Cancer medicines are strong. Although their side effects can be intense, you've got ways to ease them.

The key is to let your doctor know what problems you have, so she can recommend changes to help you.

In some cases, she may be able to change your prescriptions or adjust the dose. For example, with chemotherapy, "we try to get a dose that works against the tumor but that the patient can still tolerate," says Julie Gralow, MD, of the Seattle Cancer Care Alliance.

These are common side effects of chemotherapy and tips to help you manage them.

Nausea and Vomiting

Chemotherapy may give you these stomach issues.

Tips: Your doctor may prescribe an anti-nausea drug. There are some that you take before chemo to minimize these symptoms, and others that you take during or after chemo. Work with your doctor on this -- let them know how you’re doing so they can help you manage it.

You can also make some changes in your diet to soothe your stomach, including these:

  • Eat several small meals a day instead of three large ones.
  • Ease nausea with natural ginger found in sodas, teas, and candies.
  • Stay away from greasy, fried, salty, sweet, or spicy foods.
  • Avoid food with strong smells. And stay out of the kitchen while others are cooking.
  • Stay hydrated. Sip clear liquids like broth, juice, and sport drinks throughout the day.
  • Wait at least an hour after treatment to eat and drink.

Your doctor may also suggest that you consider acupuncture to help with the nausea and vomiting. There haven’t been a lot of studies on it, but some research shows that it might help, in addition to other treatments.

Fatigue

Many people feel very tired during their cancer treatment, even after getting sleep. Your treatments go on for a long time without a break, and a deep fatigue can build up.

Tip: Get moving.

"Research shows that women who get regular exercise during cancer treatment feel better and have more energy," says Virginia Borges, MD, of the University of Colorado-Denver School of Medicine.

You don’t have to push hard or go far. Do what you can. Try gentle forms of yoga, brisk walks, or other moderate exercise.

During chemotherapy and radiation, make your workouts less intense than they were before you had cancer. When you're ready, you can gradually make them more challenging.

Ask your doctor if there are any limits on what you can do. For instance, if your immune system is weaker because of treatment, it might be best not to exercise in a gym where you might be exposed to other people’s germs. Your doctor can also check for other causes of fatigue such as anemia and thyroid problems.

Pain or Tingling in Hands and Feet

Doctors call this "peripheral neuropathy." It's a side effect of some chemotherapy drugs. It can also happen after cancer surgery or radiation, or for other reasons, including the cancer itself.

Tip: Tell your doctor as soon as you feel symptoms. She may change the dose of your cancer medicine or add another drug to help.

Peeling, Redness on Hands and Feet

Some drugs that treat breast cancer can cause a painful "hand-foot syndrome." This involves a sunburn-like redness, tenderness, and sometimes peeling on the palms of the hands and soles of the feet.

Tip: Use thick emollient creams several times a day, Borges suggests. At night, wear socks or gloves to bed. A B6 vitamin supplement may also help.

If these things don't work, your doctor may want to change your dosage or extend your "time off" cycle with the drug.

Mouth Sores

Several kinds of chemotherapy can cause these. Radiation can also cause them. They're painful and make it hard to eat and drink.

Tips:

  • Use a soft toothbrush.
  • Avoid whitening toothpastes and mouthwashes, which may irritate sores.
  • Suck on ice pops or ice chips.
  • Avoid spicy or crunchy foods.
  • Skip alcohol and fizzy or acidic drinks, such as tomato and citrus juices.
  • Drink through a straw.

Ask your doctor about pain relief if these tips aren’t helping enough.

Swollen, Heavy Arms or Hands

If you’ve had lymph nodes removed from your armpit or chest during breast cancer surgery, you're more likely to get lymphedema, a buildup of fluid in the fatty tissues just under the skin in those areas.

To lower your odds of getting this condition, try to avoid cuts, burns, constriction, and muscle strain on your affected side.

Tips:

  • Have blood draws, shots, and blood pressure checks on the opposite side if possible.
  • Wear protective gloves when doing housework and cooking.
  • Use antibiotic cream on scratches.
  • Wear compression sleeves on long plane flights.
  • Avoid heavy lifting on your affected side.

If you already have lymphedema, ask your doctor to recommend a specially trained physical therapist who can ease the swelling and give you compression garments, special bandages, and exercises to do.

Hair Loss

Some chemo drugs make you lose your hair. If yours do, you have choices about whether and how to cover your head.

Tip: You can explore your options and try on wigs, scarves, and hats, as well as see how you feel with your head uncovered. You might build a "wardrobe" of head coverings that you can change into any time.

If you decide to get a wig, the American Cancer Society (ACS) says it's tax-deductible, and your health insurance may cover it. The ACS recommends that you ask your doctor to write a prescription for a "cranial prosthesis" and not mention a "wig" on the prescription.

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Important Safety Information

Patients should not take AFINITOR if they are allergic to AFINITOR or to any of its ingredients. Patients should tell their health care provider before taking AFINITOR if they are allergic to sirolimus (Rapamune®) or temsirolimus (Torisel®).

