Part III Management of the Side Effects of Chemotherapy and Radiotherapy

Chapter 1

How to Cope with the Side Effects 

Dealing with Type 3 Side Effects

Liver and Kidney Injuries

Liver is the most critical organ in the body’s metabolism and detoxification. In addition, it is a vital organ capable of regenerating some of the lost tissue. For liver injury, some drugs may be helpful in protecting liver. For example, amifostine (Trade name Ethyol®) is indicated to reduce the cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer. Other than amifostine, some natural products, such as milk thistle, may be useful in protecting or improving liver health.

Kidney toxicity is also referred to as nephrotoxicity, which is one of the most common toxicity resulted from chemotherapy. There are two important indicators of nephrotoxicity: BUN and creatinine. When kidney is damaged, blood levels of BUN and creatinine are usually elevated. Because urea is a waste form of nitrogen in the body, elevated BUN levels indicate that there is extra nitrogenous waste in the blood stream not properly filtered off by the kidney. As to creatinine, it is produced from creatine, an important molecule in energy production of muscle. Creatine is constantly converted into creatinine, which is constantly filtered off by the kidneys and disposed of in the urine.

In other words, kidney is critical in filtering off both BUN and creatinine to remove waste from the body. Therefore, when kidney function is affected by chemotherapy, blood levels of both BUN and creatinine are elevated. 

Peripheral Neuropathy

Neuropathy means disease or dysfunction of the nerves, which can be a side effect of chemotherapy. For peripheral neuropathy, the most commonly affected areas are the tips of fingers and toes. Common symptoms of peripheral neuropathy include tingling, burning, numbness/pain in the affected areas, and loss of balance, although sometimes other areas may also be affected. Massage one’s hands and feet may help improve blood circulation and temporarily relieve the pain. For a patient with peripheral neuropathy, he/she should see a doctor about any neuropathy symptoms to prevent further nerve damage. 

© Jiajiu Shaw, 2023

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Part III Management of the Side Effects of Chemotherapy and Radiotherapy

Chapter 1

How to Cope with the Side Effects 

Dealing with Type 2 Side Effects

Anemia (lower levels of red blood cells)

As mentioned before, both chemotherapy and radiotherapy can lower RBC count and result in anemia. Generally, the RBC count for a healthy adult is about 5 x 10⁶/µL. Because chemotherapy or radiotherapy could damage bone marrow, which produces RBCs, RBCs are not replaced at the same rate as they are being destroyed. As a result, the RBC count becomes much lower than that in a healthy person, a situation referred to as anemia.

If patients become anemic due to cancer therapies, they will have reduced blood levels of RBCs, which carry oxygen from the lungs to the body’s muscles and other organs. As a result, patients can become tired more easily; patients may also feel dizzy or light-headed when they quickly stand up from a crouching position. Although a normal healthy body can replenish lower levels of RBCs, it does take time. In addition, multiple treatments of chemotherapy or radiotherapy can hamper the reproduction process of RBCs. During the cancer therapy, when the RBC count is significantly below acceptable levels, it could cause a physician to temporarily suspend the chemotherapy or radiotherapy. In more serious conditions, blood transfusion or treatment by a specific bone marrow stimulating drug(s) may become necessary. Some of these drugs will be briefly described in the following sections.

Otherwise, what can a patient do? First, a patient should watch the diet. For example, eat nutritious food including liver, red meat, and green vegetables (such as spinach) to supplement iron in blood, which is important for maintaining RBC levels. Most of the body's iron is bound to hemoglobin in RBCs. When red blood cells die, the released iron is carried by transferrin (iron-binding plasma glycoprotein) to the bone marrow, to make new RBCs.

Iron pills can be very useful for treating anemia, but they should be taken under the prescription of the physician because of the potential side effects. When too much iron is taken, it could slowly accumulate and could become toxic in different organs, including the liver and heart.

In addition to iron supplement, patients should take some other dietary supplements, such as vitamin C, which is important for iron absorption, and vitamin B₁₂, which is important in maintaining normal RBC formation. Furthermore, patients should rest often to conserve energy and not to conduct any vigorous exercises.

