Do What You Can to Ease Side Effects of Treatment for Kaposi’s Sarcoma

It’s likely that you will have physical concerns since your cancer may cause symptoms and your treatment may cause side effects. In this section, you’ll learn more about how to respond to some of the most common symptoms and side effects from treating Kaposi’s sarcoma (KS).

Here are some common side effects from treatment for KS and how to ease them. You may not have all of these. We’ve listed them in alphabetical order so you can find help when you need it.

Anemia (Low Red-Blood-Cell Levels)

Your doctor will take blood samples from you for tests throughout your treatment. One thing he or she is checking for is your red-blood-cell count. Red blood cells carry oxygen throughout the body. If your body does not have this oxygen, you may feel tired. Decreased red-blood-cell counts can be caused by small amounts of blood loss, chemotherapy, or radiation.

If your doctor tells you that you have anemia, take these actions to feel better.

• Add mild exercise, such as walking, to your daily routine.

• Ask your doctor if you should take a red cell growth factor. These drugs, which include Procrit (epoetin alpha) and Aranesp (darbepoetin alfa), can help treat anemia.

• Balance activity with rest. Save your energy for important tasks.

• Drink plenty of water. Dehydration adds to fatigue.

• Take short rests when you’re tired. Avoid long naps during the day so that you can sleep well at night.

• Talk with your doctor about medications or treatments that may help manage your anemia.

Anxiety and Depression

Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back throughout treatment.

Taking these actions may ease your mental stress.

• Ask your doctor about medications for depression and anxiety.

• Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.

• Talk with your family or friends.

Constipation

This may be a side effect of chemotherapy or some pain medicines. Constipation may include difficult or infrequent bowel movement. It can range from mildly uncomfortable to painful. Taking pain medications can lead to constipation, so it’s wise to take these preventive actions. These same steps will give you relief if you are already constipated.

• Drink plenty of fluids, especially water and prune juice.

• Eat foods high in fiber, such as cereals, whole grains, fruits, and vegetables.

• Exercise.

• Take stool softeners or a laxative only as prescribed by your doctor.

Diarrhea

This may be a side effect of chemotherapy. Diarrhea, which includes loose or frequent bowel movements, or both, may lead to dehydration if you don’t take these precautions.

• Ask your doctor about medications that may help.

• Avoid milk and milk products.

• Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.

• Drink more fluids, such as water and broth, to prevent dehydration.

• Eat low-residue, low-fiber foods such as those included in the BRAT diet (bananas, rice, applesauce, and toast).

Drowsiness

Severe drowsiness may be a side effect of chemotherapy or immunotherapy. It may get better after several weeks of treatment. If you notice this, talk with your doctor about options for relief. These may include adjusting the dose you take or changing the time of day that you take the drug. Don’t change your schedule without your doctor’s instructions to do so.

Dry or Irritated Skin

This may be a side effect of radiation therapy.

• 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, sun block, cologne, cosmetics, or powder on your skin within 2 hours after treatment because they may cause irritation.

• Don’t apply heat or cold to the treated area. Bathe only with lukewarm water.

• Don’t bandage skin with tape. If you must bandage a wound, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

• Don’t scratch, rub, or scrub treated skin. After washing, gently blot dry.

• If you must shave the treated area, use only an electric shaver. Don’t use lotion before shaving. And don’t use hair-removal products.

• Keep your nails well trimmed and clean.

• Protect your skin from sun exposure by wearing sunscreen with a SPF (sun protection factor) of at least 15.

• Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.

Hair Loss

Losing your hair can be upsetting because baldness is a visible reminder that you are being treated for KS. Chemotherapy and radiation can cause hair loss, which is called alopecia. Keep in mind that your hair will probably grow back after treatment.        

Try these coping tips.

• 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’ll be ready with head coverings, if you choose to use them.

• Your scalp may be more sensitive to temperature and sun, so protect it with sunscreen and hats or scarves.

Infection

Because chemotherapy can reduce the number of white blood cells in your body, it can decrease your body’s ability to fight off infection.

Taking these actions may reduce your risk of infection.

• Wash your hands often, especially before eating and after going to the bathroom or touching animals.

• Stay away from people who are sick with an illness you could catch, such as a cold or the flu.

