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Do What You Can to Ease Side Effects of Treatment for Testicular Cancer

In this section, you’ll learn more about how to cope with some of the most common symptoms of testicular cancer and side effects of treatment. You may not have all of these. 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, chemotherapy, radiation, or by the cancer itself.

If your doctor tells you that you have anemia, take these actions to feel better:

  • Take short rests when you’re tired. Avoid long naps during the day so that you can sleep well at night.

  • Add mild exercise, such as walking, to your daily routine. This may help you sleep better.

  • Balance activity with rest. Save your energy for important tasks.

  • Eat a balanced diet including high quality protein foods. 

  • Drink plenty of water. Dehydration adds to fatigue.

  • Talk with your doctor about medications or treatments that may help manage your anemia.

Anxiety and depression

Many people may feel blue, anxious, or distressed after being told they have cancer. This can be a normal response to the diagnosis. These feelings may continue or come and go throughout treatment. It is common for symptoms of anxiety and depression to occur separately.

Taking these actions may ease your mental stress:

  • Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.

  • Talk with your family or friends. Identify what you can do to support one another.  

  • Ask your doctor about medications for depression and anxiety.

  • Reduce caffeine intake, which can worsen anxiety symptoms in some people.  

  • Set time aside daily for relaxation techniques, such as meditation. 

  • Ask your doctor for a referral to a social worker, psychologist, or psychiatrist 

Appetite loss

People who eat well during cancer treatment maintain their strength better and tend to be more active. 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 or reduce your appetite. For example, chemotherapy can make you nauseated, change the way food tastes and smells, or make you too tired to want to eat. Sometimes people will develop trouble swallowing as a result of treatment. Pain and depression can be other common causes of appetite loss. 

Ask your doctor for a referral to a registered dietitian if you are having trouble maintaining your desire to eat. Also, try these tips to maintain an appropriate calorie intake:

  • 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.

  • Ask your doctor, nurse, or dietitian about high-protein drinks that can help supplement your diet.

  • 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 bowel function. In addition to water, fruit juices, and other liquids, try these foods to increase fluids: gelatin, pudding, soups, popsicles, and ice cream.

  • Eat small meals throughout the day instead of three large ones. Include a snack at bedtime. 

  • Keep snacks handy to eat when you are hungry.

  • Eat with friends or play your favorite music at mealtime to boost your appetite.

  • Eat your biggest meal in the morning. Many people getting treatment for cancer find that this is when their appetite is greatest.

  • If you can, increase your activity level. Doing so may stimulate your appetite.

  • On days you don't feel like eating at all, don't worry about it. Try again the next day. If you find your appetite doesn't improve in several days, talk with your doctor or nurse. 

Bleeding problems

Chemotherapy can interfere with your body’s ability to make platelets, which help stop bleeding when you get a cut or bruise. The following are signs of excessive bleeding. If you notice them, report them to your doctor:

  • Unexpected bruising

  • Small red spots under the skin

  • Signs of blood in your urine (reddish or pinkish color)

  • Black tarry stools or blood on the toilet tissue after a bowel movement

  • Bleeding from your nose or gums

  • Vomiting blood

If your doctor tells you your platelet count is low, follow these steps to help minimize your risk of bleeding:

  • Check with your doctor before taking any prescription, over-the-counter, or herbal medications. Some, such as aspirin, may further increase your risk of bleeding.

  • Check with your doctor before drinking alcohol. Be gentle if using dental floss or toothpicks. Check with your doctor before you have any dental work done. 

  • Use a toothbrush with soft bristles so you don’t irritate your gums and cause them to bleed. Be gentle if using dental floss or toothpicks. Check with your doctor before you have any dental work done. 

  • Blow your nose gently to reduce your risk of nosebleeds.

  • Be especially careful not to cut yourself when using knives, scissors, clippers, or other sharp tools.

  • Be careful not to burn yourself when cooking or ironing.

  • Avoid contact sports or situations in which you might be injured. 

  • Ask your doctor if you should avoid sexual activity.

  • Avoid anti-inflammatory pain medicines, such as ibuprofen, unless otherwise advised by your doctor.  

  • Use an electric razor instead of a blade because you are less likely to cut yourself with one.

Constipation

Constipation may include difficult or infrequent bowel movements. It may be a side effect of chemotherapy. Taking pain medications can also lead to this problem as well as a lack of exercise. It can be mildly uncomfortable or painful. It’s wise to take these preventive actions. These same steps may give you relief if you are already constipated:

  • Drink plenty of fluids, especially water and prune juice.

  • Eat foods high in fiber, such as high-fiber cereals, whole grains, fruits, and vegetables.

  • Exercise.

  • Take stool softeners or a laxative only as prescribed by your doctor.

  • Do not use enemas unless recommended by your doctor. 

