Managing Side Effects

Managing the Side Effects of Cancer and Cancer Treatment

by Rosalyn Carson-DeWitt, MD

Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these drugs as advised by your doctor or the booklet they came with. If you have any questions, call your doctor.

Medicine may help ease or prevent side effects of treatment, or control certain side effects once they happen. These effects can happen from cancer or its treatment.

Medications to Help Manage Nausea and Vomiting

Common names are:

Dexamethasone
Dronabinol
Granisetron
Lorazepam
Metoclopramide
Ondansetron
Prochlorperazine

Common problems for dexamethasone are:

Headache
Light-headedness
Sleeping problems
Restlessness
Depression
Anxiety
Acne
Increased hair growth
Easy bruising
Irregular or absent menstrual periods

Common problems for dolasetron are:

Diarrhea
Headache
Belly pain

Common problems for dronabinol are:

Vertigo
Light-headedness
Sleepiness

Common problems for granisetron are:

Belly pain
Constipation
Diarrhea
Headache
Unusual tiredness or weakness

Common problems for lorazepam are:

Clumsiness or unsteadiness
Light-headedness
Drowsiness
Slurred speech

Common problems for prochlorperazine are:

Blurred vision, changes in color vision, problems seeing at night
Fainting
Loss of balance
Restlessness or need to keep moving
Shuffling walk
Stiffness of arms or legs
Trembling and shaking of hands and fingers

Common problems for metoclopramide are:

Diarrhea (with high doses)
Sleepiness
Restlessness

Common problems for ondansetron are:

Constipation
Diarrhea
Fever
Headache

Medicine to Ease Pain

There are many methods to ease pain linked to cancer and its treatments.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs ease pain and inflammation from:

Cancer that has spread to your bones
Fluid build-up caused by the tumor or treatments

Common NSAIDs are:

COX -2 antagonists
Ibuprofen
Naproxen

Common problems are:

Stomach cramps, pain, or discomfort
Sleepiness
Light-headedness
Headache
Heartburn, indigestion, nausea, or vomiting

Corticosteroids

Like NSAIDs, corticosteroids help to ease pain and inflammation.

Common names are:

Dexamethasone
Prednisone

Common problems are:

Increased appetite
Indigestion
Nervousness or restlessness

Opioid Pain Relievers

Opioids act on the central nervous system to relieve pain. They may cause dependence, resulting in higher doses to obtain the same pain relief. You will be watched by your doctor if you have to take opioids.

Opioids are:

Fentanyl transdermal patch
Hydrocodone
Methadone
Morphine
Oxycodone

Acetaminophen is often blended with an opioid to give better pain relief than using one medicine alone. These are:

Acetaminophen with hydrocodone
Acetaminophen with oxycodone

Some problems are:

Light-headedness
Sleepiness
Nausea or vomiting
Constipation

Medicine to Support Your Blood Cells

During cancer treatment, blood cells can be destroyed along with cancer cells. Medicine to boost blood cells counts are:

Darbepoetin alpha
Epoetin /EPO/Erythropoietin—red blood cells
Filgrastim /G-CSF—white blood cells
Oprelvekin—platelets
Pegfilgrastim

Filgrastim helps your bone marrow make new white blood cells. White blood cells fight off and lower the risk of infection.

Epoetin helps your bone marrow to make new red blood cells This will lower the risk of anemia. It takes some time for the medicine to work. A blood transfusion can be done if you need red blood cells sooner.

Oprelvekin helps boost platelet numbers. Platelets help your blood clot, so very low counts can lead to serious bleeding. If your platelet counts fall below a specific level, you may be given transfusions.

Common problems for darbepoetin alpha are:

Changes in blood pressure
Muscle aches
Headaches
Diarrhea

Common problems for filgrastim are:

Headache
Pain in arms or legs
Pain in joints or muscles
Pain in lower back or pelvis
Skin rash or itching

Common problems forepoetin are:

Cough, sneezing, or sore throat
Fever
Swelling of face, fingers, ankles, feet, or lower legs
Weight gain

Common problems for pegfilgrastim are:

Bone pain
Flu-like symptoms
Nausea or vomiting
Breathing problems

References:

Cancer pain. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain.html. Accessed August 21, 2019.

Cancer pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cancer-pain. Updated July 1, 2019. Accessed August 21, 2019.

Opioids for chronic cancer pain. EBSCO DynaMed website. Available at: https://www.dyname.... Updated November 2, 2018. Accessed August 21, 2019.

Pain control. National Cancer Institute website. Available at: https://www.cancer.gov/publications/patient-education/paincontrol.pdf. Accessed August 21, 2019.

Last reviewed December 2019 by Mohei Abouzied, MD
Last Updated: 7/21/2020

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