• Avoid crowds. If you must go out, choose a time when fewer people will be out, such as during the week or late at night.

• Avoid children who have recently been given live virus vaccines.

• Do not cut or tear your cuticles.

• Take extra care when using knives, scissors, or other sharp objects.

• Take good care of your teeth and gums.

• Do not squeeze or scratch cuts or blemishes.

• Take a warm bath, shower, or sponge bath every day. Do not use harsh bath products, such as skin scrubs. Do not rub your skin too hard with washcloths or towels.

• If you skin is dry or cracked, ask your doctor if lotion or oil will help.

• Clean any cuts or scrapes right away. Wash them with soap and warm water, followed by an antiseptic. Continue to wash cuts and scrapes once a day until they heal.

• Ask someone else to clean up litter boxes, animal waste, fish tanks, and bird cages.

• Avoid standing water, such as bird baths, vases, and humidifiers.

• Wear protective gloves when gardening or cleaning.

• Do not get any immunizations, such as a flu shot, without asking your doctor first.

• Do not eat raw or undercooked seafood, fish, meat, or eggs.

• Use an electric razor instead of a blade to minimize the risk of cuts.

Call your doctor right away if you have any of these signs of infection: a temperature of 100.5° or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.

Loss of Appetite

Eating well during cancer treatment can help you maintain your strength, stay active, and lower your chances of infection. When you’re being treated for cancer, a diet high in calories and protein is best. The problem is that side effects of treatment can change the way food tastes to you or reduce your appetite. Try these tips to stimulate your desire to eat.

• If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue, and cancer treatments cause you to use more protein than usual.

• If you can, eat high-calorie foods to help you maintain your weight. These foods may include margarine or butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing.

• Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, fruit juices, and other liquids, eating certain foods can help increase your fluid intake. These foods include gelatin, pudding, soups, Popsicles, and ice cream.

• Eat small meals throughout the day instead of three large ones.

• Keep snacks handy to eat when you are hungry

• Eat with friends or play your favorite music at mealtime to boost your appetite.

• Eat your biggest meal in the morning. Many people getting treatment for cancer find this is when they have their biggest appetite.

• If you can, increase your activity level. Doing so may stimulate your appetite.

• On days you don’t feel like eating at all, don’t worry about it. Try again the next day. If you find your appetite doesn’t improve after several days, talk with your doctor or nurse.

Menopausal Symptoms

Some types of chemotherapy can damage a woman’s ovaries. Or they may cause menopausal symptoms in women who’ve not yet reached menopause. These symptoms include hot flashes, vaginal dryness, mood swings, and weight changes. Periods may become irregular or may stop, and you may not be able to get pregnant. For some women, the loss of a menstrual period is permanent.

• Continue with regular pelvic exams.

• If needed, talk with your doctor about birth control before treatment begins.

• Report any unusual bleeding to your doctor.

• Talk with your doctor about ways to manage menopausal symptoms, such as using lubricants for vaginal dryness, doing mild exercise, and talking with a therapist about mood swings or signs of depression.

Mouth Sores (Mucositis)

Some types of chemotherapy may cause mouth sores. These may hurt and make eating an unpleasant experience.

To prevent sores in your mouth, take these actions.

• Brush your teeth after meals and before bedtime; floss every day.

• Keep your mouth and lips clean and moist.

• Use sugar-free candies or gums to increase moisture in your mouth.

To ease the pain if you get sores in your mouth, take these actions.

• Ask your doctor about topical mouth medications.

• Avoid alcohol and mouthwashes containing alcohol because they may irritate the sores.

• Avoid hot, rough, or spicy foods because they may irritate the sores.

• Avoid tobacco because it may irritate the sores. Smoking can also make you more susceptible to sores.

• Take over-the-counter pain medication, such as Tylenol (acetaminophen), if necessary.

Call your doctor or nurse if your temperature reaches 100° or higher.

Nausea or Vomiting

Nausea or vomiting as a result of chemotherapy or radiation treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea.

• Acute-onset nausea and vomiting occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be 5 to 6 hours after treatment, and the symptoms end within the first 24 hours.

• Anticipatory nausea and vomiting are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.

• Delayed-onset vomiting develops more than 24 hours after treatment.

