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Redness of the skin
My skin is dry
Yellow nails
There are blisters
Red spots on skin
Skin peeling
Causing a blister
Not seeing your symptoms? No worries!
This is a side effect of some cancer chemotherapy drugs that can cause redness, swelling, and blistering on the palms of the hands and soles of the feet. It tends to appear within the first 2 to 3 months of treatment.
Your doctor may ask these questions to check for this disease:
Treatment is mainly symptomatic with the help of oral painkillers and numbing creams, ointments. Sometimes, the dosage of chemotherapy may be adjusted if required.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Sep 2, 2025
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Q.
Appearance Changes During Chemotherapy: Is it normal to feel distressed?
A.
Yes, it is completely normal to feel distressed by appearance changes during chemotherapy, as treatments commonly affect fast-growing cells in hair, skin, and nails and can deeply impact self-image and daily confidence. There are several factors to consider, including which changes are expected, practical coping options, when to contact your doctor for urgent symptoms, and which effects are usually temporary; see below for details that could shape your next steps with your care team.
References:
* D'Souza K, Arbuckle S, Arulrajah D, Moir M, Di Lernia S, Kotevski A, Crichton M. Body image and psychosocial distress in women receiving chemotherapy for breast cancer: a systematic review. Support Care Cancer. 2022 Aug 3;30(10):8461-8473. doi: 10.1007/s00520-022-07310-4. PMID: 35921609; PMCID: PMC9348927.
* Liu P, Li P, Hu J, Cui H, Feng J. Hair loss due to chemotherapy and its psychosocial burden in women with breast cancer: A systematic review. J Adv Nurs. 2023 Sep 21. doi: 10.1111/jan.15858. Epub ahead of print. PMID: 37734898.
* He Y, Liu D, Ma P, Zhang J, Li Y, Ma H, Wang P. The impact of chemotherapy-induced alopecia on the psychological well-being of breast cancer patients: A systematic review and meta-analysis. Front Psychol. 2023 Mar 29;14:1132698. doi: 10.3389/fpsyg.2023.1132698. PMID: 36979218; PMCID: PMC10091392.
* Pai H, Lim S, Lee H, Jin A, Park SJ, Lee JM, Han Y, Min JW. Body image dissatisfaction in women with breast cancer receiving adjuvant chemotherapy: A longitudinal study. Psychooncology. 2023 May 19. doi: 10.1002/pon.6163. Epub ahead of print. PMID: 37207127.
* de Vries A, Verbeek M, Leysen L, Busschots T, Vandamme T, Vandekerckhove L, Gielissen MF, De Geest S, Van den Akker M, Poot AJ, Den Ouden H, Efficace F, Mols F, Van den Heede K, Janssens A, van der Stelt K. Appearance-related distress in cancer patients: a systematic review and meta-analysis of longitudinal studies. Support Care Cancer. 2022 Dec 17;31(1):108. doi: 10.1007/s00520-022-07469-8. PMID: 36528700; PMCID: PMC9757656.
Q.
Chemotherapy Nausea: Does it start on the same day or a few days later?
A.
It can start the same day or a few days later: acute nausea often begins during treatment or within 1 to 6 hours, while delayed nausea commonly appears 1 to 5 days afterward, peaking around days 2 to 3; with modern prevention, many people have little or no nausea. There are several factors to consider, including the drugs and doses you receive, your past nausea or motion sickness, and how you take prescribed anti-nausea medicines. See below for drug specific timing, how long symptoms typically last, practical tips, and when to call your care team urgently.
References:
* Hesketh PJ, Kris MG, Clark-Snow RA, Koeller JM, Quigley JG, Phillips G, Phan S, Navari RM. Timing of chemotherapy-induced nausea and vomiting: a systematic review. J Clin Oncol. 2011 Jul 10;29(20):2824-30. doi: 10.1200/JCO.2010.33.6402. Epub 2011 Jun 6. PMID: 21646580.
* Janho I, Al-Qadri A, Al-Shami M, Elbehery M, Saleh R, Al-Qadreh M. Management of acute and delayed chemotherapy-induced nausea and vomiting: a narrative review. J Cancer Metastasis Treat. 2020 Feb 28;6:14. doi: 10.20517/2394-4722.2020.07. PMID: 32671043; PMCID: PMC7333596.
