Do What You Can to Ease Side Effects of Treatment for Uterine Cancer

It’s likely that you will have physical concerns. After all, the cancer may cause symptoms and your treatment may cause side effects. What you notice depends on your treatment, and that depends on how much the cancer has spread from your uterus. It’s not likely that you will have all the side effects listed. They are listed alphabetically, so you can find help easily when you need it. Look for the side effect you are having to learn how to cope.

Anemia (Low Red-Blood-Cell Levels)

Throughout your treatment, your doctor will test your blood. 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, by chemotherapy or radiation, or by the cancer itself.

Take these actions to feel better:

• Take short rests when you’re 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.

• 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. You may have these feelings as well if you were told that you needed to have a hysterectomy. These feelings may continue or come back during your recovery from surgery or during other treatments.

• Talk with your family or friends.

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

• Ask your doctor about medications for depression and anxiety.

Appetite Changes

People who eat well during cancer treatment maintain their strength better, are more active, and are better able to lower their chance of infection. It’s important to remember that your body needs energy to heal itself. Maintaining your weight is a good way to know if you are giving your body the energy it needs. When you’re being treated for cancer, a diet high in calories and protein is best. The problem is that side effects of treatment, especially chemotherapy, can make you not want to eat. Some chemotherapy treatments can change the way food tastes to you. Hormone therapy can also cause appetite changes. Ask your doctor for a referral to a registered dietitian if you are having trouble maintaining your appetite or your weight.

Also, 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.

• Eat high-calorie foods to help you maintain your weight, such as 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, try gelatin, pudding, soups, fruit bars, 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 that this is when their appetite is greatest.

• If you can, increase your activity level. Doing so may boost 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 in several days, talk with your doctor or nurse.

Bleeding

Bleeding from the vagina may be a side effect of surgery to remove your uterus. It’s normal to have vaginal bleeding or brownish spotting for one to three weeks after surgery and some spotting for up to about six weeks after surgery. If you have more bleeding than this, you should let your doctor know. Here’s what you can do to cope with bleeding:

• Use sanitary pads to absorb the vaginal discharge. Change the pads regularly.

• Discharge from the vagina will look somewhat bloody. Gradually, it becomes brownish. Then it stops altogether. Talk with your doctor or nurse if you notice heavy bleeding.

Constipation

This may be a side effect of chemotherapy or some pain medicines used after surgery. Constipation, which includes difficult or infrequent bowel movements, 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

Diarrhea includes loose or frequent bowel movements, or both. It may be a side effect of external radiation therapy or chemotherapy. Many drugs can cause bowel changes, too. Diarrhea may lead to dehydration if you don’t take these precautions:

• Avoid milk and milk products.

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

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

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

• Ask your doctor about medications that may help.

Hair Loss (Alopecia)

This can be a side effect of chemotherapy. Losing your hair can be upsetting because thinning or baldness is a visible reminder that you are being treated for cancer. Keep in mind that your hair will 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.

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

Hot Flashes

You may have hot flashes, as well as other symptoms of menopause, if you have surgery to remove your uterus. A hot flash is also called a hot flush. It is a sudden rush of warmth to the face, neck, upper chest, and back--with or without sweating. It can last for a few seconds to an hour or more. To ease them, try these tips:

• Try keeping a diary to identify what actions or situations trigger a hot flash. Recognizing what causes the hot flashes may help you avoid them.

• Limit your intake of hot drinks, caffeine, alcohol, and spicy foods.

• Avoid strenuous exercise.

• Layer your clothing so that you can add or remove as needed.

• Stay out of environments with very warm temperatures.

• Use sprays or moist wipes to help lower skin temperature.

• Ask your doctor about relaxation training or acupuncture.

• Ask your doctor about medications you can take to ease symptoms. 

• Ask your doctor about taking phytoestrogens. These are estrogens that come from plants. Soy products and some herbs contain phytoestrogens. Although raising the amount of phytoestrogens in the diet is commonly recommended to lessen the severity of hot flashes, studies have shown conflicting results about their effectiveness.

