• Managing the Side Effects of Cancer and Cancer Treatment

    The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
    Medications may help to either prevent or reduce side effects of treatment, or to manage certain side effects once they occur. Since you can develop these symptoms from the treatment and/or from the cancer itself, it is essential that you discuss them with your doctor when you notice them, and ask if any of these medications are appropriate for you.

    Drugs to Help Manage Nausea and Vomiting

    Antiemetics, are given to help treat nausea and vomiting, which may be caused by chemotherapy , radiation therapy , surgery , or other aspects of cancer and its treatment.
    Antiemetics given by prescription include the following:
    • Dexamethasone
    • Dronabinol
    • Granisetron
    • Lorazepam
    • Metoclopramide
    • Ondansetron
    • Prochlorperazine
    Common side effects for dexamethasone include:
    • Upset stomach, vomiting
    • Headache
    • Lightheadedness
    • Insomnia
    • Restlessness
    • Depression
    • Anxiety
    • Acne
    • Increased hair growth
    • Easy bruising
    • Irregular or absent menstrual periods
    Common side effects for dolasetron include:
    • Diarrhea
    • Headache
    • Abdominal or stomach pain
    Common side effects for dronabinol include:
    • Vertigo
    • Lightheadedness
    • Drowsiness
    Common side effects for granisetron include:
    • Abdominal pain
    • Constipation
    • Diarrhea
    • Headache
    • Unusual tiredness or weakness
    Common side effects for lorazepam include:
    • Clumsiness or unsteadiness
    • Lightheadedness
    • Drowsiness
    • Slurred speech 
    Prochlorperazine can be taken by mouth, injection, or a suppository. Ondansetron and granisetron can be taken orally or as injections. Metoclopramide is usually given by injection.
    Common side effects for prochlorperazine include:
    • Blurred vision, change in color vision, or difficulty 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 side effects for metoclopramide include:
    • Diarrhea (with high doses)
    • Drowsiness
    • Restlessness
    Common side effects for ondansetron include:
    • Constipation
    • Diarrhea
    • Fever
    • Headache

    Drugs to Decrease Pain

    To help manage pain, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). You may also be prescribed corticosteroids or opioid pain relievers.
    Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
    NSAIDs are used to relieve pain and inflammation. You may experience pain and inflammation for a variety of reasons, such as:
    • Pain from cancer that has spread to your bones
    • Edema—fluid build up in cells caused by tumors or treatment
    NSAIDs include the following:
    • COX -2 antagonists
    • Ibuprofen
    • Naproxen
    Common side effects of NSAIDs include:
    • Stomach cramps, pain, or discomfort
    • Drowsiness
    • Lightheadedness
    • Headache
    • Heartburn, indigestion, nausea, or vomiting
    Like NSAIDs, corticosteroids help to minimize inflammation and pain due to inflammation.
    Corticosteroids include the following:
    • Dexamethasone
    • Prednisone
    Common side effects of corticosteroids include:
    • Increased appetite
    • Indigestion
    • Nervousness or restlessness
    Opioid Pain Relievers
    Opioid pain relievers act on the central nervous system. These drugs can be very effective however, they must be used with care because of their side effects. Addiction is rare in those who use these medications appropriately for pain control. If you are going to take one of these drugs for a long period of time, your doctor will closely monitor you.
    Opioid pain relievers include the following:
    • Fentanyl transdermal patch
    • Hydrocodone
    • Methadone
    • Morphine
    • Oxycodone
    Acetaminophen is often combined with an opioid analgesic to provide better pain relief than either medication used alone. And in some cases, lower doses of each medication are necessary to achieve pain relief. Examples of such drugs include the following:
    • Acetaminophen with hydrocodone
    • Acetaminophen with oxycodone
    The most common side effects of opioid pain relievers include:
    • Lightheadedness
    • Drowsiness
    • Nausea or vomiting
    • Constipation—One medication (methylnaltrexone) has been found helpful in rapidly relieving this side effect in most people taking opioids for pain.

    Drugs to Support Your Blood Cells

    During cancer treatment, blood cells can be destroyed along with cancer cells. Medications given to treat this problem are called blood stem cell support drugs and include the following:
    • Darbepoetin alpha
    • Epoetin /EPO/Erythropoietin
    • Filgrastim /G-CSF
    • Oprelvekin
    • Pegfilgrastim
    Filgrastim helps your bone marrow make new white blood cells. White blood cells fight off and reduce the risk of infection.
    Epoetin helps your bone marrow to make new red blood cells, which help reduce the risk of anemia. The medication is quite effective, but it has a two-week delay between the injection and when your red blood cell count really starts to come back. It is not used as a “quick fix” for a low red blood cell count. A blood transfusion is usually performed if you need to recover your red blood cell count more quickly.
    Oprelvekin is a platelet growth factor. 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.
    Blood stem cell support drugs are given by injection in your doctor's office.
    Common side effects for darbepoetin alpha include:
    • Changes in blood pressure
    • Muscle aches
    • Headaches
    • Diarrhea
    Common side effects for filgrastim include:
    • Headache
    • Pain in arms or legs
    • Pain in joints or muscles
    • Pain in lower back or pelvis
    • Skin rash or itching
    Common side effects forepoetin include:
    • Cough, sneezing, or sore throat
    • Fever
    • Swelling of face, fingers, ankles, feet, or lower legs
    • Weight gain
    Common side effects for pegfilgrastim include:
    • Bone pain
    • Flu-like symptoms
    • Nausea/vomiting
    • Shortness of breath


    Bader S, Jaroslawksi K, Blum HE, Becker G. Opioid-induced constipation in advanced illness: Safety and efficacy of methylnaltrexone bromide. Clin Med Insights Oncol. 2011;5:201-211.

    Cancer pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 25, 2015. Accessed May 27, 2015.

    Guide to controlling cancer pain. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002906-pdf.pdf. Accessed May 27, 2015.

    Pain control. National Cancer Institute website. Available at: http://www.cancer.gov/publications/patient-education/paincontrol.pdf. Updated May 2014. Accessed May 27, 2015.

    Treatment of pain. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain. Updated April 2014. Accessed May 27, 2015.

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