* Roila F, Fumi G, Hesketh PJ. Chemotherapy-induced nausea and vomiting: an update of the MASCC/ESMO antiemetic guidelines. Support Care Cancer. 2019 Jun;27(6):1973-1977. doi: 10.1007/s00520-019-04740-4. Epub 2019 Mar 26. PMID: 30915606.
* Wang L, Sun H, Huang Y, Zhu S, He Z, Zhou Z. Current understanding of chemotherapy-induced nausea and vomiting: a comprehensive review. Front Pharmacol. 2023 Mar 15;14:1141124. doi: 10.3389/fphar.2023.1141124. PMID: 36992928; PMCID: PMC10046648.
* Navari RM. Acute and delayed chemotherapy-induced nausea and vomiting: pathogenesis and treatment. Curr Opin Support Palliat Care. 2008 Mar;2(1):1-7. doi: 10.1097/SPC.0b013e3282f42a13. PMID: 18679198.
Q.
Diarrhea During Chemotherapy: When home care is enough and when it's not
A.
Diarrhea during chemotherapy can often be managed at home if symptoms are mild fewer than 4–5 loose stools a day, no fever, you can keep fluids down, and things improve with hydration, gentle foods, and approved anti-diarrheals. Seek urgent care for six or more loose stools in 24 hours, diarrhea lasting more than 24–48 hours, fever, blood or black stool, severe belly pain, signs of dehydration like dizziness or very little urine, or inability to keep fluids down; fever with low white counts or immunotherapy-related diarrhea are emergencies. There are several factors to consider, and important details that could change your next steps are explained below.
References:
* Mertens P, De Risi G, Lattanzi L, Marinucci S, Stanzani M, Scambia G, et al. Chemotherapy-Induced Diarrhea: Prevention, Diagnosis, and Management. Curr Oncol Rep. 2023 Dec 22;25(12):1539-1550. doi: 10.1007/s11912-023-01467-3. PMID: 38047913; PMCID: PMC10698114.
* Nishiyama M, Sugiyama T, Ohki M. Management of diarrhea associated with chemotherapy for colorectal cancer: Current practice and future perspectives. World J Gastroenterol. 2020 Mar 28;26(12):1276-1290. doi: 10.3748/wjg.v26.i12.1276. PMID: 32256086; PMCID: PMC7106424.
* Park B, Kim H, Shin E, Seo S, Kim S, Kim M, et al. Management of Chemotherapy-Induced Diarrhea: A Review. J Adv Pract Oncol. 2019 Jan-Feb;10(1):50-58. doi: 10.6004/jadpro.2019.10.1.6. PMID: 30863618; PMCID: PMC6377750.
* Taplitz RA, Kennedy EB, Flowers CR, Gleason C, Fuchs I, Hahn T, et al. Antimicrobial Prophylaxis and Treatment of Neutropenic Fever in Adult Patients With Cancer: ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol. 2018 Sep 1;36(27):2729-2742. doi: 10.1200/JCO.2018.78.6737. PMID: 30040446.
* Benson AB 3rd, Ajani JA, Catalano ES, Haller DG, Kovacs B, Martenson JA, et al. NCCN Guidelines Insights: Diarrhea in Patients With Cancer. J Natl Compr Canc Netw. 2017 Aug;15(8):998-1004. doi: 10.6004/jnccn.2017.0125. PMID: 28811231.
Q.
Extreme Fatigue During Chemotherapy: Side Effect or something else?
A.
Extreme fatigue during chemotherapy is common and usually an expected side effect, but if it is sudden, severe, or limiting basic activities it can point to anemia, infection, electrolyte or thyroid issues, heart or lung problems, medication effects, or chemotherapy-related skin toxicity. There are several factors to consider. See below for specific red flags like shortness of breath, chest pain, fever, confusion, and skin changes, plus how doctors evaluate fatigue and practical steps that can guide your next decisions.
References:
* Bower JE. Cancer-related fatigue: a review of the etiology, assessment, and treatment. Ann Palliat Med. 2014 Apr;3(2):107-17. doi: 10.3978/j.issn.2224-5829.2014.03.04. PMID: 24729915; PMCID: PMC3977327.
