Not all cancer drugs are created equal

Many of the available cancer medications have limited side effects. The story is different for others

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Cancer medications have complex effects after treatment

There are more than 50 cancer medications in common use today. Some of these will have limited side effects, while others have many. Like the effects of radiation treatment, some of the effects of chemotherapy may occur months, even years, after your treatment has ended. Whether or not you will have these long-term effects depends on many things, including your general health – weight, activity level and smoking history – at the outset of treatment. Other factors include your particular cancer type, the drugs and dosage you received, the length of time on the therapy, the way you took the drug (for example, as a tablet or injection), the combination of other drugs and/or radiation you were taking, and the way your body reacted to those treatments.

Two people can have the same kind of cancer, take the same chemotherapy and have different long-term or late effects. For a useful source of information about particular drugs or a list of side effects of common cancer drugs, visit bccancer.bc.ca and select “Drug Database” from under the Health Professionals Info heading. You can search drugs alphabetically.

Because chemotherapy flows through your body, it can affect multiple organ systems. Chemotherapy regimens have become more effective over time, and your health-care providers try to give you the least amount of chemotherapy that will still effectively treat your tumour in order to minimize side effects. Some symptoms might occur during chemotherapy and remain, but others might show up months to years later so it is good to be aware of the particular side effects that could potentially occur.

Chemotherapy targets cells that are rapidly dividing, such as cancer cells. Unfortunately, many other cells in your body also divide rapidly and so chemotherapy can affect areas of your body such as your bone marrow, mouth, skin, hair, fingernails, and stomach lining. Most of those short-term side effects resolve as the tissues heal.

Many survivors will not experience late effects, or if they experience them, will learn to adapt to them so that they continue to thrive. If you begin to experience new symptoms, they might be a result of having been on chemotherapy, as a result of aging, or due to other medications you are taking.

Please make sure that your current medical team (i.e., family physician or others involved in your care) knows you are having symptoms. Tests may be needed to determine whether you should be concerned. Earlier detection of long-term or late effects (see sidebar) can make a difference in ability to treat them.

The list of potential late effects is not complete and not every person experiences these in the same way, if at all. Many of these health issues are also strongly related to or impacted by your lifestyle. For example, if you develop a heart problem, it could be a result of your family history or your lifestyle choices (such as weight, diet, fitness level, and smoking history), not because of your cancer treatment. There is no real way of knowing exactly what the reason is for developing this problem, but it is very important you receive appropriate medical care to manage this health problem.

What can you do to cope? As always, we recommend talking with other cancer survivors who can help you compare symptoms and talk about ways to adjust to these changes. Also, discussing your situation with a professional counsellor may be useful. Visit CancerBridges.ca for updates on new information about late and long-term effects.

Late Effects

Not every cancer survivor experiences these potential late or long-term effects in the same way, or at all. They are:

  • Lung disease
  • Osteoporosis
  • Increased risk of other cancers
  • Early menopause
  • Heart disease
  • Infertility
  • Liver problems

To read other columns related to the late or long-term effects of cancer treatment such as the risk of second cancers and the long-term effects of radiation, visit survivorship.

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