14 Chemotherapy-Related Adverse Effects

  • Slide 1: Fatigue

    Slide 1: Fatigue

    Chemotherapy can cause fatigue in patients. There are other cancer-related factors that can also make the patient tired, such as low red blood count, depression, lack of sleep, and receiving radiation therapy.<sup>1</sup>

  • Slide 2: Alopecia

    Slide 2: Alopecia

    Chemotherapy-induced hair loss is considered a significant side effect of chemotherapy and ranks as one of the most troublesome chemotherapy side effects for patients overall. Some patients have been known to refuse chemotherapy because of the risk of alopecia.<sup>2</sup>

  • Slide 3: Sexual Dysfunction & Fertility Issues

    Slide 3: Sexual Dysfunction & Fertility Issues

    Chemoradiotherapy-induced hypogonadism and angiopathy cause libido loss in both men and women,<sup>3</sup> and certain therapies given to adolescent and young adult patients with cancer can lead to infertility in the future.<sup>3</sup>

  • Slide 4: Cutaneous Toxicity

    Slide 4: Cutaneous Toxicity

    Chemotherapy-induced cutaneous toxicity affects about 60% to 80% of the population receiving chemotherapy. The effects are sometimes dose-related. Examples include skin rash, dryness, pruritus, paronychia, hair abnormalities, and mucositis.<sup>4</sup>

  • Slide 5: Mucositis

    Slide 5: Mucositis

    Mucositis is a common side effect experienced as a result of radiation therapy and chemotherapy treatment; severity varies from patient to patient. Food intake may be compromised due to mouth sores.<sup>5</sup>

  • Slide 6: Thrombocytopenia

    Slide 6: Thrombocytopenia

    Cancer treatment can cause low platelet count, or thrombocytopenia (platelet count ≤30,000). When the platelet count is low during treatment, it can affect clotting and bleeding can be prolonged.<sup>6</sup>

  • Slide 7: Anemia

    Slide 7: Anemia

    Tiredness and fatigue can be a sign of a bigger problem such as anemia. Anemia may result from chemotherapy that damages healthy red blood cells. Of all patients receiving chemotherapy, 70% develop anemia during treatment.<sup>7</sup>

  • Slide 8: Ocular Toxicity

    Slide 8: Ocular Toxicity

    Antineoplastic chemotherapy can cause damage to the optic nerve and the ocular motor nerves. Adverse effects can range from mild changes such as dry eyes, to severe changes such as retinal damage and glaucoma.<sup>8</sup>

  • Slide 9: Cognitive Changes

    Slide 9: Cognitive Changes

    Chemotherapy treatment can affect a patient’s memory or attention span. It is often referred to as “chemo brain.” An individual may suffer from resulting short-term memory loss.<sup>8</sup>

  • Vandetanib May Not Be Effective for Advanced Biliary Tract Cancer

    Vandetanib May Not Be Effective for Advanced Biliary Tract Cancer

    The gastrointestinal (GI) side effects, such as nausea, vomiting, diarrhea, and constipation are among the most common experienced during chemotherapy. GI effects can occur during or after administration of chemotherapy and can vary in severity (eg, soft stool to bloody diarrhea).<sup>9</sup>

  • Slide 11: Nephrotoxicity

    Slide 11: Nephrotoxicity

    Chemotherapy agents affect the glomerulus, tubules, interstitium, or renal microvascular tubules by elevating serum creatinine, which can cause acute renal failure. In patients who have renal impairment, drug metabolism and excretion may be altered and lead to toxicity.<sup>10</sup>

  • Slide 12: Hepatotoxicity

    Slide 12: Hepatotoxicity

    Damage or injury to the liver caused by a drug or other agent results in hepatotoxicity. Certain chemotherapy drugs are toxins, which can build up in the body faster than the liver can process them, and ultimately, can result in liver damage.<sup>11</sup>

  • Slide 13: Hemorrhagic Cystitis

    Slide 13: Hemorrhagic Cystitis

    Cystitis or bladder inflammation is a common side effect that can occur during or after chemotherapy treatment. The common symptoms that occur with cystitis are dysuria, frequency, urgency, nocturia, suprapubic pain, and microscopic or gross hematuria.<sup>12</sup>

  • Slide 14: Cardiotoxicity

    Slide 14: Cardiotoxicity

    Cardiovascular effects can be among the most serious adverse events resulting from chemotherapy, and can occur early or late during the treatment. Cardiotoxicity can be mild, consisting of blood pressure changes, to more severe, such as myocardial infarction and heart failure.<sup>13</sup>

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Patients receiving treatment for cancer can experience a number of potential side effects and reactions. Clinicians should be aware of the adverse events that can result from administration of certain agents.

Fatigue can result from a number of factors, including anemia, depression, and radiation therapy.1 Similarly, alopecia affects many patients and can be one of the most disturbing side effects, sometimes preventing people from receiving chemotherapy.2

Sexual dysfunction resulting from chemotherapy and radiation therapy can often result in loss of libido.3 Affecting about 60% to 80% of patients receiving chemotherapy, cutaneous toxicities can include skin rash4 and mucositis. Mucositis is also one of the common side effects experienced as a result of radiation therapy and chemotherapy treatment, with mouth sores often affecting food intake.5

Thromobocytopenia (low platelet count) can affect clotting and cause bleeding, and is caused by alkylating, antirheumatic, and antimetabolite agents.6,7 Damage to the optic nerve and the ocular motor nerves can often occur when a patient is receiving antineoplastic chemotherapy. “Chemo-brain” can be a side effect of cancer therapy that causes memory loss and other cognitive changes.8 The gastrointestinal (GI) side effects, such as nausea, vomiting, diarrhea, and constipation are among the most common experienced during chemotherapy.9

Certain chemotherapy agents, such as antimetabolites, can cause hepatotoxicity and nephrotoxicity.10,11 Alkylating agents can cause hemorrhagic cystitis, resulting in dysuria, frequency, urgency, nocturia, suprapubic pain, and microscopic or gross hematuria.12 One of the most serious side effects of cancer treatment is cardiotoxicity, which can occur early or late in treatment.13

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