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Side effects of chemotherapy treatments are common, and they are more severe with higher doses. Side effects increase over the course of treatment. Some studies suggest that side effects can be reduced by giving the drugs for shorter durations, without losing the cancer-killing effects.
Common side effects include the following:
- Diarrhea
- Temporary hair loss
- Weight loss
- Fatigue
- Depression
- Nausea and vomiting: Drugs known as serotonin antagonists, especially ondansetron (Zofran), can relieve these two side effects. Serotonin antagonists work well in nearly all patients given moderate chemotherapy drugs, and in most patients who take more powerful drugs.
- Anemia: An abnormally low number of red blood cells is common in lung cancer. One treatment involves transfusions or injections of erythropoietin, a drug that increases red blood cell production. Erythropoietin is available as epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp), which requires fewer injections. These drugs are recommended when a patient's hemoglobin level falls below a certain level, usually less than 10 g/dL.
These side effects are nearly always temporary. Most patients are able to continue with their normal activities for all but perhaps 1 or 2 days per month.
Serious complications of chemotherapy can also occur, and vary depending on the specific drugs. These complications include:
- Increased chance for infection from suppression of the immune system.
- Severe drop in white blood cells (neutropenia): Certain chemotherapy drugs, such as taxanes, pose a higher risk for this complication than other drugs. A drug called granulocyte colony-stimulating factor (filgrastim and lenograstim) can improve the white blood cell count.
- Liver and kidney damage: Amifostine (Ethyol) reduces the risk for kidney damage in patients taking repeated regimens of cisplatin-based therapy. It is also a radioprotector; that is, it helps prevent severe effects in the esophagus from radiotherapy, with or without chemotherapy.
- Abnormal blood clotting (thrombocytopenia).
- Allergic reaction, particularly to platinum-based agents: A simple skin test is under investigation that may identify people with a potential allergic response.
Second-Line Chemotherapy
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Review Date: 07/01/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
