NCCN Guidelines for Patients® | Multiple Myeloma - page 34

32
NCCN Guidelines for Patients
®
Multiple Myeloma, Version 1.2014
3
Treatments for myeloma
Side effects of cancer treatments
Side effects of cancer
treatments
A side effect is a new or worse physical or emotional
condition caused by treatment. Each treatment for
myeloma can cause side effects, but how your body
will respond can’t be fully known. You may have
different side effects than someone else.
Controlling side effects is important for your quality
of life. There are many ways to limit these problems.
However, listing all the ways is beyond the scope
of this book. In general, changes in behavior, diet,
or medications may help. Don’t wait to tell your
treatment team about side effects. If you don’t tell
your treatment team, they may not know how you are
feeling. Common side effects of myeloma treatments
are listed below.
Radiation therapy.
Side effects of
radiation therapy
may not occur in the first few visits. Over time, you may
have nausea, diarrhea, and
fatigue
. Other common side
effects include changes in your skin and hair loss in the
treated area.
Surgery.
You may experience weakness, tiredness,
and pain after the surgery. Other common side effects
are swelling, surgical scars, and, less frequently,
infections.
Targeted therapy.
The side effects of targeted
therapy depend on the drug and dose. Some of the
side effects listed are caused by only one targeted
drug. Others are caused by many targeted drugs but
differ in how likely they are to occur. Common side
effects of targeted therapy drugs include tiredness,
weakness, nausea or vomiting, diarrhea, constipation,
low red blood cell count (called anemia), low white
blood cell count (can increase risk of infection), low
platelet count (can increase risk of bruising and
bleeding), blood clots, numbness or tingling in the
hands or feet, skin rash, and muscle aches.
Chemotherapy.
Like targeted therapy, the side
effects of chemotherapy depend on many factors.
In general, side effects are caused by the death of
fast-growing cells, which are found in the intestines,
mouth, and blood. As a result, common side effects
include low blood cell counts, infections, diarrhea,
nausea, vomiting, mouth sores, tiredness, weakness,
numbness or tingling of hands or feet, skin and nail
changes, hair loss, swelling, and not feeling hungry.
Steroids.
Most side effects of steroids go away
over time once the drugs are stopped. Common side
effects include feeling hungry, trouble sleeping, slow
wound healing, upset stomach, and swelling in the
ankles, feet, and hands.
Stem cell transplant.
Side effects can occur at
each step of treatment with a stem cell transplant.
You may feel dizzy or have tingling in your hands
and feet during apheresis. Common side effects of
chemotherapy are listed above. While waiting for the
cells to engraft, you will likely feel tired and weak.
Allogeneic stem cell transplants have a high risk of
GVHD (
g
raft-
v
ersus-
h
ost
d
isease). GVHD is when
the donated cells (the graft) see the cells in your body
(the host) as foreign and attack them. The parts of
the body most commonly damaged by GVHD include
the skin, liver, and intestines. GVHD is a serious side
effect that can cause the transplant to fail by stopping
the donated stem cells from growing in your bone
marrow. GVHD can develop within a few weeks after
the transplant or much later.
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