Side effect
management

Cancer and cancer treatments can come along with a host of unpleasant side effects. Depending on the treatment regimen you are on, these side effects can vary. This guide can help you navigate them.

Treatment regimens

FOLFOX / CAPOX
FOLFIRI / XELIRI
FOLFOXIRI / FOLFIRINOX
Lonsurf
Stivarga
Avastin
Erbitux / Vectibix
Braftovi
Radiation therapy

DocTalk

Want to learn more about how palliative care can help you manage side effects? Watch this video by Dr. Joshua Briscoe.

https://youtu.be/8-Js2U2Mets

Nausea

  • Take pre-meds. Your oncologist will likely prescribe anti-nausea medications like dexamethasone, Compazine, Zofran, Ativan, and Akynzeo. Even if you don’t feel sick, take your medications as prescribed. It’s much easier to prevent nausea than it is to treat it once it has started
  • Stay well hydrated. Drinking plenty of water and receiving fluids post-infusion can help with nausea
  • Try eating a small amount of bland food, like rice or bread to calm the nausea down
  • Choose foods that sound appealing to you. If you’re craving Cheetos, follow your gut. Avoid foods with strong smells
  • Try ginger tea, candies or gummies
  • Some patients find acupuncture or acupressure helpful
  • Look into deep breathing or muscle relaxation techniques

Skin problems

  • Try to stay out of the sun for extended periods of time. Wear hats and protective clothing, and purchase a good sunscreen. Wear it every day — whether or not you’re planning on leaving the house!
  • Chemotherapy can cause painful mouth sores. If you develop them, discuss your symptoms with your oncologist immediately. A dose reduction of 5FU can help. Stick to soft foods, like soups, broths, yogurt and smoothies. Try biotene mouthwash, or gargle with baking soda, salt, and water. Ask your doctor about prescription mouthwashes, like Magic Mouthwash and PerioGuard. If your mouth sores become infected, you might need an antiviral or antibiotic medication. Speak to your oncologist if you think this is the case
  • If you experience extremely dry skin, this can often cause painful cuts on your hands and feet. Apply a good moisturizer throughout the day, particularly after washing your hands or washing dishes
  • Some patients on Erbitux or Vectibix experience an acne-like skin rash. Your oncologist may prescribe an antibiotic, such as doxycycline, to help alleviate the rash. A good moisturizing cream, such as Aquaphor, can help

Constipation

  • Drink plenty of fluids
  • Make sure to get some light exercise. This can help get the bowels moving
  • Stool softeners such as Miralax, Dulcolax, magnesium citrate or Milk of Magnesia can help get things moving
  • Metamucil can help bowel regularity
  • Try prune juice

Diarrhea

  • Make sure to stay hydrated. Drink plenty of water and consider drinks with electrolytes
  • You may be given atropine as a pre-med to help prevent diarrhea
  • You can also take over the counter medications such as Immodium or Lomitil at home to help manage symptoms

Diagnosed: April 2021

Stage: IV

Type: Rectal cancer, liver metastases

I was diagnosed stage IV with mets to my liver in April 2021. After a liver biopsy, it was determined that my CRC was KRAS wild-type. This enabled me to start Vectibix in June 2021, when my chemo began (FOLFOX).

The Vectibix infuses for an hour. It is known to cause a rash in a very high percentage of people, so my oncologist has me taking a precautionary antibiotic (doxycycline). Vectibix also gives you “sun sensitivity” which can make your rash even worse.

My first few rounds of Vectibix were OK, nothing too bad. However, I developed HORRIBLE canker sores, had peeling, bleeding lips, rashes on my calves and a very painful rash on my upper chest that I think was sun-related.

My oncologist was able to prescribe Valtrex for the canker sores, which cleared them up in a day. Magic mouthwash (Benadryl, lidocaine, milk of magnesia) can also help. We reduced my dose in half at about round 4, and I really have not had too many issues since then. My lips and mouth can get a little sensitive but nothing like what happened when it was full strength!

At 9 rounds, my liver tumors had reduced by 75% — a great response to FOLFOX & Vectibix. My rectal tumor was only a “scar” (I did have 5 days of short course radiation which also contributed to this result).

Lifestyle factors

Bowel management
Ostomy management
Exercise
Diet
Weight management

Want to chat with other patients and caregivers about side effects?

Join one of our COLONTOWN Facebook groups:

  • Corner Cupboard is where you can find remedies for common side effects
  • Check out Live Wire to manage neuropathy from chemotherapy
  • Try the Late Show for long-term treatment after-care
  • Join Palliative Pathways for guidance on palliative care

Want to be part of our community? Fill out the registration form here.

Recent research

Skin Rash Study Before Chemotherapy in Colorectal & Head and Neck Cancer Patients

NCT Number: 01874860

Want to learn more about side effect management?

Take a look at these great resources: