Blood Clotting Problem
Anticancer drugs can affect the bone marrow's ability to make
platelets, the blood cells that help stop bleeding by making your blood
clot. If your blood does not have enough platelets, you may bleed or
bruise more easily than usual, even from a minor injury.
Be sure to let your doctor know if you have unexplained bruising, small
red spots under the skin, reddish or pinkish urine, or black or bloody
bowel movements. Also report any bleeding from your gums or nose. Your
doctor will check your platelet count often while you are having
chemotherapy. If your platelet count falls too low, the doctor may give
you a transfusion to build up the count.
Here are some ways to avoid problems if your platelet count is low:
Don't take any medicine without first checking with your doctor or
nurse. This includes aspirin or aspirin-free pain relievers, including
acetaminophen, ibuprofen, and any other medicines you can buy without a
prescription. These drugs may affect platelet function.
- Don't drink any alcoholic beverages unless your doctor says it's all
right.
- Use a very soft toothbrush to clean your teeth.
- Clean your nose by blowing gently into a soft tissue.
- Take care not to cut or nick yourself when using scissors, needles,
knives, or tools.
- Be careful not to burn yourself when ironing or cooking. Use a
padded glove when you reach into the oven.
- Avoid contact sports and other activities that might result in
injury.
Mouth, Gum, and Throat Problems
Good oral care is important during cancer treatment. Anticancer drugs
can cause sores in the mouth and throat. They can also make these tissues
dry and irritated or cause them to bleed. In addition to being painful,
mouth sores can become infected by the many germs that live in the mouth.
Because infections can be hard to fight during chemotherapy and can lead
to serious problems, it's important to take every possible step to prevent
them.
Here are some suggestions for keeping your mouth, gums, and throat
healthy:
- If possible, see your dentist before you start chemotherapy to have
your teeth cleaned and to take care of any problems such as cavities,
abscesses, gum disease, or poorly fitting dentures. Ask your dentist
to show you the best ways to brush and floss your teeth during
chemotherapy. Chemotherapy can make you more likely to get cavities,
go your dentist may suggest using a fluoride rinse or gel each day to
help prevent tooth decay.
- Brush your teeth and gums after every meal. Use a soft toothbrush
and a gentle touch; brushing too hard can damage soft mouth tissues.
Ask your doctor, nurse, or dentist to suggest a special type of
toothbrush and/or toothpaste if your gums are very sensitive.
- Rinse your toothbrush well after each use and store it in a dry
place.
- Avoid commercial mouthwashes that contain a large amount of salt or
alcohol. Ask you doctor or nurse about a mild mouthwash that you might
use.
If you develop sores in your mouth, be sure to contact your doctor or
nurse because you may need medical treatment for the sores. If the sores
are painful or keep you from eating, you also can try these ideas:
- Ask your doctor if there is anything you can apply directly to the
sores. You also may ask your doctor to prescribe a medicine you can
use to ease the pain.
- Eat foods cold or at room temperature. Hot and warm foods can
irritate a tender mouth and throat.
- Choose soft, soothing foods, such as ice cream, milkshakes, baby
food, soft fruits (bananas and applesauce), mashed potatoes, cooked
cereals, soft-boiled or scrambled eggs, cottage cheese, macaroni and
cheese, custards, puddings, and gelatin. You also can puree cooked
foods in the blender to make them smoother and easier to eat.
- Avoid irritating, acidic foods, such as tomatoes, citrus fruit, and
fruit juice (orange, grapefruit, and lemon); spicy or salty foods; and
rough, coarse, or dry foods such as raw vegetables, granola, and
toast.
If mouth dryness bothers you or makes it hard for you to eat, try these
tips:
- Ask your doctor if you should use an artificial saliva product to
moisten your mouth.
- Drink plenty of liquids.
- Suck on ice cubes, popsicles, or sugarless hard candy. You can also
chew sugarless gum.
- Moisten dry foods with butter, margarine, gravy, sauces, or broth.
- Dunk crisp, dry foods in mild liquids.
- Eat soft and pureed foods like those listed above.
- Use lip balm if your lips become dry.
Diarrhea
When chemotherapy affects the cells lining the intestine, the result
can be diarrhea (loose stools). If you have diarrhea that continues for
more than 24 hours, or if you have pain and cramping along with the
diarrhea, call your doctor. In severe cases, the doctor may prescribe an
antidiarrheal medicine. However, you should not take any over-the- counter
antidiarrheal medicines without asking your doctor first.
You can also try these ideas to help control diarrhea:
- Eat smaller amounts of food, but eat more often.
- Avoid high-fiber foods, which can lead to diarrhea and cramping.
High-fiber foods include whole-grain breads and cereals, raw
vegetables, beans, nuts, seeds, popcorn, and fresh and dried fruit.
Eat low-fiber foods, instead. Low-fiber foods include white bread,
white rice or noodles, creamed cereals, ripe bananas, canned or cooked
fruit without skins, cottage cheese, yogurt, eggs, mashed or baked
potatoes without the skin, pureed vegetables, chicken or turkey
without the skin, and fish.
- Avoid coffee, tea, alcohol, and sweets. Stay away from fried,
greasy, or highly spiced foods, too. They are all irritating and can
cause diarrhea and cramping.
- Avoid milk and milk products if they make your diarrhea worse.
- Unless your doctor has told you otherwise, eat more potassium- rich
foods because diarrhea can cause you to lose this important mineral.
Bananas, oranges, potatoes, and peach and apricot nectars are good
sources of potassium.
- Drink plenty of fluids to replace those you have lost through
diarrhea. Mild, clear liquids, such as apple juice, water, weak tea,
clear broth, or ginger ale are best. Drink them slowly, and make sure
they are at room temperature. Let carbonated drinks lose their fizz
before you drink them.
-
- If your diarrhea is severe, it is important to let your doctor know.
Ask your doctor if you should try a clear liquid diet to give your
bowels time to rest. As you feel better, you gradually can add the
low-fiber foods listed above. A clear liquid diet doesn't provide all
the nutrients you need, so don't follow one for more than 3 to 5 days.
- If your diarrhea is very severe, you may need to get intravenous
fluids to replace the water and nutrients you have lost.
Nerve and Muscle Effects
Your nervous system affects just about all your body's organs and
tissues. So it's not surprising that when chemotherapy affects the cells
of the nervous system
- as the drugs sometimes do
- a wide range of side effects can result. For example, certain drugs
can cause peripheral neuropathy, a condition that may make you feel a
tingling, burning, weakness, or numbness in the hands and/or feet.
Other nerve-related symptoms include loss of balance, clumsiness,
difficulty picking up objects and buttoning clothing, walking
problems, jaw pain, hearing loss, stomach pain, and constipation. In
addition to affecting the nerves, certain anticancer drugs also can
affect the muscles and make them weak, tired, or sore.
- In some cases, nerve and muscle effects--though annoying--may not be
serious. In other cases, nerve and muscle symptoms may indicate
serious problems that need medical attention. Be sure to report any
suspected nerve or muscle symptoms to your doctor.
Caution and common sense can help you deal with nerve and muscle
problems. For example, if your fingers become numb, be very careful when
grasping objects that are sharp, hot, or otherwise dangerous. If your
sense of balance or muscle strength is affected, avoid falls by moving
carefully, using handrails when going up or down stairs and using bathmats
in the bathtub or shower. Do not wear slippery shoes.
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