Diarrhea

This may be a side effect of chemotherapy or radiation near your stomach. Diarrhea is loose or frequent bowel movements, or both, three or more times daily. Diarrhea can lead to dehydration if you don’t take these steps to manage it:

  • Avoid milk and milk products.

  • Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.

  • Eat low-residue, low-fiber foods such as those included in the BRAT diet (bananas, rice, applesauce, and toast).

  • Eat or dink foods that are high in potassium, such as bananas or electrolyte-containing sports beverages.  

  • Drink more fluids, such as water and broth, to prevent dehydration.

  • Ask your doctor about medications that may help.

Hair loss

Losing your hair (called alopecia) can be upsetting because baldness is a visible reminder that you are being treated for testicular cancer. Chemotherapy can cause hair loss. Remember that your hair will probably grow back after treatment.

Try these coping tips:

  • Consider cutting your hair before treatment starts.

  • Think about getting a hairpiece, hat, or scarf before your hair loss starts. That way, you can get a hairpiece that matches your hair, and you’ll be ready with head coverings if you choose to use them.

  • Some insurance companies will pay for a wig if you have a prescription from your doctor.  

  • Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats.

Infection

Your doctor will take blood samples from you for blood tests throughout your treatment. One thing the doctor 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. A lowered white cell count 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 and reduce your risk of infection:

  • Wash your hands often, especially before eating and after going to the bathroom or touching animals.

  • Stay away from people who are sick with an illness you could catch, such as a cold or the flu.

  • Avoid crowds. If you must go out, choose a time when fewer people will be out, such as during the week or late at night.

  • Avoid children who have recently been given “live virus” vaccines.

  • Get enough rest.

  • Do not cut or tear your cuticles.

  • Take extra care when using knives, scissors, or other sharp objects.

  • Take good care of your teeth and gums.

  • Do not squeeze or scratch cuts or blemishes.

  • Take a warm bath, shower, or sponge bath every day. Do not use harsh bath products, such as skin scrubs. Do not rub your skin too hard with washcloths or towels.

  • If you skin is dry or cracked, ask your doctor if lotion or oil will help.

  • Clean any cuts or scrapes right away. Wash them with soap and warm water, followed by an antiseptic. Continue to wash cuts and scrapes once a day until they heal.

  • Ask someone else to clean up litter boxes, animal waste, fish tanks, and bird cages.

  • Avoid standing water, such as bird baths, vases, and humidifiers.

  • Wear protective gloves when gardening or cleaning.

  • Do not get any immunizations, such as a flu shot, without asking your doctor first.

  • Do not eat raw or undercooked seafood, fish, meat, or eggs.

  • Use an electric razor instead of a blade to minimize the risk of cuts.

  • If you feel unexpectedly warm or cold, check your temperature with a thermometer by mouth or under your armpit.  

  • 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.

Mouth sores (mucositis)

Some types of chemotherapy and radiation to the head and neck area can cause mouth sores. These sores can hurt and make eating difficult, sometimes leading to weight loss and dehydration.

To prevent sores in your mouth, take these actions:

  • Brush your teeth with a soft-bristled toothbrush after meals and before bedtime. If you normally floss, do it at least once a day unless your doctor or nurse tells you not to. If you don't usually floss, talk with your doctor before you start. 

  • Keep your mouth and lips clean and moist.

  • Use sugar-free candies or gums to increase moisture in your mouth.

To ease the pain if you get sores in your mouth, take these actions:

  • Avoid alcohol and mouthwashes containing alcohol because they may irritate the sores.

  • Avoid hot, rough, acidic, or spicy foods because they may irritate the sores.

  • Eat frequent smaller meals of moist and bland foods.

  • Drink liquids with a straw to bypass the sore.  

  • Consider mashing or pureeing foods to make them less painful to eat.  

  • Avoid tobacco because it may irritate the sores. Smoking can also make you more susceptible to sores.

  • Ask your doctor about topical mouth medications.

  • Ask you doctor about homemade mouthwash options that include baking soda, water, and sometimes salt.  

  • Take over-the-counter pain medication, such as Tylenol (acetaminophen), if necessary.

  • Call your doctor or nurse if your temperature reaches 100.5 degrees or higher.

Nausea or vomiting

Nausea or vomiting can be a result of chemotherapy or radiation treatment for cancer. It may range from barely noticeable to severe. These are a few different types of nausea:

  • Acute-onset nausea and vomiting occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be five to six hours after treatment, and the symptoms end within the first 24 hours.

  • Delayed-onset vomiting develops more than 24 hours after treatment.

  • Anticipatory nausea and vomiting is 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.

  • Breakthrough vomiting occurs despite treatment to prevent it. It requires additional treatment.

  • Refractory vomiting occurs if you’re no longer responding to antinausea treatments.

To prevent nausea, take these actions. Most nausea can be prevented:

  • Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then, make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

  • If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

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 others.