Leukopenia (low WBC count)

There are reports about a natural chemical, hesperidin, which may be helpful in increasing WBC count. Hesperidin is abundant in the peels of citrus fruit, including orange, lemon, and grapefruit. One can be creative in using the peel by blending the peel in juice or in food for easier consumption.    

Thrombocytopenia (low platelet count)

Although it does not happen for all chemotherapeutic agents, thrombocytopenia does happen to many patients. Thrombocytopenia is not uncommon for acute leukemia patients treated with radiotherapy; under serious condition, it could even be life-threatening. Similar to anemia and neutropenia, thrombocytopenia is usually temporary. When the platelet count is low (between 15,000 and 30,000 per µL), unexplained bruises may happen. When the platelet count is even lower (under 10,000 per µL), a patient may need a platelet transfusion.

As a patient, one must be careful in daily activities and try to avoid any injury because the bleeding might take much longer than normal to stop. In addition, patients need to be careful in conducting any physical activities to avoid cutting/bleeding. 

Hair Loss

Not all chemotherapy drugs cause hair loss. Some people may lose all the hair on their heads and other body hair, while others may not lose much hair. For many people, hair loss may be a difficult aspect to deal with. In this case, using a wig to cover the head could make a patient feel more comfortable. Several weeks after the therapy, the hair should begin to grow back; the new hair may be slightly different in color and texture. Usually, the new hair will be thin and soft, like baby’s hair, but will often return to its original color and texture after several months.

 

Diarrhea or Constipation

 

Crypt cells in the intestine are likely to be attacked by chemotherapy drugs and may result in diarrhea. Some chemotherapeutic drugs may cause constipation. Patients with constipation should consider taking a stool softener, such as Colace® or Senekot®. Also, drinking a lot of liquid may help prevent constipation.  If a patient has several watery stools or constipation, the patient may want to call his/her doctor or nurse.

Mouth Sores

Because epithelial cells in the mouth and esophagus are fast dividing, they are easily damaged by chemotherapy and radiotherapy. As a result, mouth sores occur often with chemotherapy and radiotherapy. For a patient to assuage that, rinse the mouth often with salty water. If a patient develops painful mouth sores and the situation is not relieved, one should call his/her physician or health practitioner and a special mouth rinse may be prescribed for the patient. If a commercial mouth wash is used, avoid those that may be irritating to the mouth.

© Jiajiu Shaw, 2022

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Part III Management of the Side Effects of Chemotherapy and Radiotherapy

Part III

 

Chapter 1

How to Cope with the Side Effects 

Coping with the Side Effects

    Before, during, and after radiotherapy or chemotherapy, there are some prescription drugs and natural products that can be used to reduce specific side effects induced by the therapy. In addition, there are also some activities that patients can do to reduce the discomfort from cancer therapies. Let’s look at them according to the types of side effects.

Dealing with Type 1 Side Effects

    In general, patients should first consult their doctors to find out what medications are expected to work best for their situations. Other activities are described under individual side effects below.

Fever and Infection

Chemotherapy often lowers WBC count in the blood resulting in neutropenia. Because white blood cells are very important in fighting against infection, when a patient’s WBC count is lower than normal level, the patient is more susceptible to infection.

 

To reduce the chance of infection, patients should avoid going to public areas, such as theater and shopping mall. Also, avoid close contact with anyone who is ill. Wash hands frequently and when washing hands, use appropriate hand soap especially when the hands are visibly soiled.  In recent years, alcohol-based hand sanitizer is becoming popular and it can be very effective in reducing the number of germs. In addition, do not eat raw food including fish, beef, oyster, and food containing raw egg. Thoroughly wash the vegetables and fruits for salad. Wash the cutting board especially after cutting raw meat, poultry, or fish. A patients should call his doctors if the body temperature reaches 101 °F (or 38.3 °C) or higher.

