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Side-Effects from High Dose Therapy

Chemotherapy drugs work by stopping the growth of cancer cells growing at a rapid rate in your body. A number of normal cells in your body also grow at a rapid rate. These include your hair, the lining of your mouth and gastrointestinal tract, and the white blood cells and platelets in your bone marrow.

Unfortunately, these are also affected by the chemotherapy. Certain side effects can be expected due to the effects of chemotherapy on these healthy cells.
Side effects from the chemotherapy will vary from patient to patient, and depend upon the type and dose of the drug given. Most side effects are temporary and can be relieved with medication.

The most common side effects of chemotherapy are:

  • Hair Loss (alopecia): Your hair may begin to fall out about seven days after you have completed chemotherapy. You may want to keep your head warm or covered with a wig, scarf, hat, cap, or turban. Your hair will begin to grow back three to four months after you have completed the high-dose therapy.

  • Mouth Sores: Mouth sores can also occur about seven days after you have finished chemotherapy. Frequent oral hygiene is very important to keep your mouth clean. You will be given a mouth care regimen to follow once your chemotherapy is complete. Mouth care should be completed five times per day. Pain medication is available to keep you as comfortable as possible.

  • Nausea & Vomiting: Nausea and vomiting may occur with your chemotherapy regimen. A plan for anti-nausea medication will be developed. If nausea/vomiting becomes severe, you may have to be hospitalized.

  • Loss of Appetite: Small, bland meals are encouraged during chemotherapy treatment. Taste changes and loss of appetite should be expected.

  • Diarrhea: This can be treated with medication. If your diarrhea is significant enough to require medication, a stool specimen may be obtained to rule out infection. Around-the-clock medication could be administered, and if need be, you will receive additional fluid through your catheter. If diarrhea becomes severe, you may have to be hospitalized.

  • Bone Marrow Supression: You can expect to see a drop in white blood cells, platelets and red blood cells after you have finished your chemotherapy.

  • Low White Blood Cell Count: The white blood cells help your body resist infection. While your WBC count is low, you will receive antibiotics to fight possible infection and will need to protect yourself from infection.

  • Low Platelet Count: Platelets help your blood to clot and prevent bleeding. A low platelet count may cause bruising, small red spots under the skin, blood in your urine or stools, or bleeding gums. While you have a low platelet count, you must be especially careful not to injure yourself. When your platelet count is too low, a platelet transfusion will be needed. This will be given at the Cancer Center or the hospital.

  • Low Red Blood Cell Count: Red blood cells carry oxygen and nutrients to your bloodstream. A low red blood count makes you feel tired and weak. When your red blood cell count is too low, a red blood cell transfusion will be needed. This will be given at the Cancer Center or in the hospital.

    There are possible side effects during the reinfusion phase as well. They include:

  • Fever or chills: These are the most common side effects. The fever and/or chills will stop after the reinfusion.

  • Allergic reaction: Allergic reactions can appear as itching, hives or skin rashes. Report any red, raised areas not present before the reinfusion.

  • Breathing difficulties: Shortness of breath, wheezing and/or difficulty breathing can also indicate an allergic reaction. Bring any symptoms of this kind to your nurse's attention.

    Below is a list of suggestions to help make the chemotherapy more pleasant for you:

    1. Eat a light breakfast.

    2. Wear comfortable clothing -- something with easy access to your IV catheter on your upper chest (button-up shirts, large-necked or V-necked shirts, sweat suits or pants work well. You can also wear gowns or pajamas).

    3. Be sure the clothing can withstand medication or blood spills.

    4. Bring an extra set of clothes, particularly underwear and pants.

    5. You may be drowsy through this process. Arrange for a family member or friend to bring you in the morning and pick you up later in the day. Family members or friends may stay throughout the treatment if you prefer, but we limit it to nor more than 2 visitors during the day.

    6. Small children should remain at home.

    7. You may bring books, a radio or cassette tapes to enjoy.

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    Copyright 2014 Washington University School of Medicine