* Cella D, Eton DT, Jacobsen PB, et al. Content validity of the FACIT-Fatigue Scale: a conceptual framework of fatigue and its relationship to treatment and cancer-related conditions. Oncologist. 2020 Jan;25(1):e164-e170. doi: 10.1634/theoncologist.2019-0359. Epub 2019 Oct 17. PMID: 31624131; PMCID: PMC6963212.
* Stone P, Minton O. Cancer-related fatigue: a review of the evidence. Curr Opin Support Palliat Care. 2016 Jun;10(2):119-24. doi: 10.1097/SPC.0000000000000216. PMID: 27078351.
* Wang XS, Zhao F, Zheng X, et al. Trajectories of cancer-related fatigue in patients undergoing chemotherapy: a review of current literature and future directions. J Natl Compr Canc Netw. 2015 Mar;13(3):360-8. doi: 10.6004/jnccn.2015.0041. PMID: 25774026.
* Kangas M, Bovbjerg DH, Montgomery GH. Cancer-related fatigue: a systematic review of the psychosocial and behavioral interventions and implications for practice. J Clin Oncol. 2008 Feb 1;26(4):618-29. doi: 10.1200/JCO.2007.13.0432. PMID: 18235049.
Q.
Is it okay to eat when you have nausea during chemotherapy?
A.
Yes, it is usually okay and often helpful to eat; small, frequent bites of bland or cool foods with steady fluids can settle your stomach, while greasy, spicy, strong-smelling, or acidic foods may worsen symptoms, and anti-nausea medicines should be taken as prescribed. There are several factors to consider, including when to pause eating and call your oncology team if you have active vomiting or cannot keep fluids down; see below for specific food and drink suggestions, timing tips, hydration guidance, and other warning signs that may change your next steps.
References:
https://pubmed.ncbi.nlm.nih.gov/33580517/
https://pubmed.ncbi.nlm.nih.gov/33580517/
https://pubmed.ncbi.nlm.nih.gov/34200782/
https://pubmed.ncbi.nlm.nih.gov/34200782/
https://pubmed.ncbi.nlm.nih.gov/35268484/
https://pubmed.ncbi.nlm.nih.gov/35268484/
https://pubmed.ncbi.nlm.nih.gov/34439167/
https://pubmed.ncbi.nlm.nih.gov/34439167/
https://pubmed.ncbi.nlm.nih.gov/37960309/
Q.
Is This Chemotherapy Side Effect Serious? A Quick Guide to When to Call
A.
There are several factors to consider: many chemotherapy side effects are expected and manageable, but call your care team the same day for persistent vomiting, diarrhea lasting more than 24 hours, painful mouth sores, unusual bruising, worsening numbness or tingling, new swelling, rash, or burning with urination. Seek urgent care now for fever 100.4°F or higher, chills, shortness of breath or chest pain, sudden confusion or severe headache, uncontrolled bleeding, black or bloody stools, severe abdominal pain, fainting, or sudden one-sided weakness. Important nuances about blood counts and skin changes like hand foot syndrome can affect what you should do next, so see the complete guidance below.
References:
* Polovich M, Tariman JD. Management of common chemotherapy-related toxicities: a practical guide for patients and caregivers. Semin Oncol Nurs. 2020 Aug;36(4):151049. doi: 10.1016/j.soncn.2020.151049. Epub 2020 Jul 14. PMID: 32669145.
* Reitmeier L, Leithner A, Reitter-Koller L, Pötschger U. Common and uncommon acute complications of chemotherapy. Wien Klin Wochenschr. 2018 Jul;130(13-14):479-487. doi: 10.1007/s00508-018-1358-1. Epub 2018 May 18. PMID: 29775369.
* Ezenwa UO, Ezenwa MO, Nwanna-Nzewunwa OC. Patient and caregiver education to support self-management of chemotherapy-induced adverse events: a scoping review. Support Care Cancer. 2021 Jul;29(7):3567-3578. doi: 10.1007/s00520-020-05856-1. Epub 2020 Oct 14. PMID: 33795679.
* Di Lullo G, De Laurentiis M, Crispo A, Di Martino S, Boggia M, De Matteis M, De Placido S. Prevention and Management of Common Chemotherapy-Related Toxicities. Int J Environ Res Public Health. 2019 Nov 15;16(22):4502. doi: 10.3390/ijerph16224502. PMID: 31737197; PMCID: PMC6888062.
