WHATS YOUR PLAN - Manage Side Effects of Chemo & Other Cancer Treatments

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This can be caused by some chemotherapy drugs. Regularly massaging the area and using eye drops can help clear blockages. Let your cancer care team know if this issue is ongoing. Many people having chemotherapy worry about hair loss alopecia. Whether or not you lose your hair will depend on the drugs you are prescribed. Some people lose all their hair quickly and others lose it after several treatments, while others may lose only a little hair or none at all. Although losing head hair is most common, you may find your eyebrows and eyelashes fall out, and you may lose hair from your underarms, legs, chest and pubic region.

When hair loss does occur, it usually starts 2—3 weeks after the first treatment. Before and while your hair is falling out, your scalp may feel hot, itchy, tender or tingly. Some people find that the skin on their head is extra sensitive, and they may develop pimples on their scalp.

After chemotherapy ends, it takes 4—12 months to grow back a full head of hair. When your hair first grows back, it may be a different colour or curly even if you have always had straight hair. In time, your hair usually returns to its original condition. Many people find losing their hair difficult.

Your hair may help form part of your sense of self — its loss can affect your self-confidence and make you feel sad or vulnerable. For many people, it's a public sign of the cancer diagnosis. Talking to your treatment team may help. Some people may be able to reduce or prevent hair loss by using a "cold cap".

This works by temporarily reducing the blood flow and the amount of chemotherapy drug that reaches the scalp. A cap is worn on the head and attached via a hose to a cooling unit, which fills the cap with cold liquid. It is worn while the chemotherapy is delivered. The cold cap can only be used with certain drugs and types of cancer, and doesn't always prevent hair loss. Check with your doctor or nurse whether a cold cap would be an option for you and whether it is available at your treatment centre.

My GP booked me in for some scans and then I was referred to an oncologist and I had a biopsy. After that, the diagnosis of non-Hodgkin lymphoma was confirmed. The next week, I would get side effects like diarrhoea, vomiting and constipation. I took ginger to help with the nausea, and I tried to live my normal life whenever I felt well enough. I still have regular check-ups and I'm back to living my usual active life.

Tell your cancer story. Some chemotherapy drugs can cause mouth sores, such as ulcers, or infections. This is more likely if you have had or are having radiation therapy to the head, neck or chest, or if you have dental or gum problems. If you notice any sores, ulcers or thickened saliva, or if you find it difficult to swallow, tell your doctor.

Some chemotherapy drugs may cause your skin to peel, darken or become dry and itchy. During treatment and for several months afterwards, your skin is likely to be more sensitive to the sun. Some people find their nails also change and become darker than usual, or develop ridges or white lines across them. Your nails may also become brittle and dry. These changes usually grow out. Some people say they have difficulty concentrating, focusing and remembering things after they have had chemotherapy.

This is called cancer-related cognitive impairment or, sometimes, "chemo brain" or "cancer fog". Thinking and memory changes may be caused by treatment or medicines, fatigue and sleep problems, or emotional concerns, such as stress or depression. These problems usually improve with time, although some people experience issues for years. Tell your doctor about any thinking and memory changes you are having, and if this issue is affecting your day-to-day life or your return to work. Blood cells are made in the bone marrow, which is the spongy part in the centre of the bones. The bone marrow makes three main types of blood cells, which have specific functions:.

Because the new blood cells are rapidly dividing, they can be damaged by chemotherapy, and the number of blood cells your blood count will be reduced. Low numbers of blood cells may cause anaemia, infections or bleeding problems. You will have blood tests at the beginning of treatment and before each chemotherapy cycle to check that your blood count has returned to normal before you have chemotherapy. If your red blood cell count drops, a reduced amount of oxygen circulates through your body.

This can cause anaemia, which can make you feel tired, lethargic, dizzy or breathless. The tips for coping with fatigue may be helpful. To minimise dizziness, take your time when you get up from sitting or lying down. Your treatment team will monitor your red blood cell levels. Let them know if you experience any symptoms of anaemia while having chemotherapy. If the levels of red blood cells drop too low, you may need a blood transfusion to build them up again.

