects can develop any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on:

  • the type of drug(s)
  • the dose
  • how the drug is given
  • your overall health

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

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. They feel nauseated even before treatment is given because they expect to be sick.

Find out more about nausea and vomiting.

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Loss of appetite

Nausea and vomiting, fatigue or a buildup of waste products as cancer cells 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 poor nutrition. Maintaining good nutrition during and after chemotherapy is important to help you recover from treatment.

Find out more about loss of appetite and taste changes.

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Sore mouth

A sore mouth is also called stomatitis or oral mucositis. It occurs because chemotherapy affects cells inside the mouth. Many drugs can cause a sore mouth, and it occurs more often when higher doses of drugs are used. A sore mouth occurs about a week (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.

Find out more about sore mouth and mouth care during cancer treatment.

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Diarrhea is an increase in the number and looseness of stools. It occurs because chemotherapy drugs often affect the cells that line the intestine. 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 for up to 2 weeks after treatment is finished.

Find out more about diarrhea.

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Pain at the injection site

Many chemotherapy drugs are given by an injection, often through a needle placed in a vein (intravenously). After the initial needle stick to insert the intravenous (IV) needle or catheter, there is usually no discomfort or pain when IV chemotherapy drugs are given.

Sometimes chemotherapy drugs can escape from the vein and leak into the surrounding tissues. This is called extravasation. Some drugs can be very irritating if they get into the tissues around the vein. These drugs are called vesicants. They can cause redness, swelling, pain, burning or stinging at the injection site. In some cases, vesicants can cause severe damage to the skin and surrounding soft tissue. If this happens, your doctor may order medicines to help reduce the pain and lower the chance of infection. If the skin is damaged, the healthcare team may apply dressings to keep the area protected and clean. Sometimes skin grafts may be needed to cover the damaged area and help it heal.

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Fatigue causes you to 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 cycle and may get better as time goes by. Fatigue can continue long after you have finished cancer treatment.

Find out more about fatigue.

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Skin and nail changes

Some chemotherapy drugs can cause minor skin changes or skin irritation. Skin changes can occur during and for some time after chemotherapy. These changes include redness, itching, dryness or rash. Your skin may be more sensitive or easily irritated by the sun during chemotherapy treatment. Your fingernails or toenails can become darker and thicker.

Your healthcare team can recommend creams or lotions that can help relieve some skin changes. Protect the skin by staying out of the sun. When you go outside, use sunscreen and wear a hat, long-sleeved shirt and pants.

Find out more about skin problems.

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Hair loss

Hair loss, or alopecia, is a common side effect of many, but not all, chemotherapy drugs. Hair follicles are sensitive to chemotherapy drugs because they grow fast. It is impossible to predict how much hair you might lose and how long will take to grow back. 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. It can begin a few days or 2–3 weeks after chemotherapy is started. Hair usually grows back once chemotherapy treatments are over.

It is often recommended that hair not be permed, straightened or coloured during treatment. It is best 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 your healthcare team about when it is okay to use these products again.

Find out more about hair loss.

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Bone marrow suppression

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 is called neutropenia. It increases the risk of infection.
  • A low platelet count is called thrombocytopenia. It increases the risk of bruising and bleeding.
  • A low red blood cell count is called anemia. It causes fatigue, paleness and malaise.

Low blood cell counts occur because chemotherapy affects blood cells made in the bone marrow. Blood cell counts often reach their lowest level about 7–14 days after chemotherapy.

Bone marrow suppression is the most common and most serious side effect of chemotherapy. When it happens, the dose of chemotherapy is adjusted right away or chemotherapy may have to be delayed to allow the blood cell counts to recover.

Find out more about bone marrow suppression.

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Organ damage

Certain chemotherapy drugs can affect different organs. The healthcare team takes steps to limit the damage to healthy cells, but occasionally organ damage can occur. Whether or not organ damage occurs depends on many factors. Some chemotherapy drugs used to treat soft tissue sarcoma can lead to:

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Flu-like symptoms

Certain chemotherapy drugs may cause flu-like symptoms. These symptoms could include fever, chills and muscle or joint aches or pain. These symptoms will usually go away after chemotherapy is finished.

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Fertility problems

Infertility is the inability to conceive a child. Chemotherapy drugs kill rapidly dividing cells throughout the body. Not only do cancer cells divide rapidly, but so do sperm cells in men and the cells surrounding the eggs (ova) in women. Some chemotherapy drugs or combinations of drugs can damage the ovaries or testicles and result in infertility. The type of drug, the dose and whether one drug or a combination of drugs is used will influence whether or not chemotherapy will affect fertility.

Many types of chemotherapy drugs can lower sperm production and affect sperm counts in men. Most chemotherapy drugs can affect a woman’s menstrual cycle and cause her to stop ovulating (ovarian failure). Women under the age of 35 years may regain ovarian function, but women older than 35 are less likely to regain ovarian function. This results in infertility.

Find out more about fertility problems.

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Note: Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.


Dr Steven Jones Using cancer genetics to guide personalized treatment

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