What is it about ?
Cytostatics are drugs that act on cell division and / or on substances necessary for cell growth. They destroy cancer cells or slow down their growth, which ultimately leads to their death.
Cytostatics are a type of “chemotherapy” or “chemo”. These drugs are associated with a whole host of side effects and are often not able to distinguish between malignant cells and healthy cells. They therefore often attack cancer cells as well as healthy cells, such as blood cells, cells that make hair, cells of the gastrointestinal system, nerve cells, kidney cells, liver cells, cells of the muscle of the heart, skin, etc.
Chemotherapy can also trigger a miscarriage and cause abnormalities in the fetus.
Having serious side effects does not mean that chemotherapy is working well. They therefore do not serve as a barometer to know if the treatment is effective.
Where do we meet them?
The side effects depend on the type of cytostatics used and are very different from one individual to another. While the treatment is hardly a problem for some, it makes others very sick.
How to recognize them?
Nausea or vomiting may already begin during the administration of chemotherapy by infusion or within 2 to 6 hours afterwards.
Hair usually begins to fall out 3-5 weeks after the first administration.
What can you do ?
You can keep a diary of side effects at your doctor’s request so that they have a better idea of their severity and frequency.
You can wear a wig to hide the hair loss. After stopping treatment, the hair grows back spontaneously and after 3 to 4 months you will no longer need a wig.
Seek medical attention immediately if you notice any warning signs, such as fever or shortness of breath (see below) or if you are in any doubt.
What can your doctor do?
Nausea and / or vomiting
If the nausea is mild, metoclopramide is given. This medicine acts on the contractions of the stomach and intestine (peristalsis of the gastrointestinal system) and on the vomiting center of the brain. If necessary, corticosteroids will be added.
If this is not sufficient, other drugs may be offered such as those acting on the body’s serotonin receptors (serotonin 5-HT3 receptor antagonist) and / or aprepitant.
Lack of blood cells
The effect of chemotherapy on the bone marrow can cause a decrease in the production of different types of blood cells. These effects only appear after 1 to 3 weeks and anemia only after several months.
- A lack of white blood cells is accompanied by an increased susceptibility to infections. Medicines that stimulate the production of white blood cells are given. In extreme cases, a bone marrow or stem cell transplant may be required.
- A lack of platelets is manifested by bleeding disorders and an increased tendency to bleeding. The number of platelets usually normalizes spontaneously. If necessary, a platelet transfusion can take place.
- A lack of red blood cells results in anemia. Blood transfusions can correct the problem and the administration of erythropoietin (EPO) can stimulate the production of red blood cells.
The following side effects require specific management :
- damage to the muscle of the heart (myocardium);
- inflammation of the nerves;
- lesions of the skin and mucous membranes;
- decreased kidney function;
- lung abnormalities;
- weakness of muscles;
- increased sensitivity to touch and cold;
- liver function disorders;
- allergic reactions.
It is often necessary to change the product or reduce the dose administered.
Anxious patients may take a mild tranquilizer a few hours before administration.
The following warning signs require prompt and appropriate treatment:
Signs of infection :
- fever above 38 ° C;
- chills;
- burning sensation when urinating;
- painful rash in the mouth;
- sore throat.
Your resistance to infections may already be significantly reduced by cancer. Chemotherapy can also destroy white blood cells, further reducing your resistance. As a result, infections can take exceptionally severe forms and should therefore be treated immediately.
Other signs :
- shortness of breath;
- small wounds that bleed for more than half an hour;
- bruises with no apparent cause;
- blood in urine or stool;
- swelling of the arm on the side of the catheter.
Persistent symptoms :
- vomiting lasting more than 24 hours;
- diarrhea lasting more than 48 hours;
- constipation lasting more than 3 days;
- sudden rash.
Want to know more?
- Metoclopramide – CBIP – Belgian Center for Pharmacotherapeutic Information
- Corticosteroids – Belgian Center for Pharmacotherapeutic Information
- 5HT antagonists3 – CBIP – Belgian Center for Pharmacotherapeutic Information
- Aprepitant – CBIP – Belgian Center for Pharmacotherapeutic Information
- EPO – CBIP – Belgian Center for Pharmacotherapeutic Information
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