Effectively managing the day-to-day side effects of chemotherapy treatment involves a holistic, team-based plan that includes the expertise of oncology practitioners, primary care providers, and allied healthcare professionals. A proactive approach to managing negative side effects, or adverse drug reactions, can help patients be more resilient and improve their quality of life. Primary care providers and other members of the team who have an established relationship with the patient are often well-suited to start the conversation about how adverse drug reactions impact daily functioning.
With more than a hundred chemo drugs in use, there’s a wide range of potential adverse drug reactions. The type of cancer being treated and the patient’s baseline health can further influence chemotherapy side effects and their severity. However, discussing a few of the most common side effects of chemotherapy treatment is a great place to start finding the right solutions for your patients.
Rocky Mountain Cancer Centers (RMCC) provides information sessions during which a patient meets with a registered nurse or nurse practitioner to discuss the side effects of chemotherapy and how to manage these symptoms. Family and friends are encouraged to attend these sessions.
Chemo brain can be one of the most frustrating chemotherapy side effects your patients experience. It typically improves slowly after completing treatment. However, some people may have lingering, lifelong executive functioning issues, including attention to task, difficulty with sequencing, impaired problem-solving, and challenges with recall and short-term memory.
Primary care providers can help track cognitive changes by obtaining a baseline cognitive functioning level and reassessing during and after chemo. Patients with long-term cognitive side effects of chemotherapy may benefit from speech therapy or occupational therapy (OT) to improve cognition and executive functioning skills related to communication or daily living skills.
These strategies may also be beneficial:
Nearly all people who go through chemotherapy treatment will experience fatigue. Because chemotherapy kills healthy cells and cancer cells, low platelet and red blood cell counts may contribute to fatigue. Dehydration, insomnia, lack of exercise, and stress may also play a role.
To help manage fatigue, patients can:
Rocky Mountain Cancer Centers (RMCC) offers a medically integrated pharmacy that can save patients the extra trip to the neighborhood pharmacy for oral cancer medications and supportive care. RMCC pharmacists can verify Medicare and supplemental health care coverage, provide on-site education, and answer your questions about the medication.
If needed, an OT, physical therapist, or social worker can provide additional training and support when planning activities, modifying the environment or tasks, or using mobility devices to help manage fatigue.
Chemotherapy treatment may cause a range of hair, nail, and skin changes, which can be physically painful and emotionally challenging for many people with cancer.
There are ways to help your patients cope with these changes. They can:
If patients would like to use a hat, scarf, or wig due to hair loss, talk to them about choosing materials that are gentle on the skin and not too tight. These items can also lift a patient’s mood and increase socialization. Patients may also want to learn how to apply makeup safely during cancer treatment.
People undergoing chemotherapy treatment are at increased risk of infection due to low white blood cell count.
To help your patients manage a compromised immune system:
When possible, encourage patients to take advantage of telehealth appointments to lower their risk of exposure and aid in energy conservation.
Chemotherapy can cause lymphedema in many areas of the body. It most commonly occurs in the arms or legs. Breast cancer patients and survivors, in particular, are at increased risk for upper extremity lymphedema. Because lymphedema is often a chronic condition, it is essential for your patients to learn how to manage it as early as possible to avoid complications, remain independent, and improve their quality of life.
Lymphedema massage and therapy from a qualified lymphedema therapist are commonly used to manage symptoms. If compression garments or wrappings are prescribed, ensure your patient knows how to wear or remove items independently or has a caregiver who can provide consistent support.
Patients may benefit from OT to learn how to safely and efficiently complete daily living and leisure activities, modify tasks, and use adaptive equipment or assistive technology if needed. Additionally, PT can help manage symptoms through exercise or teach the patient to use a mobility device.
Chemotherapy treatment may lead to various mental health conditions, including anxiety and depression. Cancer survivors also commonly experience significant survivorship guilt.
To support your patient’s mental health:
Nerve damage is a common side effect of chemotherapy. Patients often experience neuropathy in their hands and feet and may have it in other parts of the body. It may take up to two years for nerve damage to heal, and some people will have chronic neuropathy following chemo.
Patients may benefit from these strategies to manage neuropathy:
Though osteoporosis is a common and serious side effect of chemotherapy treatment, patients may not know they have the condition. For women who have gone through menopause, including early menopause, primary care providers should order a baseline bone density test and repeat testing every two to five years based on the results.
Primary care providers can also:
RMCC hematologists and oncologists can also prescribe medication for bone strengthening that may be especially helpful for breast cancer patients.
RMCC’s oncology experts provide extensive options for cancer treatment, side effect management, and support for all stages of the cancer journey. Refer a patient to learn more about how our team can help.