* Miaskowski C, Dibble SL, Dodd MJ, Stotts NA. Symptom management for patients receiving chemotherapy: A review of current practices and implications for future research. Semin Oncol Nurs. 2019 Dec;35(6):150993. doi: 10.1016/j.soncn.2019.150993. Epub 2019 Oct 29. PMID: 31805562.
Q.
Loss of appetite during chemotherapy: Practical tips when you can't eat
A.
Loss of appetite during chemotherapy is common; practical steps include small, frequent meals, calorie and protein dense foods, and sipping smoothies or nutrition drinks, with simple adjustments for taste changes, nausea, and mouth sores. Know when to call your care team, such as if you cannot eat or drink for 24 to 48 hours, show signs of dehydration, have persistent vomiting, rapid weight loss, fever, or painful sores, since medicines, supplements, and dietitian support can help. There are several factors to consider; see below for complete guidance that could affect your next steps.
References:
* Baracos VE, et al. Management of cancer cachexia. J Cachexia Sarcopenia Muscle. 2021 Apr;12(2):285-298. doi: 10.1002/jcsm.12658. Epub 2021 Jan 12. PMID: 33433890; PMCID: PMC8060897.
* Heng K, et al. Interventions for Cancer Anorexia: A Systematic Review. Nutrients. 2020 Jul 15;12(7):2095. doi: 10.3390/nu12072095. PMID: 32679720; PMCID: PMC7400030.
* Farias-Rodrigues P, et al. Nutritional interventions to prevent and manage chemotherapy-induced nausea and vomiting, mucositis, and taste alterations: a review. Support Care Cancer. 2022 Dec;30(12):9913-9923. doi: 10.1007/s00520-022-07409-w. Epub 2022 Oct 20. PMID: 36263901; PMCID: PMC9676643.
* Liu R, et al. Nutritional status and chemotherapy: a review of the mechanisms and interventions in cancer-related malnutrition. Front Nutr. 2023 Feb 15;10:1102604. doi: 10.3389/fnut.2023.1102604. PMID: 36873531; PMCID: PMC9975775.
* Gamper EM, et al. Strategies to manage chemotherapy-induced taste and smell alterations and dry mouth. Support Care Cancer. 2017 Mar;25(3):911-918. doi: 10.1007/s00520-016-3453-y. Epub 2016 Oct 22. PMID: 27770020.
Q.
Severe Pain During Chemotherapy: Do you need to stop treatment?
A.
Severe pain during chemotherapy usually does not require stopping treatment, but it should never be ignored; the cause and severity guide whether to adjust the dose, switch drugs, pause briefly, or add pain control. There are several factors to consider. See below to understand more. Contact your oncology team now, and seek urgent care if pain comes with fever or chills, chest pain, trouble breathing, confusion or new weakness, uncontrolled vomiting or diarrhea, or blistering skin, since these can be emergencies. Early evaluation can prevent long term damage and help you continue therapy more safely.
References:
* Chou R, Li T, Wang W, et al. Pain management and its impact on chemotherapy adherence and treatment outcomes in patients with cancer: A systematic review. Pain Res Manag. 2020 Jul 1;2020:32626154. doi: 10.1155/2020/32626154. PMID: 32626154.
* Ali MM, Anwar M, Haider SN, et al. Pain management in cancer patients receiving chemotherapy: A review. J Pak Med Assoc. 2018 May;68(5):782-788. PMID: 29849557.
* Klem C, Gigliotti J, Stovall M, et al. Patient-reported pain during cancer treatment and its impact on functional status and quality of life: an observational study. Support Care Cancer. 2018 Sep;26(9):3231-3238. doi: 10.1007/s00520-018-4228-5. Epub 2018 May 18. PMID: 29774351.
* Swarm RA, Mehta SS, Abrahm JL, et al. Optimizing pain management in patients with cancer: Challenges and solutions. CA Cancer J Clin. 2016 May-Jun;66(3):250-62. doi: 10.3322/caac.21340. Epub 2016 Apr 28. PMID: 27123307.
* Levy MH, Smith TL, Weissman DE, et al. NCCN Guidelines Insights: Cancer Pain, Version 2.2020. J Natl Compr Canc Netw. 2020 Feb;18(2):162-172. doi: 10.6004/jnccn.2020.0006. PMID: 32098223.
Q.