If white blood cell numbers drop during chemotherapy, it can lower your immunity. This makes you more likely to get infections and less able to fight any infections that do occur. Your doctor may recommend antibiotics as a precaution against infection. Many types of white blood cells make up the total white cell count. A type of white blood cell known as a neutrophil protects you against infection by destroying harmful bacteria and yeasts that enter the body. During chemotherapy, some people get low levels of neutrophils. This is known as neutropenia. If you have neutropenia, you may be given an injection of growth factor drugs called granulocyte-colony stimulating factor G-CSF after chemotherapy to encourage the bone marrow to make more white blood cells.

Your doctor or nurse will speak to you about possible side effects. Some people may experience bone pain or tenderness at the injection site, or show signs of an allergic reaction. During chemotherapy treatment, even a minor infection could become serious quickly. See below for when you need to contact your doctor urgently.

Contact your doctor or go to the nearest hospital emergency department immediately if you experience one or more of the following symptoms:. Platelets are the blood cells that help the blood to clot. A low level of platelets thrombocytopenia can cause problems with bleeding. You may bleed for longer than normal after minor cuts or scrapes, have nosebleeds or bleeding gums, or bruise easily.

Managing side effects of chemotherapy - Cancer Council Victoria

Your treatment team will monitor your platelet levels. If chemotherapy causes thrombocytopenia, you may need a platelet transfusion. Ask your oncologist to explain the risks and benefits of platelet transfusion. Contact your treatment team or call if you have any persistent bleeding, such as a nosebleed that doesn't stop within 30 minutes.

This is called peripheral neuropathy. It is caused by damage to the nerves that send signals between the central nervous system and the arms and legs. For many people, peripheral neuropathy is a short-term issue, but for others, it can last a long time or even be permanent. If you experience numbness and tingling, tell your doctor or nurse before your next treatment. Your treatment may need to be changed or the problem carefully monitored. Some chemotherapy drugs can affect your hearing. Your doctor may recommend that you have a hearing test before you start treatment, and this may be repeated before each cycle of chemo.

You may be at risk of losing the ability to hear high-pitched sounds. Sometimes, chemotherapy also causes a continuous ringing noise in the ears known as tinnitus. While these changes are usually temporary, let your doctor know if you notice any change in your hearing. Chemotherapy can have an impact on your desire libido or ability to have sex. It may also affect sexual organs and functioning in men and women. This can affect your ability to have children fertility. A range of issues can cause people to lose interest in sex while they're having treatment.

Aside from feeling tired and unwell, you may feel less confident about who you are and what you can do. There may also be a physical reason for not being able or interested in having sex, e. Changes in appearance can also affect feelings of self-esteem and, in turn, sexuality. If you have a partner, it may be helpful for them to understand the reasons why your libido has changed and to know that people can have a fulfilling sex life after cancer, but it often takes time.

Some partners may also feel concerned about having sex — they might fear injuring the person with cancer or feel uncomfortable with the changes in their partner. If you have sex after receiving chemotherapy, follow the contraception recommendations outlined below. Sexual intercourse may not always be possible, but closeness and sharing can still be a part of your relationship. Talk about how you're feeling with your partner and take time to adapt to any changes. Try to see yourself as a whole person body, mind and personality instead of focusing only on what has changed.

If you're worried about the changes to your relationships or sexual functioning, you may find talking to a psychologist or counsellor helpful. Your doctor may talk to you about using contraception during and after chemotherapy. Although chemotherapy often affects fertility, this doesn't mean it rules out pregnancy. Some women can still become pregnant while having chemotherapy, and a man having chemotherapy could still make his partner pregnant. Chemotherapy drugs can harm an unborn baby , so women should plan to avoid becoming pregnant during chemotherapy treatment, and men should not father a child.

