Chemotherapy is one of the most common treatment options for cancer. It is what most people relate cancer to. It involves administering a combination of anti-cancer drugs to kill cancer cells and stop their growth. Chemotherapy can also be used to decrease the size of a tumour making it easier and safer to remove through surgery; to increase the effectiveness of other cancer treatments like radiation; and in some cases, to control the cancer and enhance an individual’s quality of life.
Chemotherapy medicine can be administered to the body through the bloodstream or to a specific cancer site. It can also be given as a pill, applied to the skin or direct into the body cavity. The combination of medicines attacks the cancer cells and interferes with their ability to divide and duplicate thereby, decreasing their chance of survival.
Common Chemotherapy Side Effects in Children and how to manage them
Before getting into the side effects and how to deal with them, it is important to know why they occur. When chemotherapy medication is administered to the body, it attacks rapidly growing cancer cells as well as healthy cells.
This damage of healthy cells is what causes chemo side effects which are temporary because the damaged normal cells are usually replaced by other healthy cells. Factors that determine side effects of this treatment include:
- A patient’s general health,
- The specific chemotherapy medicine, and
- The dose of the medicine.
Some of the common side effects caused by chemotherapy cancer treatment are:
1. Anaemia: Chemotherapy can suppress the production of bone marrow leading to lower levels of red and white blood cells as well as platelets. Low levels of red blood cells cause anaemia which brings about other side effects like fatigue, weakness and shortness of breath because not enough blood is carried to all parts of the body.
Solution: Your child’s blood level should be monitored throughout the treatment and when the level is very low, a blood transfusion can be done to control the level. Chemo might also be halted until the blood count comes up and during that time, you may be asked to prevent your child from incurring injuries and infections.
2. Bleeding and bruising: These are brought about by the lowered level of platelets which help in blood clotting. A person with low levels of platelets (thrombocytopenia) is bruised easily and the bleeding is usually excessive.
Solution: Children with thrombocytopenia need to be extra careful to avoid getting even the slightest injuries, for instance, by avoiding rough games and brushing the teeth with a soft-bristle toothbrush. In some cases, such children might need a blood transfusion.
3. Loss of Hair: Chemotherapy can lead to thinning or loss of hair which will eventually grow back after treatment. However, it might have a different texture or colour.
Solution: How children take the hair loss is different; some may find it difficult to accept the situation. To make it easier for your child, reassure them that the hair will grow back, and you can consider cutting their hair short before the treatment because it might be much easier for a child to watch short hair fall out rather than long hair. When the child has lost their hair, you can get them to wear hats, scarves or even wigs depending on their preference.
4. Nausea and Vomiting: This happens when chemo medicines affect the gastrointestinal tract – the lining of the stomach, intestines and oesophagus. The effect on the intestinal walls is what also causes diarrhoea and constipation effects during chemotherapy treatment.
Solution: There are drugs that can reduce or prevent nausea while others can control diarrhoea. IV fluids can also be used to replace the fluid and nutrients lost from a child’s body.
5. Sores in the mouths, gums and throat: When the lining of the mouth, and throat are destroyed by chemotherapy medicine, mucositis (sores) can be experienced.
Solution: These can be dealt with using a mouth rinse which helps to reduce irritation and by eating softer and cooler foods while avoiding acidic foods and fruits like oranges. Ensure your child goes for regular dental check-ups.
6. Fever: When the white blood cells are destroyed and become reduced in number, it is easy to get infections as white blood cells are the ones that protect the body from infections. A fever can be the sign of a serious infection.
Solution: Once your child starts having fever, take them to a doctor to determine whether they have an infection.
7. Weight gain or loss: Different children are affected differently by chemotherapy medications. It is usually expected that a child will lose weight; however, those who are treated with steroids may have an increased appetite which can lead to gaining weight in places like the back of the neck and cheeks.
Solution: Talk to your child’s doctor about how he or she can maintain a healthy body weight depending on their medical needs. If your child is having a problem with their appetite, offer him or her several small servings instead of three large meals and ensure they remain hydrated by giving them water, broths or juices throughout the day.
8. Pain: Certain chemotherapy drugs cause muscle pain and headaches, among other symptoms.
Solution: When going through chemotherapy, ensure you do not give the child over-the-counter pain medications because they can react negatively when taken during the chemo.
9. Flu-like Symptoms: Some chemo medicines can trigger the body’s normal inflammatory response, leading to flu-like symptoms like coughs, chills and having a runny nose.
Solution: Taking fluids helps to clear mucus. Before taking any over-the-counter medicines, consult your doctor.
10. Organ Damage: Medicines used in chemotherapy may temporarily or permanently affect organs like the brain, kidneys, the heart, lungs and liver, and in some cases, the child’s hearing can also be affected.
Solution: Ensure your child gets frequent blood tests to determine how his or her organs like the kidney and bladder are functioning.
11. Nervous system side effects: Apart from symptoms like fatigue and confusion, when the nervous system is affected by chemotherapy medicine, a child can experience depression after chemo and in rare cases, they can experience seizures. These medicines can also cause peripheral neuropathy when they affect the peripheral nervous system bringing about symptoms like tingling, soreness of muscles and numbness of the hands and/or feet.
Solution: Most side effects on the neuro system go away after treatment. Report to your doctor when your child starts getting neuro system side effects. You can also take measures like protecting the areas with reduced sensation, for instance, by wearing socks or soft-soled shoes when walking, wearing warm clothing in cold weather and wearing gloves when washing clothes or dishes.
Chemotherapy can make a child feel sick, however, these side effects should not stop the treatment from being done to deal with the cancer. Have a talk with your child about the side effects they may experience and get them to tell you whenever they experience something different. That way, your child can be more receptive of the treatment.