Insomnia (Trouble Sleeping)

Insomnia can be caused by anxiety, depression, or your cancer treatment. Use these tips to improve your rest:

• Keep a regular bedtime schedule.

• Use your bed only for sleeping, not watching TV.

• If you don’t fall asleep within 15 minutes, get up, do something else, and try again later.

• Avoid stimulants such as caffeine and tobacco, especially close to bedtime.

• Don’t eat, drink fluids, or exercise close to your bedtime.

• Avoid long naps during the day.

Mouth Sores (Mucositis)

Some types of chemotherapy may cause mouth sores. Mouth sores 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.

If you get sores in your mouth, take these actions:

• 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.

• Ask your doctor about topical mouth medications.

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

• Call your doctor or nurse if your temperature reaches 100.5°F 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.

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

• 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.

• 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 antinausea 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. Then make sure you take it 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 or new medicines can be added.

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

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

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

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

• 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.

Neutropenia (Low White-Blood-Cell Levels)

Throughout your treatment, your doctor will test your blood. One thing he or she is checking for is your white-blood-cell count. Without enough white blood cells, your body may not be able to fight infection. Many types of chemotherapy can cause low white-blood-cell counts. If your doctor tells you that your white-blood-cell count is low, take these actions to stay healthy:

• Avoid crowds or people with colds.

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

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

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. Some types of chemotherapy are known to cause this. Other signs of this problem are ringing in your ears or trouble feeling hot or cold. If you have such symptoms, tell your doctor right away and take these precautions to protect yourself:

• Take extra care walking and moving so that you don’t fall.

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

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

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

Pain

You may have pain from the cancer itself, from surgical incisions, or from internal radiation. Try these tips to ease the pain:

• Take your pain medications regularly; don’t 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.

Sexual Problems

A change in your sex drive or problems with vaginal scarring, dryness, or tightness can all affect your sexual well-being. These can be caused by the hysterectomy, radiation therapy, chemotherapy, or hormone therapy. Some effects may resolve over time. Your doctor and nurse can give you suggestions for dealing with all these effects on your sexual health. Be sure to ask if you have any questions or problems.

Taking these actions may help you cope with any changes.

• Talk with your partner about changes in your ability to have sex.

• Explore new ways to share affection and intimacy.

• Discuss it with your doctor and other members of your healthcare team. They may be able to offer suggestions.

• If childbearing is an issue, talk with your doctor and your partner about this before your treatment.

Skin Dryness or Irritation

This may be a side effect of some hormone therapies or with chemotherapy or radiation therapy.

• Protect your skin from sun exposure by wearing sunscreen of at least 15 SPF.

• 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 two hours after 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.

Trouble Thinking and Remembering

You may have mild problems with concentration and memory during and after hormone therapy or 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

Tiredness is a very common symptom and side effect from surgery, chemotherapy, and radiation treatments. You may feel only slightly tired, or you may suffer from extreme fatigue.

Fatigue can last even after treatment ends. Taking these actions may help increase your energy level:

• Take short rests when you feel 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. It may help you sleep better.

• Save your energy for important tasks.

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

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

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

Vaginal Dryness and Other Vaginal Problems

Vaginal dryness and discharge can result from having a hysterectomy, which leads to menopause. In addition to vaginal dryness, lowered estrogen levels may cause women to have vaginal thinning and difficult or painful intercourse. Lubricants can help with some of these problems. Vaginal infections may also occur more often. When you talk with your doctor about these problems, make sure he or she knows you’ve had cancer. Try these methods to ease symptoms:

• Use over-the-counter vaginal moisturizers and lubricants such as Replens, Gyne-Moistrin, and Lubrin.

• Before sexual activity, use water-soluble lubricants such as K-Y Jelly, Astroglide, or any vaginal moisturizers.

• Apply vitamin E oil to the area to ease irritation and burning.

• Ask your doctor about products that may help replace estrogen vaginally.

• As relief for infections, try over-the-counter antifungal creams, but see your gynecologist for symptoms that do not go away.

Weight Gain

Some women can gain weight as a side effect from steroids or antinausea medications or from hormone therapy. 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.