Do What You Can to Ease Side Effects of Treatment for Laryngeal Cancer
During your treatment for laryngeal cancer, it’s likely that you will have physical concerns. Your cancer may cause symptoms. Your treatment may cause side effects.
Here are some common side effects from treatment for laryngeal cancer and how to ease them. You may not have all of these. The treatment you receive--surgery, radiation therapy, chemotherapy--determines which side effects you may experience. We’ve listed them in alphabetical order so that you can find help when you need it.
Anemia (low red blood cell levels)
Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your red blood cell count. Red blood cells carry oxygen throughout the body. If your body does not have enough oxygen, you may feel tired. Decreased red blood cell counts can be caused by small amounts of blood loss due to bleeding, by chemotherapy or radiation, or by the cancer itself.
If your doctor tells you that you have anemia, take these actions to feel better:
Anxiety and depression
Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back throughout treatment. Taking these actions may ease your mental stress:
Eating well during cancer treatment can help you maintain your strength, stay active, and lower your chance of infection. When you're being treated for cancer, a diet high in calories and protein is best. Side effects of treatment can change the way food tastes to you or reduce your appetite. In addition, treatments to your throat may make it difficult to eat:
If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue, and cancer treatments cause your body to use more protein than usual. A nutritionist can help you learn what is best for you to eat and drink during your cancer treatment and set up a daily menu for you. A nutritionist can also advise how to add extra calories to foods that you already eat and enjoy.
If you can, eat high-calorie foods to help you maintain your weight, such as margarine or butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing. Supplements can also help get more calories into your body.
Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, apple juice, and other liquids, try these foods to increase your fluid intake: gelatin, pudding, soups, Popsicles, and ice cream.
If your mouth is irritated, avoid foods that may cause more irritation. Foods that are acidic, such as vinegar, tomatoes, orange juice, and lemonade, or foods that can be chafing, such as crusty bread, may cause pain.
If you have problems with bleeding that won't stop or bloody noses, see Thrombocytopenia below.
Bloating and swelling
You may have swelling after surgery or radiation. Also, some chemotherapy drugs cause your body to retain water. This water retention should go away when your treatment ends. Here's what you can do for relief:
You may find it hard to breathe because of swelling from the surgery or pressure from a tumor. Depending on the location of the cancer, you may have a hole cut through your neck and into your trachea (windpipe) to help you breathe. This procedure is known as a tracheostomy. The hole (which is called a stoma) makes breathing easier. You can also try these tips:
Avoid things that make your breathing harder, such as high humidity, cold air, pollen, and tobacco smoke.
Chewing, swallowing, or talking difficulties
The tumor itself, the surgery to remove the tumor, and chemotherapy or radiation therapy may all make chewing, swallowing, or talking more difficult. Some of these side effects are temporary. Some may be permanent. Try these steps to make chewing, swallowing, or talking easier:
Ask your surgeon about steps to rebuild areas of your oral cavity. This can help restore your ability to chew, swallow, or talk. Rebuilding parts of your oral cavity may be done during the surgery to remove the tumor. Or it may be done after you have gone through treatment for laryngeal cancer.
Work with your health care team to learn ways to make chewing, swallowing, or talking easier. Many head and neck cancer teams include a speech and swallow therapist who can work with people to overcome these difficulties. Speech and swallow therapy can yield excellent results over time.
You may benefit from the placement of a feeding tube in the stomach, called a G-tube or PEG (percutaneous endoscopic gastrostomy) tube, that can be used for food, water, and medicines if you have serious trouble eating and drinking. Feeding tubes are usually temporary, inserted just during your treatment and recovery period. In rare cases, the feeding tube will stay in place if you are not able to fully eat and drink after your therapy is complete.
Occasionally, people who have had radiation develop difficulty swallowing because of narrowing of the upper part of the esophagus, called an esophageal stricture. Special tests, such as an evaluation by a speech and swallow therapist or a video swallow study, or both, can help identify this problem. If identified, an esophageal stricture can often be corrected by a dilation procedure to help widen the narrowed area.
Constipation leads to difficult or infrequent bowel movements. It can range from mildly uncomfortable to painful. Taking pain medications can lead to constipation, so it's wise to take these preventive actions. These same steps will give you relief if you are already constipated:
Diarrhea is loose or frequent bowel movements, or both. It may lead to dehydration if you don't take these precautions. Diarrhea may be caused by medications or a change in your eating habits:
Eat low-residue, low-fiber foods such as those included in the BRAT diet (bananas, rice, applesauce, and toast).