• Breakthrough vomiting occurs despite treatment to prevent it. It requires additional treatment.

• Refractory vomiting occurs after one or more chemotherapy treatments--essentially, you’re no longer responding to anti-nausea treatments.

To prevent nausea, take these actions. Most nausea can be prevented.

• Ask your doctor about getting a prescription medicine to control nausea and vomiting. These drugs include Compazine (prochlorperazine), Zofran (ondansetron), Anzemet (dolasetron), and Kytril (granisetron). Make sure you take the medicine as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

• If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

To help ease nausea or vomiting if you have it, try these tips.

• Ask your doctor or nurse about using acupressure bands on your wrists, which may help to decrease your nausea.

• 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.

• Do not eat fatty or fried foods, spicy foods, or sweet foods.

• Eat room-temperature or cold foods. The smells from hot foods may make your nausea worse.

• Try eating foods and drinking beverages that were easy to take or made you feel better when you had the flu or were nauseated from stress. These might be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.

Neutropenia (Low White-Blood-Cell Levels)

Your doctor will take blood samples from you throughout your treatment. One thing he or she is checking for is your white-blood-cell count. Many types of chemotherapy can cause low white-blood-cell counts, as can the cancer itself. A lowered white cell count is called neutropenia. Without enough white blood cells, your body may not be able to fight infection.

If your doctor tells you that your white-blood-cell count is low, take these actions to stay healthy.

• Ask your doctor about drugs called white cell growth factors. Drugs such as Neupogen (filgrastim) and Neulasta (pegfilgrastim) can help treat low white blood cell counts.

• Avoid crowds and people with colds.

• Call your doctor right away if you have any signs of infection. Signs include a temperature of 100.5° or higher, severe chills, a cough, pain, a burning sensation during urination, or any sores or redness.

• Wash your hands often or use hand sanitizer throughout the day to kill germs.

Numbness, Tingling, or Muscle Weakness in Your Hands or Feet (Peripheral Neuropathy)

If you have numbness, tingling, or weakness in your hands and feet, you may have nerve damage called peripheral neuropathy. This can be a side effect of chemotherapy or immunotherapy. Other signs of this problem are ringing in your ears or feeling hot or cold. If you have symptoms such as these, your doctor may adjust your dose. Or your doctor may prescribe medicine or some vitamins. You should also take these precautions to protect yourself.

• If your daily activities become too difficult, ask your doctor for a referral to an occupational or physical therapist. They can help teach you new ways of doing things so that you can stay as active as possible.

• Take extra care walking and moving so that you don’t fall. Wear only well-fitting shoes at home and away from home.

• Take extra care when driving (you may have trouble feeling the gas and brake pedals). Ask friends and family to drive you places.

• Use warm, not hot, water for bathing to prevent burns. Consider using a shower chair or railing to improve your stability.

Thinking and Remembering Problems

You may have mild problems with concentration and memory during and after chemotherapy. Being tired can make this worse.

Taking these actions may help.

• Make lists and write down important information.

• Use other tools to help organize your life, such as calendars, pill dispensers, or alarm clocks.

Tiredness and Fatigue

Tiredness is a common symptom and side effect from chemotherapy and radiation treatments. It is also a symptom of anemia, which is a low red blood cell count as noted from blood tests. Or it can be caused from a B12 vitamin or iron deficiency, which your doctor may also find in a blood test. Whatever the cause, you may feel only slightly tired or you may suffer from extreme fatigue.

Taking these actions may help increase your energy level. Fatigue can last 4 to 6 weeks after treatment ends.

• Add mild exercise, such as walking, to your daily routine. It may help you sleep better.

• Drink plenty of fluids. Dehydration leads to increased fatigue.

• Save your energy for important tasks.

• Take action to treat a poor appetite, because eating improperly can make you tired.

• Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.

• If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.

Weight Gain

Weight gain may be a sign of damage to your thyroid, which can be a side effect of immunotherapy. Take these actions to help manage your weight.

• Increase the amount of your daily exercise. Strive to be active every day.

• Eat a balanced, low-calorie diet.

• Increase the amount of fruits and vegetables you eat. And drink more water. These can help fill you up--and are good for you--without adding a lot of calories.