Anemia is common in people with cancer, especially those receiving chemotherapy. Anemia is an abnormally low level of red blood cells (RBCs). RBC’s contain hemoglobin (an iron protein) that carries oxygen to all parts of the body. If the level of RBCs is too low, parts of the body do not get enough oxygen and cannot work properly. Most people with anemia feel tired or weak. The fatigue (tiredness) associated with anemia can seriously affect quality of life and make it more difficult for patients to cope with cancer and treatment side effects.
Appetite changes are common with cancer and cancer treatment, including chemotherapy. Individuals with a poor appetite or appetite loss may eat less than usual, not feel hungry at all or feel satiated (full) after eating only a small amount. Ongoing appetite loss can lead to weight loss, malnutrition and loss of muscle mass and strength. The combination of weight loss and loss of muscle mass, also called wasting, is referred to as cachexia.
Blocked Intestine (Gastrointestinal, or GI, Obstruction)
In some types of cancer (such as bile duct, cervical, colorectal and ovarian cancers), the tumor can grow so it blocks the path that food and fluids take when they travel through the stomach, intestines or GI tract (bowels). Normally, the intestines move food and fluids through the GI tract, and enzymes, fluid and electrolytes help the body to absorb nutrients. In a GI obstruction, the food and fluids cannot move through the system, and the normal contractions the intestines make to move the food (called peristalsis) can cause intense pain.
If left untreated, a GI obstruction is a very serious and even life-threatening problem. Patients with a GI obstruction may experience nausea and/or vomiting, pain from the obstruction and cramping from the movement of the intestine as it tries to move food along.
Diarrhea is frequent, loose or watery bowel movements. It is a common side effect of certain chemotherapeutic drugs or of radiation therapy to the pelvis, such as in women with uterine, cervical or ovarian cancers. It can also be caused by certain tumors, such as pancreatic cancer.
Fatigue is extreme exhaustion or tiredness, and it is the most common problem that people with cancer experience. More than half of patients experience fatigue during chemotherapy or radiation therapy, and up to 70 percent of patients with advanced cancer experience fatigue. Patients who feel fatigue often say that even a small effort, such as walking across a room, can seem like too much.
Fluid in the Abdomen (Ascites)
Ascites is the buildup of fluid in the abdomen, in the area around the organs known as the peritoneal cavity. Ten percent of all ascites are caused by cancer and is called malignant ascites. Most cancer-related ascites appears in patients with the cancers of the ovary, endometrium (lining of the uterus), breast, colon, gastrointestinal (GI) system or pancreas. These cancers can cause fluid to build up in the body. People with ascites may experience weight gain, abdominal swelling, a sense of fullness or bloating, a sense of heaviness, indigestion, nausea and/or vomiting, changes to the navel, hemorrhoids (a condition that causes painful swelling near the anus) and/or ankle swelling.
Hair Loss (Alopecia)
A potential side effect of radiation therapy and chemotherapy is hair loss. Radiation therapy and chemotherapy cause hair loss by damaging the hair follicles responsible for hair growth. Hair loss may occur throughout the body, including the head, face, arms, legs, underarms and pubic areas. The hair may fall out entirely, gradually, or in sections. In some cases, the hair will simply thin, sometimes unnoticeably, and may become duller and dryer. Losing one’s hair can be a psychologically and emotionally challenging experience and can affect a patient’s self-image and quality of life. However, the hair loss is usually temporary, and the hair often grows back.
An infection occurs when harmful bacteria, viruses or fungi (such as yeast) invade the body and the immune system is not able to destroy them quickly enough. Patients with cancer are more likely to develop infections because both cancer and cancer treatments (particularly chemotherapy and radiation therapy to the bones or extensive areas of the body) can weaken the immune system. Symptoms of infection include fever (temperature of 100.5F degrees or higher), chills or sweating, sore throat or sores in the mouth, abdominal pain, pain or burning when urinating or frequent urination, diarrhea or sores around the anus, cough or breathlessness, redness or swelling around a cut or wound, and unusual vaginal discharge or itching.
Menopausal Symptoms in Women
Menopausal symptoms depend on the type of therapy and may include hot flashes, night sweats, vaginal dryness, vaginal itching or vaginal irritation or discharge, painful sexual intercourse, difficulties with bladder control, depressed feelings and insomnia.
Mouth Sores (Mucositis)
Mucositis is an inflammation of the inside of the mouth and throat, leading to painful ulcers and mouth sores. It occurs in up to 40 percent of patients receiving chemotherapy treatments. Mucositis can be caused by a chemotherapeutic drug directly or the reduced immunity brought on by chemotherapy or radiation treatment to the head and neck area.
Nausea and Vomiting
Vomiting, also called emesis or throwing up, is the act of expelling the contents of the stomach through the mouth. It is a natural way for the body to rid itself of harmful substances. Nausea is the urge to vomit. Nausea and vomiting are common in patients receiving chemotherapy for cancer and in some patients receiving radiation therapy. Many patients with cancer say they fear nausea and vomiting more than any other side effects of treatment. When it is minor and treated quickly, nausea and vomiting can be quite uncomfortable but cause no serious problems. Persistent vomiting can cause dehydration, electrolyte imbalance, weight loss, depression and avoidance of chemotherapy.
Depending on the stage of disease, 30 to 75 percent of all patients experience pain from cancer. Cancer pain can be treated successfully. Pain can make other aspects of cancer seem worse, such as fatigue (tiredness), weakness, sleep disturbance and confusion.
Pain can come from the tumor itself or may be a result of cancer treatment. Pain from a tumor can be a result of the tumor growing and spreading to the bones or other organs, and putting pressure on and damaging nerves. Pain from surgery is normal and may persist for months or years. Common procedures that cause pain afterward include mastectomy (removal of the breast and, occasionally, the surrounding tissue), chest surgery, neck surgery and amputation of a limb (stump pain). Phantom pain is perceived pain in an organ or limb that has been removed. Pain may develop after radiation therapy and go away on its own. It can also develop months or years after treatment, especially after radiation therapy to the chest, breast or spinal cord. Certain chemotherapeutic drugs can cause pain along with numbness in the fingers and toes. Usually this pain goes away when treatment is finished, but sometimes the damage can be permanent.
The skin is an organ system that contains many nerves. Because of this, skin problems can be very painful. Because the skin is on the outside of the body and visible to others, many patients find coping with skin problems especially difficult. Because the skin protects the inside of the body from infection, skin problems can often lead to other serious problems. As with other side effects, prevention or early treatment is best. In other cases, treatment and wound care can often improve pain and quality of life. Skin problems can have many different causes, including chemotherapy leaking out of the intravenous (IV) tube that can cause pain or burning, peeling or burned skin caused by radiation therapy, and/or pressure ulcers (bed sores) caused by constant pressure on one area of the body.