If you or your partner become pregnant, talk to your specialist immediately. The type of birth control you choose will depend on what you and your partner are comfortable using. Some people use barrier contraception such as a condom or female condom, which provides protection against any chemotherapy drugs that may be present in their body fluids. If you want to have children in the future, talk to your doctor about how chemotherapy might affect you and what options are available.

Women may be able to store eggs ova or embryos, and men may be able to store sperm for use at a later date. This needs to be done before chemotherapy starts and requires careful consideration. Chemotherapy can reduce the levels of hormones produced by the ovaries. For some women, this causes periods to become irregular during chemotherapy but they return to normal after treatment. For other women, chemotherapy may cause periods to stop completely menopause. After menopause, women can't conceive children. Signs of menopause include hot flushes, sweating especially at night , and dry skin.

Menopause — particularly when it occurs in women under 40 — may, in the long term, cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your doctor about ways to manage menopausal symptoms. Chemotherapy drugs may lower the number of sperm produced and reduce their ability to move. This can sometimes cause infertility, which may be temporary or permanent. The ability to have and keep an erection may also be affected, but this is usually temporary.

If the problem is ongoing, talk to your doctor. Many people experience side effects from chemotherapy. Side effects are caused when the chemotherapy damages rapidly dividing healthy cells. Information and support P: Understand more about treatments that you may undertake. Find your local treatment centre in metropolitan and regional Victoria. Find out more about advanced cancer including what it is, how it is treated, what might happen and what support is available. Understand more about when cancer is diagnosed in children, teen and young adults and how to manage the needs of the child, family, friends and community.

Understand more about the role genetics has in cancer risk and how to find out more if you are concerned about a family history of cancer. Information and support 13 11 20 Support in your language 13 14 50 askanurse cancervic. Our wig service is free, private and personalised. We offer an extensive range of synthetic wigs along with headscarves, beanies and cotton caps.

Learn about the importance of exercise and its benefits during and after cancer treatment. Includes tips and example exercise techniques. Information to assist you with the emotional, physical, practical, spiritual and social challenges you may face now that treatment has finished. Information and tips for people with cancer and their partners to help understand and deal with the ways cancer and its treatment may affect your sexuality. Our Forgotten Cancers Program is committed to improving survival for less common and low survival cancers.

Cancer Council Victoria is a company limited by guarantee governed by a Board of Directors who are advised by committees. Support Research Prevent Menu. Managing side effects of chemotherapy Wednesday 1 August, Preparing for side effects Some people have no side effects, others experience a range. Recording side effects It can be useful to keep a record of your chemotherapy treatment in one place.

Trying complementary therapies Complementary therapies are sometimes used with conventional medical treatments. Feeling tired and lacking energy Feeling tired and lacking energy fatigue is the most common side effect of chemotherapy. I didn't know how to make it better and I was scared that's how it would be: Allow your body to recover by taking regular breaks.

Make time for regular exercise. Light to moderate exercise can reduce treatment-related fatigue and improve mood. Talk to your health care team about suitable activities for you. See Exercise for People Living with Cancer. Ask for, and accept, offers of support from family, friends and neighbours. They can help with shopping, driving, housework or gardening. If you have children, ask trusted family and friends to look after them during your chemotherapy sessions and to be on call in case you become unwell afterwards. Relaxation or meditation exercises may help improve your sleep or give you more energy.

Consider trying acupuncture — some studies suggest this may help reduce physical tiredness after chemotherapy. Check with your doctor whether your fatigue is related to low levels of red blood cells anaemia. Anaemia can be treated.

Managing Chemotherapy Side Effects

Discuss the impact of the treatment with your employer. Some workplaces may allow you to work flexibly during or after chemotherapy. Options include taking a few weeks off, reducing your hours or working from home.

Appetite changes, nausea or vomiting It is common for your appetite to change when you are going through chemotherapy. My mouth felt very dry, which made food taste unappetising. Adding extra sauce helped. Have frequent snacks instead of large meals. Try to eat extra on days when you have an appetite.