 

Flu-Like Symptoms

After a chemotherapy treatment, some people may experience flu-like symptoms such as pains and muscle aches. If not serious, patients can take over-the-counter medications such as Tylenol or Advil to relieve the pain. However, if the symptom persists, patients should contact their doctors for prescription drugs. In many states and Washington D.C., marijuana may be prescribed by physicians for pain management.

 

Nausea and Vomiting

 

For the management of nausea, patients should try not to skip meals. An empty stomach can worsen the symptom. Eat small and light meals. Drink lots of fluids, such as water, tea, and juice. Acupressure is being used by some people to reduce nausea basically by pressing a specific acupressure point near the base of the arm.  There are special wristbands available for such an acupressure; the wristband usually has a knob to apply pressure to the correct spot.  Further, there are some anti-nausea over-the-counter drugs available to prevent and treat nausea and vomiting due to chemotherapy.

 

Fatigue

Fatigue is a common symptom for people treated for cancer. For some, the fatigue may last a long time after treatment, and it can discourage them from physical activity. However, proper exercise can actually help patients reduce fatigue. Physical therapy can also help patients maintain strength in the muscles, which could help fight the sense of depression that sometimes comes with physical fatigue.

 

Most cancer drugs can reduce the RBC count and may cause anemia, which can make patients feel tired easily. Most people have to make some adjustment in work and family responsibilities. For anemia patients, it’s a good idea to plan their major activities and try to maintain their regular daily activities as much as possible. The fatigue should gradually go away after the patients recover from chemotherapy.

 

Doing regular exercise such as yoga, taichi, and walking may be helpful in relaxation. If necessary, physicians can prescribe iron supplement or other newer drugs to boost the blood cells. These include Epogen (by Amgen), Neupogen (by Amgen), and Leukine (by Berlex), which function as colony-stimulating factors because of their ability to stimulate the formation of blood cells in the bone marrow. 

 

Appetite and Taste Changes

During chemotherapy, one may lose appetite and becomes more sensitive to odors. As a patient becomes healthier, his/her appetite will improve. Again, one should try to stay with healthful food (low fat, low calorie, and high fiber) and drink a lot of liquid. Also, it’s a good idea to avoid spicy food. For some people, eating too much spicy food can result in diarrhea.

 

With a loss of appetite, important nutrients may be lacking. Suitable dietary supplement products may be used to supply needed nutrition.

Menopause

Depending on a woman’s age and the type of chemotherapy administered, chemotherapy may temporarily stop the periods. As a result, one may experience symptoms such as hot flashes, decreased libido, vaginal dryness, mood changes, and sleeping disturbances. If a patient experiences any of these symptoms, she should call her doctor or nurse about suitable treatment for the symptoms. Meanwhile, consider eating soy products (such as soy milk and tofu) which may reduce hot flashes. Wear light cotton pajamas to help prevent overheating when sleeping. Use vaginal moisturizers or other water based lubricants as needed.

 

© Jiajiu Shaw, 2022

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Part III Management of the Side Effects of Chemotherapy and Radiotherapy

Part III

 

Chapter 1

How to Cope with the Side Effects 

The major side effects of chemotherapy and radiotherapy include tissue/organ injury which occasionally may be fatal. In addition, these side effects may prevent doctors from delivering the prescribed dose of therapy according to the predetermined schedule in the cancer treatment plan. It is important to understand that the expected outcome from therapy is based on delivering treatment at the dose and schedule according to the well-designed and predetermined treatment plan. In other words, not only are the side effects of chemotherapy or radiotherapy undesirable, they may also limit a patient’s ability to accept the complete therapeutic regimen (both dose and schedule) to achieve the best outcome.

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy (Cont'd)

4. Other side effects of radiotherapy

The medium- and long-term side effects of radiotherapy that one can see or feel depend on the tissues/organs that receive the radiation. With today’s technological improvement, these side effects can be significantly reduced.
 Because radiotherapy is being used in different types of cancers and every patient’s situation is different, the side effects could vary from patient to patient. Some of the more common side effects from radiotherapy are described below:

Fatigue or tiredness

        Fatigue is among the most common symptoms of radiotherapy. Lack of energy and an overtired feeling are common symptoms. Depending on the type of cancer and the regimen of the radiation treatment, the degree of fatigue may be different. Usually, patients should gradually recover from the lack of energy several weeks after the completion of radiotherapy. 

