NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Part 6: Coping with side effects
What you can do
Be vigilant. Frustrating though it may be, you really need
to protect yourself from viruses, bacteria, and other
germs that your system just isn’t prepared to fight. After
all, the last thing you need while battling cancer is a
severe case of the flu. Basic protective measures include:
Buy a good thermometer. When you’re
immunosuppressed, or neutropenic, even a small
spike in temperature may indicate the beginning of
an infection. Monitoring your temperature can help
detect infections before they become serious.
When your counts are at their lowest, stay away
from young children if you can. They’re cute, but
they’re germ factories. If you’re a parent, encourage
your kids to be extra careful about hand washing
and covering sneezes and coughs to help mommy
or daddy stay well.
Wash your hands. A lot. Carry hand sanitizer and
try to use it whenever you touch potentially germy
surfaces such as doorknobs. (And try to avoid
Avoid salad bars and buffets (they can be almost as
germy as children!).
Ask friends and family to stay away if they’re feeling
even a little bit under the weather, or if they’ve been
exposed to someone who is sick.
If your neutrophil count is low, ask your doctor if you
should stay home from work or school. If you have
to go in to the office or school, be sure to wash your
hands often and well.
Get a flu shot every fall. Discuss the timing of
the shot with your treatment team, so you can be
immunized when your immune system is relatively
If your bone marrow is suppressed for a long time, your
treatment team may prescribe injections of a G-CSF
actor) drug, such
as Neupogen or Neulasta, that will prompt your bone
marrow to produce more neutrophils.
Nerve damage (neuropathy)
Why it happens
Several common chemotherapy drugs can cause
neuropathy—damage to nerve cells that interferes with
normal nerve signals. Peripheral neuropathy affects
the hands and feet and can manifest as an increased
sensitivity to cold, pain, burning, numbness, or a “pins
and needles” tingling.
Neuropathy can also affect nerves in the ear, leading
to hearing loss, ringing in the ears, and problems
with balance and coordination. Central neuropathy is
also a prime suspect in chemobrain, difficulties with
concentration and memory that are common in people
Neuropathy usually subsides once treatment is over, but
permanent nerve damage can occur, so your treatment
team will want to monitor these side effects very closely.