What are the side effects of chemotherapy? How to deal with them?

With the development of chemotherapeutic drugs, a variety of highly effective and low-toxicity chemotherapeutic drugs have been introduced. Since the current cytotoxic chemotherapeutic drugs are not highly targeted, and cannot kill tumor cells only without hurting normal cells and tissues, it is inevitable that chemotherapeutic drugs will kill tumor cells and have certain effects on normal tissues, which is called the toxic side effects of chemotherapeutic drugs. There are the following common reactions:

(1)Local reaction: the most common one is the leakage of chemotherapeutic drugs to subcutaneous tissues during intravenous treatment, which causes chemical damage to local skin and subcutaneous tissues, manifesting as redness, swelling and pain, and in severe cases, skin breakdown and necrosis. Clinically, procaine is often used to seal the tissue around the leakage area, keep it clean, avoid infection, and for those with unbroken skin, magnesium sulfate or Ruyi Jinhuang San can be used for external application. For drugs that are prone to severe skin loss such as Vincristine, deep vein cannulation chemotherapy is recommended for prevention.

(2)Gastrointestinal reaction: nausea, vomiting, the most common gastrointestinal toxic side effects, of which cisplatin is the strongest vomit-causing drugs, the current clinical application of the 5-HT3 receptor antagonist has significantly reduced the incidence of acute vomiting, the delayed nausea and vomiting can be used to dopamine D2 receptor antagonist - metoclopramide and other medications, and at the same time, the patient can be combined with a palatable and light diet, to avoid oversatiation and greasy food. The patient may also be given a tasty and light diet, avoiding overfilling and greasy food. Other symptoms such as loss of appetite, constipation, diarrhea, stomatitis, etc. are mostly transient, and can be quickly recovered by clinical symptomatic treatment, reminding that if the above symptoms are more serious, then it is necessary to go to the hospital.

(3)Myelosuppression: the most common side effect, different types of chemotherapeutic drugs and chemotherapeutic regimens have different points of myelosuppression, and the effect on white blood cells and neutrophils occurs 7~10 days after chemotherapy, and the majority of the patients can pass through the process smoothly, and when the white blood cells are lower than 2.0×109/L or the neutrophils are lower than 1.0×109/L, then the application of colony-stimulating factor (GCF) can be used. colony-stimulating factor (G-CSF or GM-CSF) for treatment and prophylaxis. The effect on platelets mostly occurs in 14~21 days after chemotherapy, and the majority of patients can pass through smoothly, or apply thrombopoietin (TPO) or interleukin-11 treatment and prevention. Anemia occurs mostly after several courses of treatment, and can be treated by increasing blood-supplementing foods during treatment and applying erythropoietin (EPO) if necessary.

(4) Renal function injury: some chemotherapeutic drugs can cause hepatic and renal function injury, generally related to the dose. The most common is cisplatin-induced renal tubular injury, clinical use of a certain amount of fluid hydration and diuresis can prevent its renal function damage. For patients with previous renal disorders, evaluation of renal function should be done before treatment, and the dose of chemotherapeutic drugs should be reduced if necessary.

(5) liver function damage: chemotherapy drugs can prevent liver damage, mostly transient, commonly occurring about a week after chemotherapy, clinical often apply some liver-protecting drugs to prevent chemotherapy, once the function abnormalities can also be treated with intravenous drugs to protect the liver. For patients with previous hepatitis B and cirrhosis, it is necessary to evaluate liver function and the amount of hepatitis B virus DNA before treatment to decide whether anti-hepatitis B virus treatment is needed at the same time in order to minimize liver function damage and the occurrence of acute liver necrosis.

(6) cardiotoxicity: some chemotherapeutic drugs can cause cardiac injury, the main manifestations of which are a variety of cardiac arrhythmias, and in severe cases, cardiac failure. The most common drugs such as adriamycin, paclitaxel and other drugs, its cardiotoxicity performance varies, varying degrees of severity, most of the drugs by stopping, symptomatic treatment can be restored. Evaluate cardiac function before administering drugs to patients with previous hypertension, coronary artery disease and advanced age.

(7) other: some chemotherapeutic drugs toxic side effects on some specific organs with selective prominent damage; cyclophosphamide, especially isocyclophosphamide can lead to hemorrhagic cystitis (can be prevented by mesna); bleomycin caused by pulmonary fibrosis; peripheral neuritis caused by vincristine, etc.; tesu, tesoteric, such as allergic reactions and neuromuscular symptoms. Hair loss is a toxic side effect of most chemotherapeutic drugs, only to varying degrees.

In short, most of the toxic side effects caused by chemotherapy drugs can be prevented and/or treated. For patients with cardiac, hepatic, and renal underlying pathology should be fully evaluated before treatment, and avoid applying drugs with obvious damage to the corresponding organs when choosing chemotherapy regimens, or adjusting the dose of chemotherapeutic drugs or discontinuing them.