Dryness

        Radiotherapy on patients with head and neck cancer often causes the release of free radicals in saliva glands, resulting in lack of saliva (abnormal dryness of the mouth or xerostomia). Radiation therapy may also cause dry eye (xerophthalmia). Similarly, vaginal mucosa may be dry after pelvic irradiation.

Fibrosis

        Fibrosis is the development of excessive fibrous connective tissue in an organ or tissue. As a reactive response to the high radiation energy, irradiated tissues tend to be inflamed and gradually become less elastic. Overtime, certain irradiated area may gradually become fibrosis. This happens more often for lung cancer patients being treated with radiotherapy.

Cancer (secondary malignancy)

        Because radiation can alter certain DNA, it is also a potential cause of cancer, albeit a low probability. Some patients may develop secondary malignancies several years after receiving a course of radiation treatment. In most cases, this risk is greatly outweighed by the reduction of the primary cancer.

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy (Cont'd)

3. Activation of immunologic responses

    In addition to producing the direct DNA damage, radiation can also produce a lot of free radicals, including reactive oxygen species (ROS), and cause indirect damages to normal tissues/organs.  The delicate immune system can also be disturbed by this oxidative stress, causing extraordinary number of immunological responses, including the abnormal release of many cytokines.

    Cytokines are regulatory proteins released by cells of the immune system. It has been reported that a number of cytokines may be induced by radiation, including tumor necrosis factor alpha (TNF-α), IL-1, IL-4, IL-5, IL-6, IL-8, IL-10, and transforming growth factor beta (TGF-β).  The alteration of cytokine levels in blood, skin, or other tissues can cause a number of pharmacological responses. 

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy (Cont'd)

2. Damage to cell renewal

      The following side effects are under a class called cell renewal effects.

Damage to bone marrow 

Bone marrow is the flexible tissue in the hollow interior of bones. It is responsible for the production of blood cells, including RBCs, WBCs, and platelets. If a person is exposed to a high dose of radiation for too long (especially on pelvis, chest and other bones), one can suffer bone marrow damage. As a result of radiotherapy, a patient may suffer from low WBC count (neutropenia or leukopenia), low RBC count (anemia), and/or low platelet count (thrombocytopenia). As explained in the previous chapter, neutropenia may increase a patient’s chance of infection, anemia may cause fatigue, and thrombocytopenia can increase a patient’s risk of bruising and bleeding.

 On the other hand, radiation damage to bone marrow is not completely negative. For patients that require bone marrow transplantation, a high dose TBI becomes a positive tool in that unhealthy bone marrow cells are “wiped out” by high-dose radiation before a patient receives healthy bone marrow cells or cord blood cells. 

Hair loss (alopecia)

        Radiotherapy often causes hair loss on the body part being treated [35, 36]. However, hair loss from radiotherapy is usually limited to the area treated by the radiation. For patients who receive radiotherapy for brain cancer, the most pronounced side effect may be hair loss. In this case, radiation-induced hair loss could be permanent; this is different from chemotherapy on other part of the body wherein hair loss is more likely temporary.

Anemia  

        Depending on the dose and the time of treatment, radiotherapy may or may not cause anemia for cancer patients. Many patients experience anemia at some point during treatment; in serious situations, it may cause aplastic anemia.

 Aplastic anemia is when the hematopoietic stem cells in bone marrow are seriously damaged. As a result, all blood cells are not adequately produced, and could be fatal in some cases. One of the most important pioneers in radioactivity, Marie Curie, died from aplastic anemia which was believed to have resulted from her long-term exposure to the radioactive materials she studied.

