Manage Side Effects of B-Cell Lymphoma Treatment

The powerful treatments you take for B-cell lymphoma can sometimes bring side effects, but there are plenty of ways to manage them.

How you react depends on the specific type of treatment, the dose, and your overall health. Most people with B-cell lymphoma will have some kind of chemotherapy. You may also need immunotherapy, radiation, targeted therapy, or a stem cell (bone marrow) transplant.

Ask your doctor what to expect, and learn tips that can make you more comfortable during treatment.

Nausea and Vomiting

Chemotherapy can cause nausea and vomiting, but it's not a given.

If it happens to you, your doctor can prescribe anti-nausea medication. Ask him about acupuncture, which may also give you some relief.

Fatigue

This is more than being a little tired. Cancer-related fatigue can make you feel weak and exhausted, and even resting more might not seem to help that much. Although it's common, don't ignore it. Your doctor may need to order blood tests to pinpoint the specific cause. For instance, you might lack certain vitamins or have become anemic.

To get more energy, do some light exercise and tweak your diet (perhaps with the help of a dietitian). You may also need to carve out time in your schedule for extra rest, including naps.

‘Chemo Brain’

Some people say that chemotherapy makes them feel mentally foggy. You might have a hard time concentrating or remembering things.

To deal with these problems, try writing notes for yourself that can remind you of important tasks. Or stash commonly misplaced items, like your keys, in the same place every day.

Mouth Sores

Chemo, stem cell transplants, and radiation all have the potential to cause mouth sores, which can be painful. Keep your mouth moist to get relief. Drink a lot of water and suck on ice chips or sugarless hard candy.

If you get sores, ask your doctor about writing a prescription for "magic mouthwash," a formula that a pharmacist can prepare for you. There are different versions, but it generally contains a numbing agent along with ingredients designed to kill bacteria and fungi, fight inflammation, and coat the inside of your mouth.

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Hair Loss

This is a common side effect of chemo, though it doesn't always happen. Although you can't prevent it, be gentle with your hair. For instance, wash with a mild shampoo every few days and put mineral oil on your scalp if it feels dry.

If you lose your hair, you may wish to wear a scarf, bandana, or wig. Some people like to cut their hair short or shave their head before they start losing their hair.

Keep in mind that your hair loss is temporary. It grows back after you finish your treatment, though it may have a different texture when it does.

Infections

Cancer treatment can curb your immune system -- your body's defense against germs. This makes it easier for you to get sick. To cut down the chances of an infection, your doctor might give you antibiotics or growth factors, which help you make white blood cells.

There are things you can do on your own to keep yourself healthy. Wash your hands often, avoid crowds, and stay away from people who are sick. Also clean any scrapes or wounds promptly and use an antiseptic cream.

Call your doctor right away if you notice any signs of infection, such as a sore throat, diarrhea, or a fever.

Nerve Damage

Some types of treatment, like chemotherapy, radiation, and CAR T-cell therapy, can cause nerve damage. Tell your doctor if you have any pain, numbness, or tingling.

You might need medication or vitamins. Meanwhile, take steps to keep yourself safe. Use potholders while cooking, get rid of area rugs you could trip on, and keep the rooms, hallways, and stairs in your house well-lit.  

Fever, Chills, and Itching

Immunotherapy IVs are often part of the treatment for B-cell lymphoma. Many people have reactions like fever, chills, shivering, itching, low blood pressure, or headache during their first infusion.

Your doctor will watch you closely while you get treatment. If necessary, a technician can stop the IV drip while you get more medication to ease these side effects.

It's unlikely that you'll continue to have side effects once you finish the infusion and leave the hospital.

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Red, Sore, or Blistering Skin

Radiation can cause skin reactions, especially after you've had a few treatments. Ask the radiation oncologist or nurse for advice on how to best protect your skin.

You'll probably be told to gently wash the area with baby soap or plain water and pat it dry. Don't use any creams or powders on the area unless your health care team recommends one.

If you spend time outside, be sure to use sunscreen with a high SPF or cover up with clothing.

Organ Damage

Depending on your specific treatment and any health conditions you have, your doctor may keep an eye out for damage to your heart, kidneys, liver, and lungs.

If you get a problem, he might adjust your dose or treatment.

Cytokine Release Syndrome (CRS)

This is a condition you might get if you get treated with CAR T-cell therapy, a type of immunotherapy. If you have cytokine release syndrome, you could get symptoms like:

  • Fever
  • Nausea
  • Headache
  • Rash
  • Fast heartbeat
  • Low blood pressure
  • Breathing problems

A severe case of CRS could be life-threatening. If that happens to you, your doctor may treat you with tocilizumab (Actemra) or a combination of that drug and corticosteroids.

WebMD Medical Reference Reviewed by Louise Chang, MD on June 09, 2018

Sources

SOURCES:

American Cancer Society: "Treating B-Cell Non-Hodgkin Lymphoma."

Cancer Research UK: "Radiotherapy and Your Skin," "Treatment Decisions."

Leukemia and Lymphoma Society: "Managing Side Effects."


Mayo Clinic: "Magic Mouthwash: Effective for Chemotherapy Mouth Sores?" "Tocilizumab (Intravenous Route).

NHL Cyberfamily: "Side Effects From Treatment."

UpToDate: "Axicabtagene ciloleucel: Drug information."

National Cancer Institute: "Cytokine release syndrome."

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