Chemotherapy works by targeting cancer cells, which are cells that rapidly divide as they grow in the body. But some normal cells that also grow quickly can be hurt by chemotherapy drugs. Research is being done to develop better “targeted therapies,” which attack cancer cells but leave healthy cells unharmed. Your doctor has many tools and drugs to effectively manage many side effects of chemotherapy. Don’t be afraid to talk to your doctor about side effects you are having.

Here are the cells affected by chemotherapy, the resulting side effects and suggestions to help manage the side effects:

Blood-producing cells
Blood-producing cells in the bone make a range of blood cells that fight infection, help blood clot and carry oxygen to all parts of the body. When chemotherapy damages the white blood-producing cells, you become susceptible to infections because of a shortage of white blood cells, or with the platelet-producing cells you can bruise or bleed easily because of a shortage of platelets and you can feel weak and tired because of a shortage of red blood cells. Throughout chemotherapy, your nurses and doctors check for low levels of blood cells. If levels are too low, medicines are available to boost them up.

• Managing infection
  Try to avoid cuts and scrapes, wash your hands often, avoid crowds and people with colds, coughs or other infectious diseases. Drink plenty of fluids and bathe daily, using moisturizer to soften dry and potentially cracked skin.
• Managing fatigue
  Understand your energy level and make accommodations. Do things you enjoy when you have the energy but rest or take naps when you feel the need to. Although exercise, when you are tired, seems counterintuitive, many women find activities, such as walking or gentle yoga, invigorating. Talk to your doctor before doing any exercise routine. Eating well is very important, too.

Cells in hair roots
Most women being treated for ovarian cancer lose their hair. The hair will eventually grow back, but can be slightly different in color and texture.

• Managing hair loss
  Some women choose to wear a wig so that the loss of hair doesn’t become an outward manifestation of their disease as they try to go about their life. Because women know their hair will fall out from chemotherapy, some will have parties to cut it or will donate their hair to make wigs for other women with cancer.

Cells that line the digestive tract
Nausea, poor appetite, vomiting, constipation and diarrhea, mouth and lip sores are typical side effects of chemotherapy. Drugs are available to help some of these problems.

• Managing poor appetite
  Some chemotherapy drugs create taste changes in patients. Food may taste salty or bitter but usually tastes normal again once treatment is over. Non-alcoholic mouthwash and other products can decrease dryness of the mouth. It is important to eat nutritious food, high in protein when undergoing chemotherapy. Your doctor may recommend that you see a nutritionist who can help you eat right during this time. Eating smaller meals, a few times a day is often recommended, as is trying to relish food and making it pleasant to experience, like dining with friends and family. Smoking, using tobacco and consuming harsh foods or alcohol increase the severity of these side effects.
• Managing nausea and vomiting
  Often women feel nauseated before a cycle of chemotherapy because of prior experience. Anti-anxiety drugs and complementary medical techniques, such as meditation, relaxation training or ginger, can help. Nausea and vomiting that occurs after chemotherapy can be treated with anti-emetics (anti-nausea) medications. Eating and drinking slowly and after vomiting, and staying hydrated, are very important. These side effects must be managed during chemotherapy treatments because uncontrolled vomiting and nausea can interfere with the patient’s ability to receive treatments.
• Managing diarrhea
  Diarrhea is a common side effect of chemotherapy that usually occurs in the days immediately following a chemotherapy treatment. Patients with diarrhea need to remember that they can become dehydrated quickly and should be sure to hydrate themselves. If hydration is difficult for you, your doctor can order extra fluids for you.
• Managing constipation
  Drink plenty of fluids, eat high fiber foods, move around, try to be consistent with your bowel activity and take a fiber laxative. Talk to your doctor before taking any anti-constipation remedy.
• Managing mouth and lip sores
  Use a soft toothbrush to avoid injuring your mouth and keep your mouth moist, by drinking plenty of fluids. Avoid spicy and harsh foods that can be irritating to your mouth.

Other Side Effects

Nerve Problems
Certain chemotherapy drugs can cause peripheral neuropathy, an increase in numbness caused by damage to the nerves that transmit signals between extremities and the central nervous system. This damage to the nerves often causes a tingling sensation or loss of control in the hands or feet. Acupuncture or massage and physical therapy may lessen these side effects, which are usually temporary and improve or resolve when chemotherapy treatment stops.

Sexuality and Intimacy Issues
Interest in sexual intimacy often decreases for chemotherapy patients for many reasons, including additional stress and the side effects of treatment. Patients need to maintain a positive self-image during this time and sustain open communication with their partners. When a patient is ready to engage in sexual activity, she should consider taking the following actions:

• Make time for rest before and after sexual activity to preserve energy.
• Use water-soluble lubricants as her vagina may be drier than usual due to hormonal changes.
• Experiment to find comfortable positions and avoid those that will tire her quickly.

“Chemobrain”
Many women experience forgetfulness and have trouble with concentration after receiving chemotherapy. This absentmindedness is often temporary; however, about 15 percent of chemo patients experience permanent problems. Since the cause is unknown, no treatment exists for this side effect. Women who have experienced this side effect offer several suggestions for dealing with it:

• Minimize distractions while performing important tasks.
• Keep a daily organizer/journal to keep track of appointments.
• Use the calendar on your computer and voicemail messages to remind yourself of meetings.

The National Cancer Institute offers detailed information about managing the side effects of chemotherapy.