Side Effects of Cancer Treatment

In treating cancer, it is hard to limit the effects of treatment so that only cancer cells are removed or destroyed. Because treatment also damages healthy cells and tissues, it often causes side effects.

The side effects of cancer treatment depend on a variety of factors, including the type and extent of the treatment. Side effects may not be the same for each person, and they may even change from one treatment to the next. Doctors and nurses can explain possible side effects, and they can help relieve symptoms that may occur during and after treatment.

Surgery

After a hysterectomy, women usually have some pain and general fatigue. In some cases, patients may have nausea and vomiting following surgery, and some women may have problems returning to normal bladder and bowel function. The effects of anesthesia and discomfort may also temporarily limit physical activity. Diet is usually restricted to liquids at first and gradually increases to regular meals. The length of the hospital stay may vary from several days to a week.

Women who have had a hysterectomy no longer have menstrual periods. When the ovaries are removed, menopause occurs immediately. Hot flashes and other symptoms of menopause caused by surgery may be more severe than those caused by natural menopause. In the general population, estrogen replacement therapy (ERT) is often prescribed to relieve these problems. However, ERT is not commonly used for women who have had endometrial cancer. Because estrogen has been linked to the development of uterine cancer (see Possible Causes and Prevention), many doctors are concerned that ERT may cause uterine cancer to recur. Other doctors point out that there is no scientific evidence that ERT increases the risk of recurrence. A large research study is being conducted to determine whether women who have had early stage endometrial cancer can safely take estrogen.

After surgery, normal activities usually can be resumed in 4 to 8 weeks. Sexual desire and sexual intercourse are not usually affected by hysterectomy. However, some women may experience feelings of loss that may make intimacy difficult. Counseling or support for both the patient and her partner may be helpful.

Radiation Therapy

Radiation therapy destroys the ability of cells to grow and divide. Both normal and diseased cells are affected, but most normal cells are able to recover. With radiation therapy, the side effects depend largely on the treatment dose and the part of the body that is treated. During radiation therapy, people are likely to become very tired, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.

Patients receiving radiation for uterine cancer commonly have side effects that include dry, reddened skin and hair loss in the treated area, loss of appetite, and fatigue. Radiation therapy also may cause a decrease in the number of white blood cells that help protect the body against infection. Treatment may also cause diarrhea or frequent and uncomfortable urination. Some women have dryness, itching, tightening, and burning in the vagina. Women may be advised not to have intercourse during treatment; however, most can resume sexual activity within a few weeks after treatment ends. Women may be taught how to use a dilator, as well as a water-soluble lubricant to help minimize these problems.

The National Cancer Institute booklet Radiation Therapy and You has helpful information about radiation therapy and managing its side effects.

Hormone Therapy

Hormone therapy can cause a number of side effects. Women taking progesterone may experience fatigue and changes in appetite and weight, and they may retain fluid. Premenopausal women may have changes in their menstrual periods. Women may wish to discuss the side effects of hormone therapy with their doctor.

Chemotherapy

The side effects of chemotherapy depend mainly on the drugs and the doses received. In addition, as with other types of treatment, side effects vary for each individual. Generally, anticancer drugs affect cells that divide rapidly. These include blood cells, which fight infection, help the blood to clot, or carry oxygen to all parts of the body. When blood cells are affected by anticancer drugs, patients are more likely to get infections, may bruise or bleed easily, and may have less energy. Cells in hair roots and cells that line the digestive tract also divide rapidly. As a result, patients may lose their hair and may have other side effects, such as poor appetite, nausea and vomiting, or mouth sores. Usually, these side effects go away gradually during the recovery periods between treatments or after treatment is over.

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