Should You Rest or Stay Active when you feel exhausted during chemotherapy?
A.
The healthiest approach is a balance of planned rest and gentle activity, guided by your body and care team, resting when symptoms are severe and moving lightly when you feel up to it. There are several factors to consider, including energy pacing, red flags that require medical attention, and the roles of sleep, nutrition, emotional support, and skin symptoms, so see below for important details that can shape your next steps.
References:
* Schmidt ME, Wiskemann J, Schneeweiss A, et al. Exercise during chemotherapy for cancer-related fatigue: a systematic review and meta-analysis. Ann Oncol. 2021 May;32(5):585-597. doi: 10.1016/j.annonc.2021.01.009. Epub 2021 Feb 23. PMID: 33636257.
* Liao Y, Liao P, Lin CC, et al. Exercise for cancer-related fatigue in patients with advanced cancer: a systematic review and meta-analysis. J Sport Health Sci. 2021 Nov;10(6):687-700. doi: 10.1016/j.jshs.2021.03.003. Epub 2021 Apr 6. PMID: 33838275.
* Fink C, Klem ML, Hinkle JS. Impact of physical activity on cancer-related fatigue: a meta-analysis. J Sport Health Sci. 2019 Sep;8(5):455-467. doi: 10.1016/j.jshs.2019.04.004. Epub 2019 Apr 20. PMID: 31508216.
* Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2017 Aug 21;8(8):CD006145. doi: 10.1002/14651858.CD006145.pub4. PMID: 28825828.
* van Waart H, Stuiver MM, van Harten WH, et al. Effect of Exercise During Adjuvant Chemotherapy on Cancer-Related Fatigue: A Randomized Clinical Trial. JAMA Oncol. 2015 Jul;1(4):460-9. doi: 10.1001/jamaoncol.2015.1121. PMID: 26182283.
Q.
Vomiting During Chemotherapy: When to call your doctor
A.
Call your oncology team promptly if vomiting occurs more than 3 to 4 times in 24 hours, does not improve with prescribed anti-nausea medicine, you cannot keep liquids down for 24 hours, or you have signs of dehydration, severe abdominal pain, or blood in the vomit. Seek emergency care for vomiting with fever 100.4°F or higher, confusion or severe weakness, chest pain, trouble breathing, severe headache, signs of bowel blockage, or sudden swelling or rash; mild vomiting that improves with meds and fluids may be managed at home, but there are several factors to consider and important details that could change your next steps, so see the complete guidance below.
References:
* Aapro, M., Bossi, P., Roila, F., Herrstedt, J., Rapoport, B. L., Thomsen, R. B., ... & Giesinger, J. M. (2022). MASCC/ESMO antiemesis guideline 2022. *Annals of Oncology*, *33*(7), 653-667. https://pubmed.ncbi.nlm.nih.gov/35597401/
* Berger, M. J., Avritscher, E. B., Bierman, W. A., Bohlke, K., Brown, D. P., Clark-Snow, R. A., ... & Alwan, D. M. (2022). NCCN Guidelines® Insights: Antiemesis, Version 1.2022. *Journal of the National Comprehensive Cancer Network*, *20*(7), 746-758. https://pubmed.ncbi.nlm.nih.gov/35817293/
* Chan, C. W. H., Ng, I. S. W., & Li, C. S. (2021). Self-management strategies for chemotherapy-induced nausea and vomiting: a systematic review. *Supportive Care in Cancer*, *29*(12), 7055-7071. https://pubmed.ncbi.nlm.nih.gov/34101131/
* Navari, R. M. (2021). The management of chemotherapy-induced nausea and vomiting. *Cancer Reports*, *4*(2), e1355. https://pubmed.ncbi.nlm.nih.gov/34096057/
* Jordan, K., & Warr, D. G. (2020). Chemotherapy-induced nausea and vomiting: state of the art in 2020. *Annals of Oncology*, *31*(12), 1636-1646. https://pubmed.ncbi.nlm.nih.gov/33069150/
Q.
When Is a Chemo Port (CV Port) Recommended?
A.
There are several factors to consider; see below to understand more, but in general a chemo port is recommended for long term or frequent chemotherapy, when drugs are harsh on veins, IV access is difficult, blood draws are frequent, or combination infusions are planned. It may not be needed for short, mild, or oral regimens if veins are easy, but potential risks like infection or clots and your preferences matter, so discuss with your oncology team and review the details below to guide your next steps.
