Treatment Side Effects

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Side Effect	Causes	Management	Notes
Nausea and vomiting	Most treatments	There are numerous prescription medications available. Treat early and aggressively.	If a medication is not working, talk to your doctor about trying something else.
Diarrhea Increased number of stools and/or change in consistency	Chemotherapy containing fluorouracil (5FU, Capecitabine) Irinotecan	Prescriptions including sandostatin a long acting injection. Over the counter loperamide.	After colon resection, it will take some time for your digestive system to adjust. By trial and error you will discover which foods you can tolerate.
Fatigue	All treatments	Rest when you are tired. Plan activities when you have the most energy. Ask people for help.	Fatigue may also be a result of depression, pain or sleep problems Let your doctor know if you have any of these symptoms.
Peripheral neuropathy Inability to tolerate cold, tingling and/or pain.	Oxaliplatin Given with IV administration of Calcium and Magnesium for prevention of neuropathy.	Some anti-epileptics, anti-depressants and creams are helpful. Ingest foods and liquids at room temperature. Have gloves by the refrigerator.	Symptoms usually regress after treatment. Up to 3.5% of people still have neuropathy four years after treatment ends. Most frequent treatment limiting side effect.
Mucositis (Thrush, white patches, coldsores) Opportunistic fungal infection can occur from the mouth to the anus.	Chemotherapy containing fluorouracil (5FU, Capecitabine)	Magic™ mouthwashAnti-fungal prescription medicines. Local anesthetics, analgesics.	Do not use hydrocortisone as it will exacerbate the mucositis. Do not assume that pain is a hemorrhoid. It could be thrush, and hemorrhoid cream will worsen the condition. Transient lactose intolerance may occur with mucositis. Occurs in 20-50% of people on 5FU.
Hand and Foot Syndrome Blistering, peeling. Affects skin and nails.	Capecitabine but may occur with 5FU	Mild skin creams gently applied to area. Take cool showers. Wear thick cotton socks, and avoid constrictive shoes. Avoid friction and heat.	Use a shower stool. Stay well hydrated.

Side Effect

Causes

Management

Notes

Nausea and vomiting

Most treatments

There are numerous prescription medications available.
Treat early and aggressively.

If a medication is not working, talk to your doctor about trying something else.

Diarrhea

Increased number of stools and/or change in consistency

Chemotherapy containing fluorouracil (5FU, Capecitabine)
Irinotecan

Prescriptions including sandostatin a long acting injection.
Over the counter loperamide.

After colon resection, it will take some time for your digestive system to adjust.

By trial and error you will discover which foods you can tolerate.

Fatigue

All treatments

Rest when you are tired.
Plan activities when you have the most energy.
Ask people for help.

Fatigue may also be a result of

depression,
pain or
sleep problems

Let your doctor know if you have any of these symptoms.

Peripheral neuropathy

Inability to tolerate cold, tingling and/or pain.

Oxaliplatin

Given with IV administration of Calcium and Magnesium for prevention of neuropathy.

Some anti-epileptics, anti-depressants and creams are helpful.
Ingest foods and liquids at room temperature.
Have gloves by the refrigerator.

Symptoms usually regress after treatment.
Up to 3.5% of people still have neuropathy four years after treatment ends.
Most frequent treatment limiting side effect.

Mucositis

(Thrush, white patches, coldsores)

Opportunistic fungal infection can occur from the mouth to the anus.

Chemotherapy containing fluorouracil (5FU, Capecitabine)

Magic™ mouthwashAnti-fungal prescription medicines.
Local anesthetics, analgesics.

Do not use hydrocortisone as it will exacerbate the mucositis.
Do not assume that pain is a hemorrhoid. It could be thrush, and hemorrhoid cream will worsen the condition.
Transient lactose intolerance may occur with mucositis.
Occurs in 20-50% of people on 5FU.

Hand and Foot Syndrome

Blistering, peeling. Affects skin and nails.

Capecitabine but may occur with 5FU

Mild skin creams gently applied to area.
Take cool showers.
Wear thick cotton socks, and avoid constrictive shoes.
Avoid friction and heat.

Use a shower stool.
Stay well hydrated.