Diarrhea

 

  When the lining of mouth, stomach, and intestines are injured by radiotherapy, it may cause diarrhea. It is common to have diarrhea during or after radiotherapy treatment on the stomach or abdomen. The diarrhea can gradually get worse as the treatment goes on.  Once the treatment ends, the diarrhea normally goes away gradually over a couple of weeks, but for some people it may take a little bit longer.

Skin damage

        Radiotherapy can induce tanned (hyperpigmentation), irritated, peeling or burned skin. Because recent radiotherapy technology utilizes higher radiation doses, skin damage becomes a problem that happens more often. On the other hand, in the most recent radiosurgery, such as stereotactic radiotherapy, because radiation is applied from different direction, skin damage is significantly reduced.  

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy (Cont'd)

1.       Damage to the DNA of normal cells 

 The potential adverse effects of radiotherapy to the DNA of normal cells may result in tissue/organ damage and potentially secondary cancer. This is mainly due to (1) the direct exposure of normal cells to radiation, and (2) the indirect effect from the free radicals generated by radiation, which might result in the modification of certain genes generally referred to mutation. As a result, there is a possibility that certain cancer might be induced in the future, also known as secondary cancer, especially if high radiation dose is used often. 

In recent years, significant technical improvements have been made to greatly reduce this type of potential side effect. Examples of the newer radiotherapy technologies are described in the following chapter.

© Jiajiu Shaw, 2021

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Radiotherapy and Its Side Effects: Chapter 2 - Side Effects of Radiotherapy

PART II

Chapter 2

Side Effects of Radiotherapy

Although radiotherapy is a major and often effective modality in treating cancer patients, it can inflict serious damage on healthy tissues/organs. Because radiotherapy utilizes high energy radiation to kill cancer cells, injury to normal organ is almost inevitable. For example, the acute side effects of radiotherapy can occur on any surrounding normal tissues be it skin, brain or lung.

     Fortunately, many of the side effects caused by radiotherapy are reversible, but some may not become apparent until months or even years later, such as secondary tumor formation. Fortunately, modern technologies in radiotherapy can significantly reduce the radiation exposure of normal tissues and reduce the side effects thereof.

In general, the side effects of radiotherapy can be summarized in the following four categories:

          1. Damage to the DNA of normal cells
2. Damage to cell renewal
3. Activation of immunologic responses
4.  Other side effects of radiotherapy

© Jiajiu Shaw, 2020

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Chemotherapy and Its Side Effects: Chapter 3 - Side Effects of Chemotherapy

D. Other Side Effects

D.4. Mucositis

Mucositis refers to the inflammation on the mucous membrane in the digestive system. It is one of the side effects resulted from both chemotherapy and radiotherapy. It can occur anywhere along the gastrointestinal tract starting from the mouth. Mucositis in the mouth is often referred to as oral mucositis, which is a common side effect for patients treated by chemotherapy or radiotherapy. Severe mucositis can lead to other complications including infections and difficulty to eat.

© Jiajiu Shaw, 2020

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen.

Chemotherapy and Its Side Effects: Chapter 3 - Side Effects of Chemotherapy

D. Other Side Effects

D.3. Cardiovascular toxicity (Cardiotoxicity)

Cardiotoxicity is associated with many anticancer drugs, particularly a very important class of anticancer drugs, anthracyclines. In fact, their use in cancer treatment is limited by a cumulative dose-dependent cardiotoxicity. Studies indicated that, at a cumulative dose of 550 mg/m², there was a significant increase in the development of heart failure; the use of smaller divided doses did decrease the chance of left ventricular ejection fraction. This cardiotoxicity induced by anthracyclines can cause irreversible heart failure and even fatality in some cases. 

In addition to anthracyclines, many other anticancer drugs may affect the cardiovascular system. In today’s oncology, combination therapy is becoming more popular and this could also increase the chance of cardiotoxicity.  

© Jiajiu Shaw, 2020

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen.

