Managing chemotherapy side effects

Metallic taste

This wasn’t a side effect from my chemo but rather from one of the antibiotics I had for ten days or so for pneumonia. It was utterly revolting and constant, and anything which is constant becomes sort of overpowering and all encompassing, even water tasted disgusting. Here is what helped:

• avoiding metal cutlery, chewing gum or mints (I used the sugar-free kind)
• using spices and herbs more heavily than usual
• lots and lots of tooth brushing.

Although sometimes the answer was eating Doritos constantly as this overpowered the metallic taste!

Dry mouth

…or just a yucky feeling. Keep well hydrated and try things like a cube of pineapple to stimulate salivation, this also helps if food tastes different or bland. 

Mouth ulcers

The pineapple above helps a dry mouth, unless you have mouth ulcers, in which case it feels like you are eating battery acid so avoid. Washing your mouth out with a salt-water solution twice a day after tooth brushing can be helpful. An alternative is to use Caphosol oral solution, which contains phosphate and calcium and works to lubricate the oral tissues. This is available over the counter but be warned that it isn’t cheap, though it is also available on prescription. Over-the-counter ulcer remedies such as Bonjela and Iglüu can also be useful.

Dry eyes

Drops, drops, drops! There are lots of over-the-counter dry eye drops available. Use them regularly, about four times a day, and before bed. Alternatively, use a thicker ointment at night, these work very well, but can make your vision a bit blurry so are better before bed.

Dry, chapped lips

Basically everything that can get dry gets dry! You might also get sores in the corners of your lips. Here, anything with lanolin in it helps, so brands like Lanolips, or the nipple cream Lansinoh.

Diarrhoea

This didn’t happen to me but essentially most people on chemo will get either diarrhoea or constipation. The answer to diarrhoea is to keep hydrated, and if prescribed use loperamide medication, but be sure to ring your oncology team as your chemo dose may need adjusting.

Constipation

Keep hydrated, eat plenty of fibre and keep active – it literally shakes things down and gets things moving. Use the meds if you need them; bulking agents such as ispaghula husk (Fybogel) are a natural option. An osmotic laxative can be used to pull water into the stool, such as Movicol or Laxido. These can be really effective and you can adjust the dose as needs be. Start off with one per day but you can increase up to eight sachets a day as needed.

Nausea

For me this was very mild and occasional, but the answer to this one is often to take the drugs, take all the meds you are offered, and tell them if and when you need more or something else! Non- medication remedies include eating small amounts regularly, to stop hunger worsening the nausea, and remedies such as peppermint and ginger.

Abdominal pain

Cramping pain can be related to diarrhoea or constipation but can be treated with over-the-counter medications such as Buscopan.

Sore hands and feet

…or palmar-plantar syndrome. Moisturise, moisturise and then moisturise again. I have sat with my hands in a pot of cream while watching Netflix and it really does make a difference. Ultimately though, when it got significantly worse, with blistering and severe pain, the answer was to drop the chemo dose and then change to a different chemotherapy.

Fatigue

This is more difficult to answer, but you need both rest and to keep moving. Exercise during chemotherapy can help with fatigue and to maintain fitness levels but it is also important to listen to your body and rest when you need to. Even though I am not very good at that – I am much better at advising my patients what to do!