Managing treatment side effects

Cancer treatments can cause a number of different short-term side effects in children and young adults. Although the side effects experienced will depend on the type of cancer, its stage and the kind of treatment that is being given, there are many things that you can do to manage these side effects and limit their impact on your child.

A change in taste and smell is a common side effect during or following cancer treatment. Normal taste and smell usually returns two to three months after the treatment finishes. There are a number of things that you can do to help reduce the impact of appetite and taste changes:

• Consuming foods that are high in energy and protein, such as meat, dairy, lentils, nuts and seeds, as part of a balanced diet
• Eating small meals regularly throughout the day
• Experimenting with different foods and flavours
• Keeping a wide variety of foods available
• Eating favourite foods to stimulate appetite

Nausea and vomiting may be caused by the cancer itself or the treatment that is being delivered. There are a number of medications available to treat, prevent or control nausea and vomiting. These medications, called anti-emetics, can be taken as a tablet or a wafer, given by suppository or directly into a vein through a drip. Anti-emetics (medications that help relieve nausea) may be given before treatment and provided to take home. It is important that the medication is taken regularly as directed by your doctor.

To control the nausea or vomiting, we recommend:

• Eating small, frequent snacks (not eating can worsen nausea)
• Eating dry salty foods, such as toast and crackers, and bland foods
• Keeping foods out of sight when not eating and avoid smells of cooking food
• Ensuring to continue fluid intake. Try flat lemonade or electrolyte drinks; if nausea worsens, we suggest drinking these cold and through a straw

Diarrhoea refers to the increased frequency and decreased consistency of bowel motions. Certain cancer treatments are more likely to cause diarrhoea than others. Symptoms can range from mild to severe and generally last for several days after treatment.

Strategies to help manage diarrhoea include:

• Eating small meals regularly throughout the day
• Eating white bread, rice, pasta, bananas and apple sauce
• Ensuring to continue fluid intake, in addition to broth, soup or electrolyte drinks to help maintain salt and potassium levels
• Avoiding foods that can cause gas such as cabbage and broccoli, high fibre foods, raw fruits and vegetables, and greasy, spicy or fried food

Constipation refers to bowel motions that are too hard, too small, too difficult to expel and too infrequent.

To manage constipation, we recommend:

• Drinking plenty of fluids including water, milk, tea, fruit juice or soup
• Eating high fibre foods such as fruit and vegetables and whole grains
• Doing some light exercise if able

Certain types of cancer treatments can be highly taxing on children and young adults, leading to both weight gain and weight loss. Weight changes are commonly caused by treatment-related side effects which affect the process of eating and ability to eat enough to maintain a healthy weight. To learn more about these side effects and how they can be managed, click here.

Mouth sores occur when the lining of the mouth is damaged following chemotherapy or localised radiation therapy. They can be very painful and make it difficult to eat. Good oral hygiene and symptom management are key, such as:

• Brushing teeth regularly
• Eating soft, bland foods to decrease chewing
• Consuming foods at a cold or lukewarm temperature to help reduce pain while eating
• Avoiding acidic or spicy foods

Ask your care team for ways to look after your mouth during treatment and manage mouth sores.

Fatigue is one of the most common treatment-related side effects in children and young adults. This can cause tiredness and low energy, sometimes continuing even after treatment has finished.

To help manage fatigue and tiredness, we recommend:

• Reducing visitor numbers
• Eating food and drink regularly for energy
• Resting
• Finding support for daily activities
• Avoiding long outings
• Low energy activities such as watching TV or reading

Cancer and the effects of treatments can increase the risk of infection. Ways to reduce this risk include:

• Washing hands regularly
• Showering every day
• Cleaning cuts, scrapes, sores and/or stings immediately with warm water, soap, and antiseptic
• Preventing constipation
• Staying away from large crowds of people
• Avoiding risky food choices (shell fish, deli meats, soft cheeses, takeaway foods etc)

Any sign of infection is very serious and can be life-threatening. Seek medical treatment immediately for the following symptoms:

• A temperature of 38°C or higher
• Shivers, shakes or feeling unwell

Thrombocytopenia refers to a reduction in the normal levels of functional platelets, which can increase the risk of bruising and bleeding. If there are any signs of thrombocytopenia, your care team will discuss this with you.

To help prevent injury/bleeding, it’s important to:

• Use a soft tooth brush
• Avoid using aspirin and ibuprofen medications for pain relief (talk to your care team for further information)

For minor bleeding, basic first aid principles apply:

• Apply direct pressure on the wound
• Elevate the injured limb if possible
• Rest

Seek medical help immediately for the following symptoms:

• Rectal bleeding
• Blood in urine
• Coughing blood
• Vomiting blood
• Nose bleeds

Some chemotherapy drugs and radiation therapy can cause hair loss ranging from complete to thinning or patchy loss.

There are a number of strategies that can help manage the impact of hair loss, including:

• Considering cutting long hair short
• Selecting a wig prior to hair loss to help match the colour/style
• Maintaining gentle hair care, using mild shampoos and soft hairbrushes
• Wearing a hat or scarf to protect scalp from cold
• Wearing a hat and/or sunscreen to protect scalp from heat
• Using soft linen, such as a satin or satin-like pillow case