Managing Common Side Effects of Chemotherapy for Ovarian Cancer

"Most patients typically get a lot of fatigue, muscle aches, and joint pain in that first 24 to 48 hours after chemotherapy," says Dr. Lynn Parker, gynecologic oncologist at Norton Cancer Institute. "And then [we] can see some decrease in blood counts, so fatigue again around 10 days or so after the chemotherapy is given."

Some women may become so tired that returning to work is impossible for a week or more after a chemotherapy infusion. Others may be able to work limited hours right away. Though patients should expect to feel more tired than they're accustomed to, one oncologist tells SurvivorNet that many working women are able to work 50 to 75 percent of their pre-diagnosis hours.

Patients will need to gauge themselves, learn their limits, and not overdo it. And while you shouldn't push yourself if you're not feeling well, doctors say it's important to try and incorporate some light physical activity like going for a walk into your day. Exercise doesn't just help manage fatigue, it can help you sleep, and keep you in better shape for when you're done with treatment. Plus, taking a walk isn’t just good for your body; the sunlight and fresh air can help to boost your mood.

Prioritizing healthy, restful sleep7-9 hours for most peopleis also recommended.

Managing Hair Loss

Taxol is the drug that causes hair loss, but your hair “should grow back, typically a few months after chemotherapy is completed," Dr. Parker says. And while it’s normal to feel upset about losing your hair, there are steps you can take to make the experience less distressing.

For instance, you might want to cut your hair very short or even shave your head before your hair starts falling out. If you're thinking about buying a wig, buy it before your treatment starts, or soon after. Cancer.org suggests asking if the wig can be adjusted as you might need a smaller size as you lose hair. To match your hair color, they recommend cutting a swatch from the top front of your head, where your hair is lightest. Wigs and other scalp coverings may be partially or fully covered by your health insurance. If so, ask for a prescription for a "cranial prosthesis." (Don't use the word "wig" on the prescription.) Your cancer team can likely recommend wig shops in your area.

Some women opt to try cold caps to at least slow the thinning. The caps work by constricting the blood in the scalp, which prevents some of the chemotherapy drugs from penetrating the scalp and reaching the hair follicles. However they can be very uncomfortable and cause headaches due to the extreme cold, so many women opt for wigs or scarves.

Managing Constipation

Many women experience gastrointestinal issues such as constipation or diarrhea during their treatment. "Constipation is very common after chemotherapy, and the timing I hear from patients is typically in the first few days after [a] chemotherapy [infusion]. Knowing that, we can prepare by having them take a stool softener or make dietary adjustments, hydrating well. Also being active does help with keeping your bowels functioning," says Dr. Parker.

Managing Nausea

Nausea is a side effect that most people associate with chemotherapy, but anti-nausea medications are now quite powerful and doctors are better able to manage this side effect than in the past. And while patients might feel a bit queasy, vomiting is relatively rare.

"There are wonderful things we can do now to try to keep people doing well. We give some pre-medicationsIV medications that are given prior to the infusion of the chemotherapy on the day of treatment," says Dr. Parker. "I typically have patients take something for acute nausea, whether they need it or not, in the first 24 to 48 hours after chemotherapy. Then I tend to use a low-dose steroid for about three days after chemo, to prevent delayed nausea. Usually that combination does a really wonderful job at preventing nausea and vomiting."

Natural remedies like ginger tea or ginger candies may also help soothe a queasy stomach.

Most oncologists would probably agree that if patients are vomiting they need to let their physician know because this is problem that can be prevented or managed.

That Tingling Feeling

"Neuropathy is a side effect that we can see with paclitaxel, or Taxol, during chemotherapy and after," says Dr. Parker. Patients experience it as a numbness or tingling in their hands and feet. "It is another side effect that can worsen in the first few months after chemotherapy and then start to get better. Typically, if patients have residual neuropathy a year after they finish chemotherapy then it probably will be persistent."

Dr. Parker sees her patients with each chemotherapy infusion and makes sure to find out what they’re experiencing. If the neuropathy becomes so bad that they're having trouble with daily activities like walking or buttoning clothes, "then I'd adjust down the dose of the paclitaxel, which can help us keep [the neuropathy] from getting worse. Again, we know that it will worsen a little bit as we get toward the end of chemo and in that first few months after, but if we adjust early enough we can mitigate that."

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