Avoid strong odours and cooking smells that may put you off eating. It might help to prepare meals ahead and freeze them for days you don't feel like cooking. If the taste of certain foods has changed, don't force yourself to eat them. Your sense of taste should return to normal after treatment ends. If you don't feel like eating solid foods, try enriching your drinks with powdered milk, yoghurt, eggs or honey.

Don't use nutritional supplements without your doctor's advice, as some could interfere with treatment. Ask a dietitian for advice on the best eating plan during treatment and recovery. Managing nausea Eat a light, bland meal before your treatment e. Keep sipping fluids so that you don't get dehydrated. If you aren't able to keep fluids down, contact your doctor or hospital immediately.

They may be able to treat the vomiting, or you may need to have fluids through an intravenous drip in hospital. Sip fluids throughout the day.

Sucking on ice cubes, iceblocks or jellies can also increase your fluid intake. If water tastes unpleasant, flavour it with ginger cordial or syrup. If your stomach is upset, try drinking fizzy drinks such as soda water or dry ginger ale. If you wake up feeling sick, eat a dry biscuit or slice of toast rather than skipping food. Listen to the The Thing AboutCancer podcast episode on appetite loss and nausea. Constipation or diarrhoea Some chemotherapy drugs, pain medicines and anti-nausea drugs can cause constipation or diarrhoea. Tips for managing bowel changes Constipation Eat more high-fibre foods, such as wholegrain bread and pasta, bran, fruits and vegetables, nuts and legumes e.

Drink plenty of fluids, both warm and cold, to help loosen the bowels. Prune, apple or pear juice can work well. Do some light exercise, such as walking. Avoid enemas or suppositories as they may cause infection. Let your treatment team know if you have constipation for more than a couple of days. They will be able to help. Diarrhoea Choose bland foods such as clear broth or boiled rice. Avoid spicy foods, wholegrain products, fatty or fried foods, rich sauces, and raw fruits or vegetables with skins or seeds. Limit alcohol, fruit juice, soft drinks, strong tea or coffee, and dairy products, as these stimulate the bowel.

Drink water to help replace fluids lost through diarrhoea. Talk to your cancer care team — they may change the treatment or suggest other solutions, such as using over-the-counter medicines. If diarrhoea is severe, let your cancer care team know. It can cause dehydration and you may need to go to hospital. Hair loss Many people having chemotherapy worry about hair loss alopecia. Coping with hair loss Many people find losing their hair difficult.

Scalp cooling Some people may be able to reduce or prevent hair loss by using a "cold cap". Karen's story "I'd been feeling unwell — eating made me feel nauseous and I couldn't stand to have anything tight around my stomach. Tips for managing hair loss Keep your hair and scalp very clean. Use a mild shampoo like baby shampoo. If you want to use lotion on your head, use sorbolene. Check with your nurse before using any other hair or skin care products.

Comb or brush your hair gently using a large comb or a hairbrush with soft bristles. Explain to family and friends, especially children, that the chemotherapy may make your hair fall out. Cut your hair, especially if it is long, before it falls out. Some people say this gives them a sense of control. Wear a light cotton turban or beanie to bed if you are cold at night. Use a cotton, polyester or satin pillowcase, as nylon can irritate your scalp. Talk to your hairdresser about making your hair look as good as possible even if it is thin or patchy.

If you want to dye your hair during or for about six months after chemotherapy, it is best to use vegetablebased, non-chemical dyes. If your eyelashes fall out, wear sunglasses outside to protect your eyes from dust and sun. Wear a wig, hat, turban or scarf, or go bare-headed — whatever feels best to you. If you prefer to leave your head bare, protect it against sunburn and the cold. Consider choosing a wig before chemotherapy starts. Call Cancer Council 13 11 20 for assistance in finding a wig library or shop.

