Do What You Can to Ease Side Effects of Treatment for Oral 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 oral 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 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 this oxygen, you may feel tired. Decreased red-blood-cell counts can be caused by small amounts of blood loss, by chemotherapy, 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 chances of infection. When you're being treated for cancer, a diet high in calories and protein is best. The problem is that side effects of treatment can change the way food tastes to you or reduce your appetite. In addition, treatments to your oral cavity may make it hard to eat.
You may receive a gastronomy tube temporarily or permanently to administer nourishment. If so, you'll work with a nurse to learn how to use and care for the tube. If you don't use a gastronomy tube, ask your doctor for a referral to a registered dietitian if you are having trouble eating enough healthy foods. Also, try these tips to stimulate your desire 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 you 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.
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.
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 fluids: gelatin, pudding, soups, Popsicles, and ice cream.
If your mouth is irritated, avoid foods that may cause more irritation. Foods that are acidic like vinegar, orange juice, lemonade, or foods that can be chafing, such as crusty bread may cause pain.
Bloating and Swelling
You may have swelling after surgery or radiation. Also, some chemotherapy drugs cause your body to retain water. This water retention will 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 placed in your neck, called a tracheostomy. The hole 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.
Bruising or Bleeding
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. Lowered platelet levels is called thrombocytopenia. Without enough platelets, your blood may not be able to clot. And this may lead to bruising or bleeding.
If your doctor tells you that your platelet count is low, take these actions to stay healthy:
Chewing, Swallowing, or Talking Difficulty
The tumor itself, the surgery to remove the tumor, and chemotherapy or radiation therapy all may 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 oral cancer.
Work with your healthcare 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, which can be used for food, water, and medicines if you have serious trouble eating and drinking. Feeding tubes are usually temporary. They are 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 esophageal stricture. Special tests, such as evaluation by a speech and swallow therapist, a video swallow study, or both, can help identify this problem. If identified, esophageal stricture can often be corrected by a dilation procedure. Your doctor can explain more about this.
Constipation, or difficult or infrequent bowel movements, can range from mildly uncomfortable to painful. Taking pain medications can lead to constipation, so it's wise to take these preventative actions. These same steps will give you relief if you are already constipated.
Diarrhea is loose or frequent bowel movements, or both. Diarrhea may be caused by medications or a change in your eating habits. It may lead to dehydration if you don't take these precautions.
Eat low-residue, low fiber foods such as 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, 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.
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 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 Fahrenheit or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.
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 head or neck can cause changes in your saliva and in the amount you produce. Because saliva protects your teeth, tooth decay can be a problem after treatment. And, you can have dry mouth. 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 your teeth in the usual way, use gauze, a soft toothbrush, or a special toothbrush that has a spongy tip instead of bristles.
Use a humidifier in dry weather to help decrease the discomfort associated with dry mouth.
Ask your doctor and dentist about medications and other treatments for dry mouth. You may want to use a special spray of artificial saliva to relieve the dryness.
Mouth Sores (Mucositis)
Mouth sores can be a side effect of chemotherapy or radiation to your oral cavity. These sores may hurt and make eating an unpleasant experience. Taking these actions can ease the pain.
To prevent sores, take these actions.
To ease the pain if you get sores in your mouth, take these actions.
Take over-the-counter pain medication, such as Tylenol (acetaminophen), if necessary. Talk to your doctor about whether prescription pain medication might be necessary.
Call your doctor or nurse if your temperature reaches 100.5 degrees Fahrenheit or higher.
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 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.
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've had the flu or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or other things.
Neutropenia (Low White-Blood-Cell Levels)
Numbness, Tingling, or Muscle Weakness in Your Hands or Feet (Peripheral Neuropathy)
If you have numbness, tingling, or weakness in your hands or feet, you may have nerve damage called peripheral neuropathy. This can be a side effect of chemotherapy or a symptom of the cancer itself. Other signs of this problem are ringing in your ears or trouble feeling hot or cold. If you have symptoms such as these, your doctor may adjust your dose. Or your doctor may prescribe medicine or some vitamins. You should also take these precautions to protect yourself.
Pain might be from the tumor, from the surgery, or from other treatments. Try these tips to ease pain.
Use heat, cold, relaxation techniques (like yoga or meditation), or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.
Chemotherapy and the stress of dealing with cancer can have effects on 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.
Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don't use any lotion, soap, deodorant, sun block, cologne, cosmetics, or powder on your skin within 2 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.
Thrombocytopenia (Low Platelet Levels)
Tiredness or fatigue is a very common 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.
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.