  • Do not eat fatty or fried foods, very spicy foods, or very sweet foods.

  • Eat room temperature or cold foods. The smells from hot foods may make your nausea worse.

  • Eat frequent, small, and bland meals.  

  • Rest sitting upright for a minimum of one hour after meals. 

  • Suck on hard candy, such as mint or lemon drops, to remove bad tastes. 

  • For some people metal spoons and forks cause a bitter taste. Consider plastic in this case.  

  • Ask your doctor or nurse to help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.

  • Ask your doctor or nurse about using acupressure bands on your wrists, which may help to decrease your nausea.

Numbness, tingling, or muscle weakness in your hands or feet (peripheral neuropathy)

If you have numbness, tingling, or weakness in your hands and feet, you may have nerve damage called peripheral neuropathy. This can be a side effect of chemotherapy or 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 chemotherapy dose. Or your doctor may prescribe medicine or some vitamins. You should also take these precautions to protect yourself:

  • Take extra care walking and moving so that you don’t fall. Wear only well-fitting shoes.

  • Use warm, not hot, water for bathing to prevent burns. Consider using a shower chair or railing to improve your stability.

  • If your daily activities become too difficult, ask your doctor for a referral to an occupational therapist or a physical therapist. They can help teach you new ways of doing things so that you can stay as active as possible.

  • Give yourself plenty of time to do things so you are not rushed.  

  • Take extra care when driving (you may have trouble feeling the gas and brake pedals). Ask friends and family to drive you places.

  • Avoid snug clothes or tight shoes as they may make symptoms worse. 

  • Always wear shoes to protect your feet and check your feet daily for injury or open sores.  

Sexual changes

Testicular cancer can affect your sexual life. Some of these changes are temporary. Some are longer lasting. In both cases, there are steps you can take to feel good about your body and to enjoy intimacy with your partner. Here are some suggestions:

  • Focus on your physical recovery including diet, rest, and activities.

  • Ask your doctor or nurse when it is OK to resume sexual activity.

  • If you are in a relationship, include your partner in discussions.

  • Wait to engage in sexual activity until you and your partner are rested and free from distractions.

  • Create a romantic mood.

  • Try different positions until you find one that is most comfortable for you and your partner.

  • Use pain medications, if needed.

  • Remember that you cannot “give” someone cancer.

  • Remember that sexual activity will not make the cancer come back or grow.

  • Remember that your partner is also affected by your cancer. Talk about both of your feelings and fears.

  • Explore different ways of expressing love. These might include hugging and holding, stroking and caressing, and talking.

  • When thinking about the effects cancer may have had on your sexuality, you may want to ask yourself these questions: How has my illness interfered with my role as partner or father or other roles? How has my illness changed the way I see myself and feel about myself? How has my illness affected my sexual functioning?

Skin dryness or irritation

Red, dry, or itchy skin may be a side effect of radiation therapy. To get relief, try these tips:

  • Protect your skin from sun exposure by wearing sunscreen of at least 15 SPF (sun protection factor).

  • 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, sunblock, cologne, cosmetics, or powder on your skin within two hours after treatment because they may cause irritation.

  • Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.

  • Don’t scratch, rub, or scrub treated skin. After washing, gently blot dry.

  • Don’t bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

  • Don’t apply heat or cold to the treated area. Bathe only with lukewarm water because it is less dehydrating.

  • Add oil to bath water (mineral or baby) or apply immediately after showering. 

  • Apply skin cream twice daily. Water-based skin cream is advised.  

  • If you must shave the treated area, use only an electric shaver because you are less likely to cut yourself with one. Don’t use lotion before shaving. And don’t use hair-removal products. Both can irritate skin.

  • Keep your nails well trimmed and clean so you don’t accidentally cut yourself.

  • If it is okay with your doctor, drink plenty of water. Two to three quarts of liquid a day is a common recommendation. 

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:Sometimes the fatigue will hit suddenly and cannot be relieved by rest. 

  • Make lists and write down important information.

  • Use other tools to help organize your life, such as calendars, pill dispensers, or alarm clocks.

  • Get plenty of rest. 

Tiredness

Tiredness is a very common symptom of testicular cancer and side effect from chemotherapy and radiation treatments. It is also a symptom of anemia, which is a low red blood cell count. Whatever the cause, you may feel only slightly tired or you may suffer from extreme fatigue. Sometimes the fatigue will hit suddenly and cannot be relieved by rest. Fatigue can last for months after treatment ends.

Taking these actions may help increase your energy level:

  • Take action to treat a poor appetite, because eating improperly can make you tired.

  • Dehydration can make fatigue worse, so be sure to keep hydrated.  

  • Find a balance between rest and activities that keeps you feeling well.  

  • Exercise during treatment has been shown to reduce fatigue. 

  • If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as shopping or yard work. Some people reduce their hours at work.

  • Follow the tips under Anemia.

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