Consider registering for a Look Good Feel Better workshop, where you can try on wigs and other head wear and learn new make-up techniques. Call or visit lgfb. Read Cancer Council's Hair Loss fact sheet available from your local Cancer Council website, or call 13 11 20 for more information. Mouth sores Some chemotherapy drugs can cause mouth sores, such as ulcers, or infections. Tips for mouth care Discuss any dental issues with your oncologist before seeing the dentist. If you need any dental work, tell your dentist you're having chemotherapy. Use a soft toothbrush to clean your teeth twice a day.

Rinse your mouth four times a day with 1 tsp bicarbonate of soda or salt in a glass of warm water. Avoid mouthwashes containing alcohol. Try to prevent mouth ulcers by sucking on ice during chemotherapy sessions. Sip fluids, especially water, and eat moist foods such as casseroles or soups if you have a dry mouth. Moisten foods with gravy or sauce. Soothe tender gums or mouth with plain yoghurt. Blend foods to make them easier to eat.

Try smoothies made of fruit and yoghurt. Avoid smoking and alcoholic drinks, as well as very hot foods and spicy, acidic or coarse foods e. These can all aggravate mouth sores. Read the Mouth Health and Cancer Treatment fact sheet, available from your local Cancer Council website, or call 13 11 20 for information. Skin and nail changes Some chemotherapy drugs may cause your skin to peel, darken or become dry and itchy.

Tips for looking after your skin and nails Use a moisturising soap or sorbolene cream as a soap replacement. After showering, gently pat your skin dry with a towel rather than rubbing it. Use a moisturising lotion or cream containing the ingredient urea to help with the dryness. Wear loose, non-restricting clothing.

Choose cotton fabric instead of rough wool or synthetic fibres. Wash your clothing in mild detergent for people with sensitive skin. Stop shaving or waxing until your skin is healed. Protect your skin from the sun when UV levels are 3 or above. This advice applies to everyone, but is especially important when having chemotherapy.

If your skin becomes red or sore in the area where the intravenous device went in, let your doctor or nurse know immediately. Avoid chlorinated swimming pools as the water can make skin changes worse. Thinking and memory changes Some people say they have difficulty concentrating, focusing and remembering things after they have had chemotherapy. Tips for managing cognitive changes Use a calendar to keep track of tasks, appointments, social commitments, birthdays, etc. Learn something new, e. Write down anything you need to remember, e.

Discuss these issues with your partner, family or workplace, and ask for their support or assistance. Get plenty of sleep. Deep sleep is important for memory and concentration. Do light exercise every day to help you feel more alert and sleep better. You can also listen to The Thing About Cancer podcast episode on brain fog.

How chemotherapy affects the blood Blood cells are made in the bone marrow, which is the spongy part in the centre of the bones. The bone marrow makes three main types of blood cells, which have specific functions: Anaemia If your red blood cell count drops, a reduced amount of oxygen circulates through your body. Infections If white blood cell numbers drop during chemotherapy, it can lower your immunity. A small scrape can quickly become serious. But when I feel like an infection is coming on, I've learnt to see my doctor straightaway.

When to seek medical help Contact your doctor or go to the nearest hospital emergency department immediately if you experience one or more of the following symptoms: Bleeding problems Platelets are the blood cells that help the blood to clot. Tips for when you have a low platelet count Be careful when using scissors, needles, knives or razors, as you may bleed easily. Small cuts or nicks can also harbour germs where an infection can start. Use an electric razor when shaving to reduce the chance of nicking yourself. Wear thick gloves when gardening to avoid injury.

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The gloves will also prevent infection from soil, which contains bacteria. Use a toothbrush with soft bristles to avoid irritating your gums. Wear comfortable, well-fitting shoes indoors and outdoors to avoid cuts and scrapes on your feet. Blow your nose with care. If you bleed, apply pressure for about 10 minutes and bandage as needed. If you have problems with bleeding, talk to your doctor. Tips for managing numb hands or feet Take care when moving around — you may be more prone to trip and fall if your feet are numb or your legs are weak.