Hair loss (alopecia)
Losing your hair can be upsetting because baldness is a visible reminder that you are being treated for cancer. Not every type of chemotherapy or radiation will make you lose your hair. Keep in mind that your hair will grow back after chemotherapy; however, it may not grow back in an area that has received radiation. Try these coping tips:
Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair.
If you are having more infections than usual, you may have a lowered white blood cell count. See Neutropenia below.
Insomnia (trouble sleeping)
Insomnia can be caused by anxiety, depression, or your cancer treatment. Use these tips to improve your rest:
Mouth dryness (xerostomia)
Radiation to your larynx can cause changes in your saliva and in the amount of saliva you produce. Because saliva protects your teeth, tooth decay and chronic dry mouth can be a problem after treatment. These actions ensure good mouth care and can help keep your teeth and gums healthy and make you feel more comfortable:
If it is hard to floss or brush the teeth in the usual way, use gauze, a soft toothbrush, or a special toothbrush that has a spongy tip instead of bristles.
Mouth sores (mucositis)
Mouth sores can be a side effect of chemotherapy and radiation. These sores may hurt and make eating an unpleasant experience.
To prevent sores in your mouth, take these actions:
To ease the pain if you get sores in your mouth, take these actions:
Nausea or vomiting
Nausea or vomiting as a result of chemotherapy or radiation treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea:
Anticipatory nausea and vomiting. These are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.
Your doctor will prescribe medication for nausea. Most nausea can now be prevented or successfully treated with medication.
To prevent nausea, take these actions. Most nausea can be prevented:
To help ease nausea or vomiting if you have it, try these tips:
Try eating foods and drinking beverages that were easy to take or made you feel better when you had the flu or were nauseated from stress. These may be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.
Neutropenia (low white blood cell levels)
Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your white blood cell count. Many types of chemotherapy can cause low white blood cell counts, as can the cancer itself. Lowered white blood cell counts is called neutropenia. Without enough white blood cells, your body may not be able to fight infection.
If your doctor tells you that your white blood cell count is low, take these actions to stay healthy:
Call your doctor right away if you have any of these signs of infection: a temperature of 100.5 degrees or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.
Pain may be from the tumor, from the surgery, from radiation, or from other treatments. Try these tips to ease pain:
Use heat, cold, relaxation techniques (such as yoga or meditation), or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.
Sexuality and reproductive issues
Chemotherapy and the stress of dealing with cancer can affect your sexual health. Sexuality issues may include reduced libido (interest in and ability to have sex) and infertility. Taking these actions may help you cope with these changes:
Skin dryness or irritation
Radiation treatment can cause dry or red skin in the area being treated. Good skin care is important at this time. Your doctor or nurse will show you how to keep the area clean. Also, follow these tips for protecting your skin:
Only use lotion or cream with advice from your doctor or nurse. Ask what kind of lotion you can safely use to moisturize and soothe your skin. Don't use any lotion, soap, deodorant, sunblock, cologne, cosmetics, or powder on your skin within two hours after treatment because they may cause irritation.
Thinking and remembering problems
You may have mild problems with concentration and memory during and after chemotherapy. Being tired can make this worse.
Taking these actions may help:
If you have trouble remembering information, such as names, directions, and task sequences, be certain to let your medical provider know, and ask what can be done to help improve your cognitive health. Cognitive interventions may be especially important after treatment ends.
Thrombocytopenia (low platelet levels)
Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your platelet levels. Many types of chemotherapy can cause low platelet levels, as can the cancer itself. Low platelet levels is called thrombocytopenia. Without enough platelets, your blood may not be able to clot properly.
If your doctor tells you that your platelet count is low, take these actions to stay healthy:
Tiredness is a very common symptom and side effect from chemotherapy and radiation treatments. It is also a symptom of anemia, which is a low red blood cell count as noted from blood tests. Whatever the cause, you may feel only slightly tired or you may suffer from extreme fatigue.
Taking these actions may help increase your energy level. Fatigue can last four to six weeks after treatment ends. Resting is important, but doctors usually tell people to try to stay as active as they can. Finding a balance between rest and exercise is a good idea:
After radiation to the head and neck area, many people develop low thyroid gland function. The thyroid gland normally makes a hormone that is associated with the body's metabolism. Radiation can eventually cause low thyroid function, called hypothyroidism. Hypothyroidism can cause fatigue. If appropriate, your doctor can test you for this. Treatment for hypothyroidism is available and highly effective.