Do What You Can to Ease Side Effects of Treatment for Ewing Sarcoma

It's likely that you will have physical concerns since the cancer may cause symptoms and the treatment may cause side effects. In this section, you'll learn more about how to respond to some of the most common side effects and symptoms from treating Ewing sarcoma.

Here are some common side effects from treatment for Ewing sarcoma and how to ease them. You may not have all of these. We've listed them in alphabetical order so you can find help when you need it.

Anxiety and Depression

Many people may feel blue, anxious, or distressed after being told they have cancer. These feelings may continue or come back throughout treatment.

Taking these actions may ease your mental stress.

• Talk with your family or friends.

• Consider joining a cancer support group or finding a cancer "buddy" who can help you cope.

• Ask your doctor about medications for depression and anxiety.

Bladder Damage

Certain chemotherapy drugs and radiation to the pelvis can damage the bladder. To prevent or minimize damage, you can take these steps.

• Drink plenty of fluids.

• Ask your doctor about the drug Mesnex (mesna), which protects the bladder from chemotherapy damage.

Bleeding and Bruising

Certain kinds of chemotherapy may reduce your blood platelet count. Without enough platelets, your blood may have trouble clotting. That may lead to a problem called thrombocytopenia. Even a minor injury may cause you to bleed or bruise.

If your doctor tells you that your platelet count is low, take these actions to avoid causing injuries that could lead to uncontrolled bleeding.

• Call your doctor if you develop a rash, bleeding, or bruising.

• Protect your skin from cuts, scrapes, and sharp objects.

• Take steps to prevent constipation, which can lead to hemorrhoids and bleeding.

• Use a soft toothbrush to prevent bleeding gums.

Drowsiness

Severe drowsiness may be a side effect of chemotherapy. It may get better after several weeks of treatment. If you are drowsy, talk with your doctor about these options for relief.

• Adjusting the dose you take

• Changing the time you take the drug

Dry or Irritated Skin

This may be a side effect of radiation therapy. To take care of your skin after treatment, follow these steps.

• Check with your doctor or nurse about protecting your skin from sun exposure by wearing sunscreen of at least 15 SPF (sun protection factor). Don't apply sunscreen or other lotions to your skin without first checking. 

• Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don't use any lotion, soap, deodorant, sun block, cologne, cosmetics, or powder on your skin within two hours after treatment because they may cause irritation.

• Wear loose, soft clothing over the treated area. Cotton underwear can help prevent further irritation.

• Don't scratch, rub, or scrub treated skin. After washing, gently blot dry.

• Don't bandage skin with tape. If you must bandage it, use paper tape, and ask your nurse to help you place the dressings so that you can avoid irritation.

• Don't apply heat or cold to the treated area. Bathe only with lukewarm water because it's less dehydrating.

• Keep your nails well trimmed and clean so you don't accidentally scratch yourself.

Hair Loss

Losing your hair, called alopecia, can be upsetting because baldness is a visible reminder that you are being treated for Ewing sarcoma. Chemotherapy and radiation can cause hair loss. Keep in mind that your hair will probably grow back after treatment.

Try these coping tips.

• Consider cutting your hair before treatment starts.

• Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair and you'll be ready with head coverings, if you choose to wear them.

• Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats or scarves.

Heart Damage

Certain chemotherapy drugs can damage the heart. To prevent or minimize damage, you can take these steps.

• Don't exceed the recommended dose of Adriamycin (doxorubicin).

• Ask your doctor about checking your heart with a test called an echocardiogram or an ultrasound during treatment.

Infection

Your doctor will take blood samples from you for blood tests throughout your treatment. One thing he or she is checking for is your white blood cell count. Many types of chemotherapy can cause low white blood cell counts, as can the cancer itself. A lowered count is called neutropenia. Without enough white blood cells, your body may not be able to fight infection.

If your doctor tells you that your white blood cell count is low, take these actions to stay healthy.

• Avoid crowds or people with colds.

• Wash your hands often or use hand sanitizer throughout the day to kill germs.

Call your doctor right away if you have any of these signs of infection.

• A temperature of 100.5 degrees F or higher

• Severe chills

• A cough

• Pain

• A burning sensation during urination

• Sores or redness on your skin

Mouth Sores (Mucositis)

Some types of chemotherapy may cause mouth sores. These may hurt and make eating an unpleasant experience.

To prevent sores in your mouth, take these actions.

• Brush your teeth after meals and before bedtime. Check with your doctor about flossing.

• Keep your mouth and lips clean and moist.

• Use alcohol-free mouth washes to keep your mouth clean.

To ease the pain if you get sores in your mouth, take these actions.

• Avoid alcohol and mouthwashes containing alcohol because they may irritate the sores.

• Avoid hot, rough, or spicy foods because they may irritate the sores.

• Avoid tobacco because it may irritate the sores. Smoking can also make you more susceptible to sores.

• Take over-the-counter pain medication, such as Tylenol (acetaminophen), if necessary.

• Ask your doctor about topical mouth medications and stronger pain medicines.

• Call your doctor or nurse if your temperature reaches 100.5 degrees F or higher.

Nausea or Vomiting

Nausea or vomiting as a result of chemotherapy or radiation treatment for cancer may range from barely noticeable to severe. It may help you to understand the different types of nausea.

• Acute-onset nausea and vomiting occurs within a few minutes to several hours after chemotherapy. The worst episodes tend to be five to six hours after treatment, and the symptoms end within the first 24 hours.

• Delayed-onset vomiting develops more than 24 hours after treatment.

• Anticipatory nausea and vomiting are learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.

• Breakthrough vomiting occurs despite treatment to prevent it. It requires additional treatment.

• Refractory vomiting occurs after one or more chemotherapy treatments--essentially, you're no longer responding to antinausea treatments.

To prevent nausea, take these actions. Most nausea can be prevented.

• Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

• If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

To help ease nausea or vomiting if you have it, try these tips.

• Try eating foods and drinking beverages that were easy to take or made you feel better when you've had the flu or were nauseated. These might be bland foods, sour candy, dry crackers, ginger ale, flat soda, or others.

• Do not eat fatty or fried foods, very spicy foods, or very sweet foods.

• Eat room-temperature or cold foods. The smells from hot foods may make your nausea worse.

• Ask your doctor or nurse to help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.

• Ask your doctor or nurse about using acupressure bands on your wrists, which may help to decrease your nausea.

Thinking and Remembering Problems

You may have mild problems with concentration and memory during and after chemotherapy or from radiation to the skull for tumors there. Being tired can make this worse.

Taking these actions may help.

• Make lists and write down important information.

• Use other tools to help organize your life, such as calendars, pill dispensers, or alarm clocks.

Tiredness

Tiredness is a very common symptom and side effect from chemotherapy and radiation treatments. It is also a symptom of anemia, which is a low red blood cell count, as noted from blood tests. Whatever the cause, you may feel only slightly tired or you may suffer from extreme fatigue.

Fatigue can last four to six weeks after treatment ends. Taking these actions may help increase your energy level.

• Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.

• Add mild exercise, such as walking, to your daily routine. It may help you sleep better.

• Save your energy for important tasks.

• Drink plenty of fluids. Dehydration leads to increased fatigue.

• Take action to treat a poor appetite, because eating improperly can make you tired.

If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.