References:
* García-Prieto J, Mañas R, Gil-Calvo M, et al. ESMO Guidelines Committee recommendations for central venous access in cancer patients. ESMO Open. 2023 Dec;8(6):102047. doi: 10.1016/j.esmoop.2023.102047. PMID: 38153922; PMCID: PMC10759082.
* Gabriel J. Central venous access devices: A guide to selection and management. Nurs Stand. 2023 Mar 22;38(3):61-69. doi: 10.7748/ns.2023.e11956. PMID: 37052989.
* Shumaker L, Knoerl R. Central Venous Access Devices: Indications, Placement, and Management Considerations for Outpatient Parenteral Antimicrobial Therapy (OPAT). Infect Dis Clin North Am. 2023 Jun;37(2):291-306. doi: 10.1016/j.idc.2023.02.007. PMID: 37197825.
* Mussa B, Capra M, Cortese G, et al. Guidelines for the use of central venous access devices in oncology patients: Recommendations of the Italian Group for the Study of Venous Access (GISAV). J Vasc Access. 2021 May;22(3):323-332. doi: 10.1177/1129729820967398. Epub 2020 Oct 19. PMID: 33076755.
* Pons A, de la Cueva R, Ros J, et al. Long-term central venous access: guidelines for insertion and management. J Vasc Access. 2019 Jun;20(3):239-247. doi: 10.1177/1129729819830571. Epub 2019 Feb 19. PMID: 30777176.
Q.
Which chemotherapy side effects you should never ignore?
A.
Dangerous chemotherapy side effects to never ignore include fever 100.4 F/38 C or higher, chills, shortness of breath or chest pain, rapid heartbeat, sudden severe fatigue, confusion, severe headache, vision changes or seizures, vomiting over 24 hours or inability to keep fluids down, diarrhea 4 to 6 times a day, dehydration signs, unusual bleeding or bruising, severe mouth or throat sores, painful red or blistering skin on hands or feet, one-sided arm or leg swelling, and new or worsening pain. There are several factors to consider; see below for the key thresholds, when “common” symptoms become dangerous, and the exact next steps to take and who to call.
References:
* Schwebel CP, Al-Sawad S, Ganiere K, Ganiere T, Faderl S. Oncologic Emergencies: Recognition and Management. Am J Med Sci. 2017 May;353(5):472-479. PMID: 28400494.
* Hanrahan TP Jr, Dehghan H, Loaiza-Bonilla A. Management of Chemotherapy-Induced Adverse Events. The Oncologist. 2018 Jul;23(7):789-798. PMID: 29910408.
* Klastersky J. Neutropenic Fever in Oncology Patients. Am J Med. 2018 Oct;131(10):1138-1144. PMID: 30125867.
* Postow MA, Sidlow M, Hellmann MD. Common Toxicities of Immunotherapy and Chemotherapy in Patients With Cancer and Strategies for Management. JAMA Oncol. 2019 Dec 1;5(12):1761-1769. PMID: 31806316.
* Zuniga R, Green E, Zuniga P, Zuniga D. Adverse Events in Oncology: Emergency Department Presentation. West J Emerg Med. 2016 Apr;17(2):206-13. PMID: 27072895.
Q.
Why does a chemotherapy regimen change?
A.
There are several factors to consider; see below to understand more. Regimens often change when the cancer is not responding, side effects become unsafe including toxic skin or hand foot reactions, lab or health changes raise risk, new or better therapies become available, or testing reclassifies the disease. These adjustments are common and aim to improve safety, effectiveness, and quality of life, not necessarily because things are worse; see below for what to ask your care team, symptoms to track and when to seek urgent care, and tools like a skin symptom checker that could guide your next steps.