Chemotherapy and Its Side Effects: Chapter 3 - Side Effects of Chemotherapy

D. Other Side Effects

The above side effects are directly related to the rapid growth of cells. There are other significant side effects that are not directly related to the fast growing of normal cells. These side effects include liver damage, kidney damage, pain, rash, constipation, nausea, vomiting, weight loss, ototoxicity, electrolyte abnormality, cardiotoxicity, and depression of the immune system. Among them, liver and kidney damages are most critical and are often the sources of other side effects. Some of these side effects are described below.

© Jiajiu Shaw, 2020

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen.

Chemotherapy and Its Side Effects: Chapter 3 - Side Effects of Chemotherapy

Part I

Chapter 3

Side Effects of Chemotherapy

      Chemotherapy can result in a wide range of side effects; many of them are due to its adverse activity on the fast-growing normal cells of the body such as bone marrow cells, hair follicle cells, and crypt epithelial cells on the small intestine lining. Other effects are due to its adverse activities on vital organs such as liver, kidney, and heart. Although the side effects induced by individual drugs can be different from drug to drug, they can be generalized and described below.

A.    Bone Marrow

Because most anticancer drugs tend to damage fast-growing bone marrow cells, which produce new blood cells, blood-related side effects are not unexpected as a result of chemotherapy. Basically, there are three major blood-related side effects resulted from bone marrow damage by chemotherapy; they are briefly described below:

A.1. Neutropenia

Neutropenia is defined as an abnormal decrease in the number of neutrophils, an abundant type of granular WBC that is highly destructive of microorganisms. A low WBC count may leave a patient vulnerable to bacterial infection and the chemotherapy regimen has to be put on hold until the WBC count is back to an acceptable level for the chemotherapy to resume. This is often a problem that interferes with the chemotherapy regimen.

A.2. Anemia

Anemia is defined as a deficiency of hemoglobin (Hb), which is an iron-containing protein that carries oxygen from the lungs to the body’s brains, muscles, tissues, and other organs; oxygen is critical to the health of tissues and organs. Symptoms of anemia include light headedness, tiredness, or dizziness when a patient stands up suddenly from a crouching position.

A.3. Thrombocytopenia

Thrombocytopenia refers to the condition of lower than normal platelet count. Platelets play a fundamental role in hemostasis (a complex process that causes the blood to clot and bleeding to stop) and are a natural source of growth factors including platelet-derived growth factor (PDGF), which plays a significant role in the repair and regeneration of connective tissues. A low platelet count may cause a person to experience bruising more easily or excessive bleeding. Patients with acute myeloid or lymphocytic leukemia often experience low platelet count. This is especially true when patients with acute leukemia are treated with chemotherapy

All of these three side effects are related to bone marrow damage and they can be diagnosed through the complete blood count (CBC) which represents the three types of cells in blood.

Currently, there are several drugs approved by the FDA to reduce individual side effects resulted from bone marrow damage. These drugs will be discussed later. In addition, some natural products have been claimed to have certain protective effects on bone marrow damage. However, one needs to look into the scientific evidence before making any conclusion or decision.

© Jiajiu Shaw, 2020

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen.

Status and Update of this Blog, September 30, 2018

Since this blog started on 9/7/2015, this blog has been viewed for 14,641 times by people around the world.

The first five countries are Israel (8,762), United States (2,796), Ireland (589), Russia (547), and Germany (546). The other viewers were from Ukraine, Brazil, United Kingdom, Japan, Spain, France, Cyprus,  Hong Kong, Canada, Italy, Thailand, Philippines, India, Malaysia, Mexico, Singapore, Chile, Argentina, Puerto Rico, Kenya, Brunel, etc. Isreal has moved up to the first place and United States of America has dropped to the second.

As to the browsers, 44% used Chrome, 29% used Firefox, 14% used Explorer, 8% used Safari, 1% used Opera, and the rest by all others. It is pretty clear that Chrome has been and is still the primary browser.

As to the operating systems, 44% used Windows, 18% used Linux, 14% used Android, 14% used Macintosh, and the rest by other systems. It is obvious that Windows is the most popular operating system.

One recent happening to share with you is that, as the principal investigator (PI), I have recently received another research grant from National Institutes of Health (NIH) of the United States to investigate a novel small molecule to reduce the side effects incurred by total body irradiation. The news release can be found on the website of 21^st Century Therapeutics, www.21-cti.com.

