Tips to Help You Manage Side Effects

As you get ready to start treatment, it’s normal to feel nervous about side effects you might face. To help you prepare, here’s a treatment-by-treatment guide to the most common ones.

Keep in mind that side effects vary even between two people on the same treatment. That's because every person -- and every cancer case -- is unique. The good news is most side effects are temporary and there are ways you can manage them.

Surgery

Most lung cancer surgeries are a procedure called a thoracotomy. The doctor cuts into your chest and spreads your rib cage open to get to the tumor. This is a major operation, and it takes weeks or months to recover.

Based on the size and location of your tumor, the surgeon may be able to do something called minimally invasive video-assisted thoracoscopic surgery (VATS). If this works for you, you’ll have less pain and you’ll get better faster.

The side effects will vary based on how much of your lung was removed and which type of procedure you had, but here’s an idea of what to expect and how to deal with it.

Pain and weakness. Your doctor will prescribe medication to relieve your pain, but you’ll need to allow time to rest and heal. It’s a good idea to keep a journal so you can track and describe your symptoms. If it gets worse, work with your doctor to adjust medications and fine-tune the dosage.

Shortness of breath. You may feel this even though you’re getting enough oxygen and you can breathe normally. It’s how your brain processes chest pain. It should get better overthe next few weeks as you heal. If your lungs are in good shape (other than the cancer) you can usually return to normal life after a while -- even if an entire lung was removed. If you also have a non-cancerous lung disease like emphysema or chronic bronchitis, you may always feel short of breath with some types of activity.

Chemotherapy

These drugs attack cells that divide quickly, which is why they work against cancer cells. But some healthy cells also do this, like those in your hair follicles, bone marrow, and the lining of your mouth and intestines. Chemo attacks them, too, and that leads to certain side effects. They depend on the type and dose of drugs you get and the length of time you take them.

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They're usually short-term and go away after you're done with treatment. You can take steps to ease them. Report them to your medical team so that they can be treated promptly. Doctors can reduce your dose and delay or stop treatment to keep symptoms from getting worse.

Nausea and vomiting. Feeling like you're going to throw up or actually doing it can be a problem on treatment days. Your doctor will give you medicine to keep these symptoms at bay.

Hair loss. Follicles, the tiny structures that hair grows out of, contain some of the fastest-growing cells in your body. So chemo attacks them, too. Within a few weeks of starting treatment, you may lose some or all of your hair. The good news is that it's almost always temporary. It can make you feel better to cut or shave before it starts to fall out. If you opt to go bald, use an electric shaver so you don't cut your scalp. If you get a wig, shop for it while you still have hair so you can match it to your current hair color.

Bleeding or clotting problems. Platelets are blood cells that help stop bleeding. They plug damaged blood vessels and help your blood clot. If you don't have enough of them, you may bleed or bruise more easily than usual, even from a minor injury. Your doctor will check your platelet count often during your treatment. If it falls too low, you may need a transfusion.

Loss of appetite. Instead of three large meals per day, have five or six small ones. Avoid greasy, salty, sweet, or spicy food that might make you feel queasy. If even the smell of food is a turnoff, eat cold meals instead.

Diarrhea. Frequent bowel movements that are loose or watery can get in the way of your daily life. They can also drain too much liquid from your body. Skip dairy and high-fiber, greasy, or spicy foods. Drink water or suck on ice chips, and call you doctor if your symptoms last more than a day.

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Constipation. If you don't go often enough, or if it hurts, you can be more likely to get hemorrhoids or have other problems. Eat more high ­fiber foods like whole grains, nuts, fruits, and vegetables. If these lifestyle changes don't help, talk to your doctor.

Fatigue. Medications, lack of sleep, and pain can leave you feeling tired and weak. You'll likely be most tired in the days right after treatment. You'll start to feel better over time -- until the next treatment.Take short naps during the day to revive yourself. Soak in the tub before bedtime to help you sleep better. Your friends and family may ask how they can help. Let them! Better yet, assign them tasks like cooking, cleaning, and grocery shopping.

Infections. They can be life-threatening if you're on chemo. Take your temperature any time you feel too warm, too cold, or just not well. If your reading is 100.4 F or higher for more than 1 hour, or 101 F or higher for any length of time, call your doctor right away. Wash your hands often to get rid of harmful bacteria. Ask the people around you to do the same.

External Radiation Therapy

It's a lot like getting an X-ray, but the dose is stronger. Before treatments start, the radiation team will take precise measurements to adjust the size and shape of the beam. That makes sure it hits the tumor. The beam destroys cancer cells on impact, but it can also damage healthy cells around them. The procedure itself is painless, but you could have side effects. Some are the same as those with chemo and surgery, and you can treat them the same way.

  • Shortness of breath
  • Fatigue
  • Nausea and vomiting
  • Diarrhea
  • Hair loss
  • Loss of appetite

Other side effects can include:

Skin changes in the area being treated. Thesecan range from mild redness to blistering and peeling. Clean it each day with warm water and a mild soap that your nurse says is safe to use. Don't use other products on the treatment area unless your doctor or nurse approves them.

Sore throat. Your windpipe and esophagus, which are in the middle of your chest, may be exposed to radiation. That could cause a sore throat and trouble when you swallow. This can make it hard to eat anything other than soft foods or liquids for a while.

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Targeted Therapy

Doctors have found new drugs that target the changes that cause cells to grow into cancer. They don’t affect your body the way that standard chemo drugs do, but they can still cause side effects.

Skin problems. You might have rashes. Tell your doctor if you notice any skin changes. If you don’t treat them, they can get worse and lead to infections.

High blood pressure. Your doctor will watch your readings closely if you are getting a drug that can cause this reaction.

Heart damage. Your doctor will test your heart before treatment and watch your condition closely.

Immunotherapy

The newest approach to lung cancer treatment uses drugs to help your immune system spot and destroy cancer cells better. It shows great promise when traditional treatments fail, especially for people whose cancer is in a later stage.

The most common side effects are flu-like symptoms, fatigue, rashes, fever, and drops in blood pressure. But immunotherapy is very new, so doctors still aren’t sure which side effects will happen or how serious they may be.

WebMD Medical Reference Reviewed by William Blahd, MD on May 31, 2016

Sources

SOURCES:

American Cancer Society: “Surgery for non-small cell lung cancer.”

American Cancer Society: “Chemotherapy for non-small cell lung cancer.”

American Cancer Society: “Getting Help for Nausea and Vomiting.”

University of Southern California Keck School of Medicine: “A Patient’s Guide to Lung Surgery.”

Lung Cancer Alliance: “Hair Loss.”

Memorial Sloan Kettering Cancer Center: “Blood Clotting: Thrombosis.”

University of Michigan Health System: “Thoracic Surgery -- After Your Lung Surgery Patient Education -- Discharge Information.”

American Cancer Society: “Diarrhea.”

LungCancer.org: “Understanding and Managing Chemotherapy Side Effects: Constipation.”

LungCancer.org: “Understanding and Managing Chemotherapy Side Effects: Fatigue.”

American Cancer Society: “Infection in People With Cancer.”

Radiological Society of North America: “Lung Cancer Treatment.”

American Cancer Society: “Targeted therapies for non-small cell lung cancer.”

Garrido-Castro, C. Translational Lung Cancer Research, April 2013. 

National Cancer Institute: ‘FDA Approves First Immunotherapy Treatment for Lung Cancer.”

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