Nasal cavity and paranasal sinus cancer

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Side effects of targeted therapy for nasal cavity and paranasal sinus cancer

Side effects can happen with any type of treatment for nasal cavity and paranasal sinus cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy and radiation therapy can cause side effects because they damage healthy cells as they kill cancer cells. Because targeted therapy doesn’t usually damage healthy cells, it tends to cause fewer and less severe side effects than these treatments. If side effects develop, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. 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 targeted therapy will depend mainly on:

  • the type of drug or drug combination given
  • the dose
  • how the drug is given, such as by intravenous or by mouth
  • your overall health

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

Skin problems

Cetuximab (Erbitux) commonly causes skin problems during therapy and for some time afterward. The skin can become red, itchy, dry and may start to peel. You may also develop a rash or acne. The area around the injection site may become swollen or red. A rash around the injection site may appear shortly after the injection.

Nail changes may also happen with targeted therapy. Skin around the nails can become swollen and red with cracks or open sores. This can cause pain.

Your healthcare team may suggest lotions, creams or other medicines that can help relieve skin problems. It is important to protect your skin from the sun during targeted therapy because sun exposure can make skin problems worse.

Find out more about skin problems.

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Flu-like symptoms

Flu-like symptoms are common side effects of many targeted therapies. They include:

  • fever
  • chills
  • headache
  • muscle and joint pain
  • nausea and vomiting
  • loss of appetite

These symptoms most often happen after the first treatment and usually occur immediately after treatment is given. They usually lessen and go away once the body gets used to the drug.

Taking medicines like acetaminophen (Tylenol) can help reduce some of these symptoms. Check with your doctor or healthcare team if these symptoms do not go away or are bothersome.

Learn more about nausea and vomiting and loss of appetite.

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Fatigue

Fatigue makes a person feel more tired than usual and can interfere with daily activities and sleep. Fatigue is a common, temporary problem that can occur with many targeted therapy drugs. It is often related to the dose of the drug given and usually goes along with flu-like symptoms. Cetuximab (Erbitux) can also lower levels of magnesium in the blood, which causes fatigue.

Tell your healthcare team if you are bothered by fatigue.

Find out more about fatigue.

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Intestinal problems

Cetuximab (Erbitux) can cause intestinal problems, including diarrhea and constipation. These problems usually go away after treatment is finished. The healthcare team can suggest ways to help manage these problems and may prescribe medicines for diarrhea or constipation.

Bowel perforation (a hole or tear in the small or large intestine) is a rare but serious side effect of cetuximab. If a person has a bowel perforation while taking targeted therapy, surgery is usually needed to fix the perforation.

Find out more about diarrhea and constipation.

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Sore mouth and throat

Cetuximab can cause a sore mouth (also called stomatitis or oral mucositis). It occurs more often when higher doses of drugs are used. A sore mouth can develop within 2 weeks of starting the therapy. It quickly improves on its own after treatment is finished.

Painful sores, ulcers or infection can develop in the mouth, throat or gums. 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 throat and mouth care.

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Low blood cell counts

Bone marrow suppression is a condition in which one or more of the main types of blood cells are lower than normal.

  • A low white blood cell count (neutropenia or leukopenia) 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 malaise (feeling ill).

Targeted therapy may affect the bone marrow’s ability to make blood cells, especially white blood cells and platelets. Drugs like cetuximab (Erbitux) can cause bleeding, such as coughing up blood or blood in the stool. Bleeding can cause wounds to heal more slowly. It can also increase the risk of other problems such as wound infection.

Your healthcare team will regularly check your blood to make sure blood cell counts stay within a normal range. Targeted therapy may have to be stopped for a while if the levels go too low, to allow the number of cells to return to normal.

Find out more about bone marrow suppression.

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Blood clots

Blood clots are a rare but serious side effect of targeted therapy. A blood clot in the leg is called a deep vein thrombosis (DVT). In the most serious cases, a blood clot can break off and travel to the lungs (called a pulmonary embolus, or PE). PE can cause shortness of breath and low oxygen levels in the blood.

Low doses of medicines that thin the blood (called anticoagulants) may be given to help lower the risk of blood clots.

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Allergic reaction

An allergic reaction, or hypersensitivity, is not a common side effect of targeted therapy, but it can happen. An allergic reaction is most likely to happen when drugs are given through a needle placed in a vein (intravenously). It usually happens shortly after the drug is given. Although any drug can cause an allergic reaction, some targeted therapy drugs are more likely than others to cause an allergic reaction.

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Organ damage

Organ damage is a rare side effect of targeted therapy. The heart and lungs are the most common organs that may be damaged by targeted therapy drugs.

Symptoms of heart and lung damage include swelling of the hands or feet, fast or uneven heart beat, chest pain and shortness of breath or problems breathing. Tell your doctor or healthcare team right away if you have any of these symptoms. The dose of the drug may need to be lowered, or the drug could be stopped to prevent more damage to the heart or lungs.

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