Use gloves and warm socks to keep your hands and feet warm, or soak your hands and feet in warm water to relieve symptoms. These might bring on vomiting. Avoid eating foods that are hard to digest such as spicy foods, fried foods, or other high-fat foods including rich sweets and sauces. Avoid completing mouth care for 2 hours after eating to prevent nausea.

If you need to lie down, lay on your right side and keep your head elevated about 12 inches above your feet. Instead of drinking beverages with your meals, drink beverages between meals. Drink 6 to 8 eight-ounce glasses of fluid per day to prevent dehydration. Choose cold beverages such as flat soda or flavored drink mixes.

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You can also choose ice cubes, popsicles, or gelatin. Try to eat more food at a time of day when you feel less nauseous. If you feel nauseous when you first wake up, keep a box of crackers on your night stand and eat a few before getting out of bed. Or, try eating a high-protein snack such as lean meat or cheese before going to bed protein takes longer to digest. After every episode of vomiting, gargle with a baking soda solution 1 teaspoon of baking soda in 8 ounces of warm water to cleanse your mouth.

Tell your health care providers immediately if your nausea causes vomiting that is persistent or severe if you can't keep fluid or foods down on a continual basis. Persistent vomiting can cause dehydration. Dehydration Persistent vomiting and diarrhea cause the body to lose large amounts of water and nutrients.

When you are in the hospital, you will receive intravenous fluids. When you are an outpatient, please tell your health care provider if you are vomiting persistently or have persistent diarrhea and experience any of these signs of dehydration: Loss of appetite Feeling nauseous from your chemotherapy or radiation might cause you to lose your appetite. During your hospital stay, you might be unable to eat a well-balanced diet due to nausea, vomiting, mouth sores, or loss of appetite. If these side effects prevent you from maintaining proper nutrition, your doctor might want to give you intravenous nutrition, depending on your specific nutritional deficiencies.

After you are discharged from the hospital, you might continue to have side effects from your treatment such as decreased appetite, taste changes, mouth sores, dry mouth, or diarrhea. These side effects might prevent you from trying to maintain good nutrition. Over time, many of these problems will improve. Here are some suggestions to increase your appetite: Eat small, frequent meals or snacks from 6 to 8 times a day. Drink beverages after meals instead of before or during a meal so you do not feel as full.

Try to eat more protein and fat and fewer simple sugars. Eggs, fish, and high-protein puddings will provide you with high nutritional content and high protein in small portions. Custards, peanut butter, ice cream, yogurt, peas, beans, and nuts are also high in protein. Rinse your mouth with water before meals. Chew your food completely. Sip liquids frequently while eating to keep food moist and to help with swallowing.

Drink 6 to 8 eight-ounce glasses of fluid per day.

Gargle with club soda or add lemon or lime to water to thin saliva. Try to eat soft foods with sauces, dressings, broths, sour cream, or gravies to make the food easier to swallow. Try dunking your foods, such as bread, into soups to moisten them. Suck on ice chips or sugar-free gum or candies to keep your mouth moist. Liquid nutritional drinks might be helpful when your mouth is most dry. Ask your health care provider for more information. Mouth sores Mouth sores are common after chemotherapy. To prevent mouth sores: In the hospital, you will be given mouth care products and instructions on how to use them.

You will use two types of mouth rinses daily to keep your mouth clean. You are expected to perform your mouth care independently several times a day. Do not use commercial mouthwashes or lozenges. Patients can brush their teeth after each meal with a small, soft toothbrush and fluoride toothpaste.

Rinse your mouth and gargle with this solution at least 4 to 6 times a day, especially after meals and before going to bed. Use dental floss daily, if allowed by your doctor. If mouth sores develop: If you are able to eat, eat slowly. Cut your food into small pieces and chew it completely. Eat foods that are warm or at room temperature. Avoid hot foods and drinks. A soft diet can be prescribed for you, if necessary. Talk to your health care provider about a soft diet. Liquid nutritional drinks might be helpful when you have mouth sores.

