| Since chemotherapy and
radiotherapy work by killing dividing cells, they will affect normally dividing cells as
well as malignant (cancerous) ones. The normal cells which divide most rapidly in the body
are those in the bone marrow, the gut and the hair follicles. These are the areas where
the immediate side effects of treatment are seen. The following are the main temporary
side effects which may be experienced as a result of treatment for cancer. Bone marrow suppression (Low blood count)
Blood cells are made in the bone marrow (the spongy material which fills the bones). There
are red cells, which carry oxygen around the body, platelets that help the blood to clot
normally and white cells which fight infection. Almost all chemotherapy as well as some
radiotherapy causes bone marrow suppression. This means that the bone marrow cannot make
the usual number of cells and a blood or platelet transfusion may be necessary. When the
white cell count is low, infections are quite common. Your child will have regular blood
tests (known as blood counts) so that the timing and dose of treatment can be changed as
necessary.
Following an intensive block of chemotherapy, the blood count
usually takes 3 or 4 weeks to recover.
Risk of infection
All through chemotherapy your child will be more at risk of infection. When the white cell
count is low your child may absorb germs from his own skin or gut. In spite of this he
will be able to cope with most minor infections perfectly normally. However, some
infections that usually cause little trouble may prove more serious. Measles and chicken
pox can be particularly serious if your child is not immune. If your child is exposed to
either of these, let the ward know straight away so that a protective injection or
medication can be given. If your child develops one of these infections let the hospital
know immediately so that appropriate treatment can be given.
If your child is generally unwell or has a fever, especially
when you know the blood count is low, seek advice from the hospital. Your child will
probably need to be admitted for intravenous antibiotics until the hospital can be sure
about the type of infection.
Hair loss
Many of the drugs used in chemotherapy make your child's hair fall out temporarily. It
always grows again quite normally within a few months of stopping treatment. If you and
your child wish, a wig will be provided; many children prefer to wear baseball caps, hats
or scarves.
Radiotherapy to the brain also causes hair loss and sometimes
there may be permanent thinning of the hair at sites where a very high dose has been
given.
Loss of appetite and weight
Chemotherapy may make your child feel sick and directly affect the lining of his gut so
that he will not want to eat and will lose weight. Modern anti-sickness drugs are now very
effective. Your child's weight will be checked regularly. If he is losing too much weight
he may need to be fed through a naso-gastric tube (a tube passed through the nose and into
the stomach) or intravenously through the central line. The weight usually returns to
normal when treatment is over.
Drowsiness
About 6 weeks after radiation to his head, your child may feel sleepy for a few days but
this will soon pass. |