AFINITOR can cause serious side effects, such as lung or breathing problems, infections, or kidney failure. Some of these side effects can be severe and can even lead to death. Your health care team may have ways to help manage side effects that do occur. It's important to talk with your doctor or nurse about side effects you experience and the best ways to manage them. Serious side effects include:

Lung or Breathing Problems: Patients should tell their health care provider right away if they have any of these symptoms: new or worsening cough, shortness of breath, chest pain, difficulty breathing, or wheezing.

Infections: AFINITOR may make patients more likely to develop an infection, such as pneumonia, or a bacterial, fungal, or viral infection. Viral infections may include reactivation of hepatitis B in people who have had hepatitis B in the past. Patients may need to be treated as soon as possible. Patients should tell their health care provider right away if they have a temperature of 100.5°F or above, have chills, or do not feel well. Symptoms of hepatitis B or infection may include the following: fever, chills, skin rash, joint pain and inflammation, tiredness, loss of appetite, nausea, pale stools or dark urine, yellowing of the skin, or pain in the upper right side of the stomach.

Angioedema: Patients who take an angiotensin-converting enzyme (ACE) inhibitor medicine during treatment with AFINITOR are at a possible increased risk for a type of allergic reaction called angioedema. Talk with your health care provider before taking AFINITOR if you are not sure if you take an ACE inhibitor medicine. Get medical help right away if you have trouble breathing or develop swelling of your tongue, mouth, or throat during treatment with AFINITOR.

Kidney Failure: Patients taking AFINITOR may develop kidney failure. Patients should have tests to check their kidney function before and during their treatment with AFINITOR.

Delayed Wound Healing: AFINITOR can cause incisions to heal slowly or not heal well. Call your health care provider right away if your incision is red, warm, or painful; if you have blood, fluid, or pus in your incision; if your incision opens up; or if your incision swells.

Before taking AFINITOR, tell your health care provider about all your medical conditions, including if you:

  • Have or have had kidney problems
  • Have or have had liver problems
  • Have diabetes or high blood sugar
  • Have high blood cholesterol levels
  • Have any infections
  • Previously had hepatitis B
  • Are scheduled to receive any vaccinations. You should not receive a live vaccine or be around people who have recently received a live vaccine during your treatment with AFINITOR. If you are not sure about the type of vaccine, ask your health care provider
  • Have other medical conditions
  • Are pregnant or could become pregnant. AFINITOR can cause harm to your unborn baby. If you are able to become pregnant, you should use effective birth control while using AFINITOR and for 8 weeks after your last dose. Talk to your health care provider about birth control options while taking AFINITOR
  • Are breastfeeding or plan to breastfeed. Do not breastfeed during treatment and for 2 weeks after your last dose

Tell your health care provider about all of the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Using AFINITOR with certain other medicines can cause serious side effects. Keep a list of medicines you take and show it to your health care provider when you get a new medicine. Especially tell your health care provider if you take St John's wort (Hypericum perforatum), medicines that weaken your immune system (your body's ability to fight infections and other problems), or medicines for:

  • Fungal infections
  • Bacterial infections
  • Tuberculosis
  • Seizures
  • HIV-AIDS
  • Heart conditions or high blood pressure

If you are taking any medicines for the conditions listed above, your health care provider might need to prescribe a different medicine or your dose of AFINITOR may need to be changed. Tell your health care provider before you start taking any new medicine.

Common Side Effects

The most common side effect of AFINITOR in treating advanced hormone receptor-positive, HER2-negative breast cancer was mouth ulcers and sores (67%). Tell your health care provider if you have pain, discomfort, or open sores in your mouth. Your health care provider may tell you to use a special mouthwash or mouth gel that does not contain alcohol, hydrogen peroxide, iodine, or thyme.

Other common side effects of AFINITOR include:

  • Infections (50%)
  • Rash (39%)
  • Feeling tired (36%)
  • Diarrhea (33%)
  • Loss of appetite (30%)
  • Nausea (29%), vomiting (17%)
  • Weight loss (25%)
  • Cough (24%), shortness of breath (21%)
  • Abnormal taste (22%)
  • Headache (21%)
  • Pain in arms and legs (9%), back (14%), joints (20%)
  • Swelling of arms, hands, feet, ankles, face, or other parts of the body (19%)
  • Nose bleeds (17%)
  • Fever (15%)
  • Constipation (14%)
  • High blood glucose (14%)
  • Difficulty sleeping (13%)
  • Feeling weak (13%)
  • Itching (13%)
  • Dry mouth (11%)
  • Hair loss (10%)

Other side effects that may occur with AFINITOR:

  • Absence of menstrual periods (menstruation). You may miss 1 or more menstrual periods. Tell your health care provider if this happens
  • AFINITOR may affect fertility in females and males, and may affect your ability to become pregnant if you are female or your ability to father a child if you are male. Talk to your health care provider if this is a concern for you

Tell your health care provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of AFINITOR. For more information, ask your health care provider or pharmacist. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see full Prescribing Information for AFINITOR, including Patient Information.

The brands listed are the trademarks or register marks of their respective owners and are not trademarks or register marks of Novartis.

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