Avoid crunchy foods such as potato chips and nuts. Drink liquids through a straw to make swallowing easier. Do not talk with food in your mouth. Avoid eating or drinking acidic foods and beverages such as tomatoes, oranges, grapefruits, and their juices. Instead, try nectars and imitation fruit drinks with vitamin C. If you are unable to eat due to your mouth sores, your health care providers will monitor you nutritional status very closely. You will be given pain medicines intravenously to control or decrease the discomfort caused by the mouth sores while you are in the hospital.

Skin rash A skin rash or other irritation might occur because of chemotherapy, an allergic reaction to a medicine, or from an infection. Most skin rashes improve but require time for healing. Gently cleanse the affected area using lukewarm water and mild soap. Do not rub your skin. Pat your skin dry with a soft towel.

Do not scratch or rub the affected area. Do not apply any ointment, cream, lotion, or powder to the affected area unless it has been prescribed. Do not apply cosmetics, shaving lotions, perfumes, or deodorants on the affected area. Use only an electric razor if you need to shave within the affected area. Do not wear tight-fitting clothing or clothes made from harsh fabrics such as wool or corduroy.

These fabrics can irritate the skin. Instead, choose clothes made from natural fibers such as cotton. Do not apply medical tape or bandages to the affected area unless you are told to do so by your health care provider. Do not expose the affected area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.

Do not expose the affected area to direct sunlight. Sun exposure might intensify your skin reaction and lead to severe sunburn. Wear a large-brimmed hat or protective clothing to minimize sun exposure.

Continue to protect yourself from the sun even after your course of treatment has been completed. Hair Loss Hair follicles are very sensitive to radiation and chemotherapy. This side effect can be very upsetting. Talk to your nurse or social worker about wearing scarves, hats, or a wig. All participating patients receive a complimentary gift bag of skin care and cosmetic products. Use a mild shampoo such as baby shampoo without any perfumes. Wash your scalp with warm water. Avoid rubbing and do not scratch. Pat dry with a soft towel. Avoid excessively combing or brushing your hair.

Avoid using hair spray, oils, or creams. Avoid using heat sources on your hair including hair dryers, rollers, or curling irons. Do not perm or color your hair. Ask your health care provider when you can go back to coloring or perming your hair. Protect your head from the sun, cold, and wind by wearing a head covering such as a cap, turban, scarf, or hat made of cotton or a cotton blend. Fatigue Everyone has a different level of energy, so bone marrow transplantation will affect each patient differently.

Be alert to your personal warning signs of fatigue. Fatigue warning signs might include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety , or impatience.

Plan ahead, organize and prioritize your daily activities. Change storage of items to reduce trips or reaching. Combine activities and simplify details. Balance periods of rest and work. Rest before you become fatigued. Frequent, short rests are beneficial. A moderate pace is better than rushing through activities. Walking is an excellent way for you to regain your strength and stamina. Eat a well balanced, nutritious diet. Managing stress can play an important role in combating fatigue. Adjust your expectations and ask others for support and help.

Talk to your health care providers. Although fatigue is a common, and often expected, side effect of cancer and its treatments, mention your concerns to your health care providers. There are times when fatigue might indicate an underlying medical problem. Other times, there might be medical interventions to assist in controlling some of the causes of fatigue. Finally, there might be suggestions that are more specific to your situation that would help in combating your fatigue.

Be sure to let your doctor or nurse know if you have: Increased shortness of breath with minimal exertion. Inability to control side effects from treatments such as nausea, vomiting, diarrhea, or loss of appetite. Uncontrollable anxiety or nervousness. Insomnia difficulty sleeping Many patients have trouble sleeping during their hospital stay. If necessary, you might be given a prescription medicine to help you fall asleep. Practice relaxation techniques such as mental imagery, deep breathing, reading, or listening to calming music.

Make sure you are comfortable. Arrange your pillows so you can maintain a comfortable position. Avoid napping too much during the day. At the same time, remember to balance activity with rest. If you feel nervous or anxious, talk to your spouse, partner, or a trusted friend.

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