The following are some tips to help lymphoma patients deal with the side effects of their treatment.
Myelosuppression occurs when chemotherapy or radiation interferes with the ability of the bone marrow to produce an adequate number of blood cells.
- Treatments may be stopped, delayed or reduced to give the bone marrow a chance to recover.
- Injections of growth factors can also be effective. Growth factors are chemicals found naturally in the body that stimulate the bone marrow to make blood cells.
- Mild exercise and enjoyable distractions can also help.
Neutropenia occurs when myelosuppression causes a decrease in the primary white blood cells. A low count of these blood cells can lead to infection.
- Avoid crowds or people with colds.
- Wash your hands often or use a hand sanitizer throughout the day to kill germs.
- Call the doctor right away if you have any of these signs of infections: a temperature of 100.5°F or higher, severe chills, a cough, pain, a burning sensation during urination or any sores or redness.
Thrombocytopenia occurs when myelosuppression depletes the number of platelets in the blood. Platelets help start the blood clotting process, so a low count can result in easy bruising.
- Do only mild, low-impact activity for exercise, such as walking or swimming.
- Shave with an electric razor instead of a blade.
- Use a soft-bristle toothbrush.
Anemia occurs when myelosuppression causes a reduction in the number of red blood cells and hemoglobin. Anemia can cause patients to feel very tired.
- Take short rests when you are tired. Avoid long naps during the day so that you can sleep well at night.
- Add mild exercise, such as walking, to your daily routine.
- Balance activity with rest. Save your energy for important tasks.
- Drink plenty of water. Dehydration adds to fatigue.
- Eat small meals frequently throughout the day.
- Talk with your doctor about medications or treatments that may help manage your anemia.
- Get up slowly from lying or sitting positions to reduce dizziness.
- Consider cutting your hair short before treatment starts.
- Think about getting a wig, hat or scarf before your hair loss starts. That way, you can get a wig that matches your hair, and you will be ready with head coverings if you choose to use them.
- Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats or scarves.
- Be gentle to your hair and scalp. Use low heat when using a hair dryer.
- Pat hair dry rather than rubbing it with a towel.
- Use a soft brush and a wide-tooth comb when fixing hair.
- Avoid dying your hair or using chemicals on it.
Nausea and Vomiting
- Consume a liquid diet before chemotherapy (broth or consommé, water, etc., but no milk).
- Ask your doctor about getting a prescription medicine to control nausea and vomiting. Make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse again.
- If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.
- Eat smaller and more frequent meals rather than a few large meals each day.
- Try eating foods and drinking beverages that have made you feel better in the past when you’ve had the flu or were nauseated. These may be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda or others.
- Do not eat fatty or fried foods.
- Avoid foods that are too hot or too cold, too sweet or too spicy.
- Avoid strong or offensive odors.
- Get plenty of fresh air.
- Ask your doctor or nurse if he or she can help you learn a relaxation exercise. This may make you feel less anxious and more in control and decrease your nausea.
- Ask your doctor or nurse about using acupressure bands on your wrists, which may help decrease your nausea.
Upset Stomach and Diarrhea
- Drink plenty of fluids slowly and frequently.
- Avoid drinking coffee, tea and alcohol.
- Avoid sweets as well as fried, greasy or spicy foods.
- Eat low-fiber foods such as eggs, potatoes, white bread, or creamed cereals and foods included in the BRAT diet (bananas, rice, applesauce and toast).
- Avoid dairy products such as milk, cheese or ice cream.
- Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn and dried beans.
- Look for signs of dehydration, including dry mouth or skin, decreased urine and dizziness or lightheadedness when you stand up.
- Drink plenty of liquids (8 glasses a day).
Mouth and Lip Sores
- Keep your mouth and lips clean and moist.
- Use lip balm or another lip moisturizer.
- Use a soft toothbrush and nonabrasive toothpaste.
- Brush your teeth after eating.
- Use mouthwash that does not contain alcohol.
- Frequently rinse your mouth with warm salt water.
- Avoid flossing your teeth if your blood counts are low.
- Use sugar-free candies or gums to increase moisture in your mouth.
- Eat soft foods to avoid bruising the membranes in your mouth.
- Avoid foods that might irritate your mouth, such as spicy foods, citrus fruits and juices and pretzels.
- Ask your doctor about topical mouth medications.
- Take over-the-counter pain medication, such as Tylenol, if necessary.
- Eat light, easily digestible foods, including soft foods or commercial dietary supplements such as Ensure or Boost.
- Try to eat frequent small meals.
- Avoid citrus fruits, especially juices.
- Keep a diary to help you identify when you have the most energy and what activities make you feel fatigued or give you energy. This can help you plan your activities for the times when you have the most energy.
- Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.
- Get a good night’s sleep; about 8 hours is usually recommended for adults.
- Keep a regular bedtime schedule.
- Do something relaxing before bedtime such as reading, watching TV or taking a bath.
- If you do not fall asleep within 15 minutes, get up and do something else and try again later.
- Don’t eat, drink fluids or exercise close to your bedtime.
- Take action to treat a poor appetite, because eating improperly can make you tired.
- Ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.
- Learn and practice a relaxation technique; it will help you emotionally as well as physically.
- Rest and sleep during treatment.
- Take pain medications regularly; do not wait for your pain to become severe.
- Take steps to avoid constipation, a common side effect of pain medications.
- Change your activity level. See if you feel better if you rest more or move around more – either may help.
- Distract yourself with music, funny videos or computer games.
- Use relaxation techniques, such as yoga or meditation, or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.
- Perform light exercise.
Skin Dryness and Irritation
- Protect your skin from sun exposure by wearing sunscreen of at least 15 SPF. Areas of the skin that have received radiation will always need extra protection, even after treatment is completed.
- Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin.
- Don’t use any lotion, soap, deodorant, sunblock, cologne, cosmetics or powder on your skin within 2 hours of treatment because they may cause irritation.
- Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.
- Don’t scratch, rub or scrub treated skin. After washing, gently blot dry.
- Don’t bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.
- Don’t apply heat or cold to the treated area. Bathe only with lukewarm water.
- Keep your nails well trimmed and clean.