Lymphoma Side Effects and Toxicity

Lymphoma and its treatments can cause pain and toxicity (side effects in your body caused by treatment).You can better manage these problems when you know what to expect and what to do.This sheet can help. It has facts about pain and side effects from chemotherapy, radiation therapy, and steroid use. It also has important treatment matters, information to tell your doctor, and when to call your doctor.

Chemotherapy Side Effects

Chemotherapy uses drugs to kill cancer cells or keep them from growing. But these drugs also kill healthy cells, which can cause side effects. Side effects vary by the type of chemotherapy drugs used.They include:

Decreased Blood Cell Production: This means that your body has less than normal red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).
Diarrhea: This is when you have runny bowel movements more than several times a day.
Fatigue: This is when you feel like you have no strength or energy, and you feel tired all of the time.
Hair Loss: Chemotherapy may or may not cause hair loss (“alopecia”) anywhere on your body.
Mouth Sores (mucositis):The inside of your mouth can become red or sore because of chemotherapy. Most mouth sores can be treated with medication.
Nausea or Vomiting: You may have nausea (feel like you want to throw up) or vomiting (when you throw up). There are medicines that can stop nausea and vomiting.You should tell your doctor if you have nausea. If the doctor gives you nausea medicine, you should tell him/her whether it is working.
Sterility: Chemotherapy can sometimes produce either temporary or permanent sterility (the inability to have children).This is because some chemotherapy can harm sperm and egg cells.You should talk to your doctor about whether you can store your sperm or eggs before you undergo chemotherapy.
Libido: Chemotherapy can often cause a lower libido (sex drive). Usually a normal libido will return after you finish your chemotherapy treatment.

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Radiation Side Effects

Radiation uses high energy x-rays to kill cancer cells. Radiation can cause side effects.These side effects will appear in the part of your body that is being treated with radiation.They may include:

Fatigue: This is when you feel like you have no strength or energy, and you feel tired all of the time.
Hair Loss: Sometimes radiation causes hair loss, but only in that part of your body getting treated. This means that if you get radiation to your stomach and bowels, you will not have hair loss on your head.This is not the same as hair loss from chemotherapy.
Nausea: You may have nausea (feel like you want to throw up) after radiation treatments.This often happens to people who have radiation to their abdomen (stomach and bowels).
Skin Changes: Your skin might get red and itch or hurt. Skin changes almost always go away after radiation therapy is finished.

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Steroid Side Effects

Very often patients will receive steroids (cortisone, prednisone, dexamethasone, glucocorticoid). These medicines may have side effects, including:

Insomnia: This is when you are not able to fall asleep.
Increased Appetite: This is when you feel hungry all of the time.
Mood/Personality Changes: This is when you feel more angry, sad, or anxious than normal. You may also feel that you are more emotional than before.
Weight Gain: This is when you gain a lot of weight in a short period of time.

Steroids are often used for short periods of time, so you may not experience any of these side effects.

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Important Treatment Matters: Things to Help Yourself

There are some things that you can do to lessen the side effects of chemotherapy or radiation:

You should drink a lot of liquids before chemotherapy. These can include water, non-caffeine soft drinks, and clear broth.
You should avoid citrus or tomato juice if your mouth is sore. Milk and cream can be soothing to drink.
You should eat smaller meals more often, rather than a few large meals each day.

You may be able to take medicines to prevent nausea before chemotherapy.You should speak with your doctor about this.
If you experience vomiting or diarrhea, you should speak with your doctor about how you can avoid dehydration (losing too many body fluids).
You should avoid crowds or people who may have a cold or flu if your blood counts are low.
If you are taking steroids, you may want to avoid making important decisions.This is because you may not be able to think clearly.

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Important Information to Tell Your Doctor

You should tell your doctor and health care team about any other medications you are taking. This includes any herbs, vitamins, herbal supplements, large amounts of foods/drinks (such as tea), or medicine given to you by another doctor. This is because they may affect your lymphoma treatment.

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When to Call Your Doctor

You should speak with your doctor or members of your health care team about any matter that seems different or is bothering you during your treatment. If you experience any of these issues, you should contact your doctor immediately:

Fever of 100.5 F (38.6 C) or higher (you may have chills before the fever).
Constipation or diarrhea that lasts for more than 48 hours.
Dizziness (feeling unbalanced or lightheaded).
Severe shortness of breath (feeling like you cannot breathe).
Bleeding that does not stop quickly.
Unusual bruising that does not go away.
Constant nausea or vomiting, even though you are taking nausea medication.
Not being able to eat, drink, or swallow for more than 24 hours.

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