By the way, if you’d like to read more than just my blog, you can order my second book (SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY) from amazon.com. Meanwhile, please continue to read my blog and recommend it to your loved ones and friends.

Thank you for our visit.

© Jiajiu Shaw, 2018

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. All contents posted are extracted from the book, "SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY", prepared by Dr. Jiajiu Shaw, Dr. Frederick Valeriote, and Dr. Ben Chen. 

Status of this blog as of November 13, 2016

As of November 12, 2016, this blog has been viewed for 4,283 times by people around the world. The top three countries are United States (1,680), Israel (1,298), and Germany (528). People in many other areas are also visiting. These include Brazil, Russia, Taiwan, France, Italy, Philippine, Thailand, United Kingdom, India, Malaysia, Mexico, Singapore, Chile, Argentina, Puerto Rico, Kenya, Brunel, and more. Thank for viewing my blog and I sincerely hope that you can learn something from my blog.

As to the browsers used, 51% used Chrome, 22% used Firefox, 15% used Explorer, 6% used Safari, 2% used Qt, and the rest by all other browsers. Again, Chrome is still the primary browser.

As to the operating systems used, 65% used Windows, 18% used Macintosh, 5% used Linux, and the rest by other systems. It is clear that Windows is the most popular operating system used.

By the way, my 2^nd book, Side Effects of Chemotherapy and Radiotherapy, was published in October 2016. If you are interested, the book is available at shawcreativeinc.com and at amazon.com.

Please continue to read my blog and recommend it to your loved ones and friends. Thank you for your visiting.

  

Disclaimer: This blog is written solely for informational purposes. It does not constitute the practice of any medical, nursing or other medical professional health care advice, diagnosis, or treatment. Some of the contents posted are extracted from the two books I published, IS CANCER IN US and SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY.

Novel/Unconventional Methods for Cancer Treatment (3)

(3) Ozone Treatment: Using Oxygen to Kill Cancer Cells

How does the ozone treatment work?  First of all, we need to explain the difference between ozone and oxygen.  Ozone is a pale-blue triatomic gas (molecular formula O₃), that converts into oxygen (molecular formula O₂) under normal condition.  Ozone is a very strong oxidizing agent and maybe that is why it is being used instead of oxygen.  Secondly, it is believed that cancer cells are anaerobic and they will die under a higher oxygen condition.

One example of ozone therapy involves removing part of the blood from the body, saturating the blood with ozone, and then putting the ozone-rich blood back into the body.  Another example is to simply inject by I.V. a fluid saturated with ozone or oxygen into the body.  In both methods, ozone is gradually converted into oxygen in the body.  Both methods are based on the same theory that high oxygen concentration in the blood will kill cancer cells.

I may not disagree with the theory but I am not sure if this technology is good enough in practice.  In my opinion, there are potential issues to be answered: Will the method be able to deliver high enough concentration of oxygen to the tumor to kill cancer cells?  How about the potential side effects to normal cells?  It is known that too much reactive oxygen species (ROS) can be increased by chemotherapy, radiation, and many other factors.  In this case, the high oxygen concentration in blood could increase ROS in different organs and could be potentially harmful to some normal cells.

Some people believe that under higher oxygen concentration, cancer cells will die.  Theoretically, if cancer cells are placed under any conditions that are not suitable for them to grow, they will die.  The same thing happens to normal cells.  As I mentioned in the early sections, most cancer cells are derived from normal cells, thus, they are similar to normal cells in many ways.  Macroscopically speaking, for any conditions that normal cells can grow, cancer cells will grow.  However, cancer cells can grow under certain conditions that normal cells cannot grow. 

With that understanding, it is reasonably to conclude that a simple oxygen treatment might not work satisfactorily for cancer treatment and significant improvement may be necessary.  

© Jiajiu Shaw, 2016

All contents posted in this blog are extracted from the book "IS CANCER IN US", available at Amazon.

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