References:
* Miller KD, Antman K, Belani C, et al. Management of chemotherapy-related toxicities. J Natl Compr Canc Netw. 2019 Sep;17(9):1063-1070. doi: 10.6004/jnccn.2019.7042. PMID: 31548687. https://pubmed.ncbi.nlm.nih.gov/31548687/
* Gujral H, Jani K, Jain S, et al. Chemotherapy dose modification in older adults with cancer: a narrative review. J Geriatr Oncol. 2022 Sep;13(6):811-817. doi: 10.1016/j.jgo.2022.06.002. Epub 2022 Jul 1. PMID: 35919379. https://pubmed.ncbi.nlm.nih.gov/35919379/
* Xia L, Li J, Liu X, et al. Molecular Mechanisms and Strategies to Overcome Chemotherapy Resistance in Solid Tumors. Front Cell Dev Biol. 2022 Jul 19;10:943111. doi: 10.3389/fcell.2022.943111. PMID: 35914619; PMCID: PMC9344400. https://pubmed.ncbi.nlm.nih.gov/35914619/
* Miller KD, Antman K, Belani C, et al. Precision Oncology: A Paradigm Shift in Cancer Treatment. J Natl Compr Canc Netw. 2019 Sep;17(9):1071-1077. doi: 10.6004/jnccn.2019.7043. PMID: 31548688. https://pubmed.ncbi.nlm.nih.gov/31548688/
* He S, Cai Z, Chen M, et al. Individualized Chemotherapy: The Integration of Pharmacogenomics and Artificial Intelligence in Oncology. Cancers (Basel). 2023 Aug 5;15(15):3957. doi: 10.3390/cancers15153957. PMID: 37554558; PMCID: PMC10416972. https://pubmed.ncbi.nlm.nih.gov/37554558/
Q.
Why does chemotherapy cause vein pain?
A.
Chemotherapy can cause vein pain because the drugs irritate and inflame the delicate lining of veins, which is common and usually manageable; repeated infusions can harden and sensitize veins, some medicines can trigger vein spasm or nearby nerve irritation, and rare leakage outside the vein can injure surrounding tissue. There are several factors to consider. See below to understand more, including which symptoms should prompt urgent medical attention and the ways your care team can adjust treatment to reduce pain and protect your veins.
References:
* Chen X, Cui C, Zhu C, Guo Y. Venous irritation caused by infusional chemotherapy: Mechanisms, risk factors, prevention and management. Front Pharmacol. 2018 Sep 20;9:1062. doi: 10.3389/fphar.2018.01062. PMID: 30297920; PMCID: PMC6158229.
* Le T, Nguyen T, Do B, Vu Q. Chemotherapy-induced phlebitis: a systematic review. J Oncol Pharm Pract. 2020 Dec;26(6):1481-1490. doi: 10.1177/1078155220917260. Epub 2020 Apr 15. PMID: 32290638.
* Chen J, Chen K, Xu H, Zhang R, Sun C. Vascular endothelial injury in cancer therapy: A review of mechanisms and clinical implications. Pharmacol Res. 2020 Oct;160:105058. doi: 10.1016/j.phrs.2020.105058. Epub 2020 Aug 1. PMID: 32750596.
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Q.
Working and Doing Housework During Chemotherapy: How to decide?
A.
There are several factors to consider when deciding whether to keep working or doing housework during chemotherapy; the right choice depends on your side effects, the demands of your tasks, your support system, and how your energy changes across treatment cycles. See below for practical adjustments, pacing strategies, warning signs that mean you should call your doctor, and workplace or home accommodations, as these details can significantly influence your next steps.
References:
https://pubmed.ncbi.nlm.nih.gov/32415843/
https://pubmed.ncbi.nlm.nih.gov/32415843/
https://pubmed.ncbi.nlm.nih.gov/33319208/
https://pubmed.ncbi.nlm.nih.gov/33319208/
https://pubmed.ncbi.nlm.nih.gov/35166708/
https://pubmed.ncbi.nlm.nih.gov/35166708/
https://pubmed.ncbi.nlm.nih.gov/32432729/
https://pubmed.ncbi.nlm.nih.gov/32432729/
https://pubmed.ncbi.nlm.nih.gov/31801550/
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Harris, C. S., Wang, D., & Carulli, A. (2014). Journal of Oncology.
https://journals.sagepub.com/doi/abs/10.1177/1078155213475466Aslaner Ak, M., Ertop Doğan, P. (2022). Journal of Oncology.
https://journals.sagepub.com/doi/abs/10.1177/10781552211072465Jung, S., Sehouli, J., Patzelt, A., & Lademann, J. (2015). Influence of mechanical stress on palmoplantar erythrodysesthesia-a case report. Oncology Research and.
https://karger.com/ort/article/38/1-2/42/263136