Managing Side Effects

Side effects vary in severity and duration from person to person and are dependent on the type of treatment. Often the most severe side effects occur in the early days of treatment and gradually subside as your body adjusts to treatment but some side effects can remain. Sometimes it can be difficult to distinguish between side effects caused by treatment and the progression of melanoma so it is important to report all side effects to your treating clinician.

Asymptomatic side effects are those that not produce obvious symptoms that you can feel. These side effects can decrease white blood cell production, cause elevations in liver enzymes, or changes in kidney function. Left untreated, these effects can cause serious symptoms and conditions.
Asymptomatic side effects are detected and monitored by blood tests. Depending on your treatment, you will receive regular blood tests for liver function, kidney function, and/or blood cell counts. Abnormal test results may indicate a need to treat your side effects or change your cancer treatment.

Symptomatic Side Effects cause symptoms that you can feel. You should report all symptoms to your treating clinician so they can be addressed and because if left untreated they could result in serious conditions.

Common Side Effects

Lymphoedema

Lymphoedema is the build-up of excessive amounts of fluid resulting in swelling of parts of the body. It can be caused by the surgical removal of lymph nodes or radiation to lymph nodes which results in an obstruction to the flow of lymph fluid.

Lymph nodes are located in the armpits, groin, abdomen, chest and neck. Their purpose is to filter out harmful bacteria and assist in the body’s response to infection.

Lymphoedema may present at any stage after surgery or radiation with symptoms including ache, heaviness, tightness or swelling of the limb involved. The progress is usually gradual with an increase in swelling and symptoms in the affected limb or body part. Removal of lymph nodes from one area may result in swelling in the limb or body part closest to that area (armpit node removal may affect the arm closest) . For those who develop Lymphoedema, early detection and interventions are essential in minimising its impact. Risk factors for developing swelling include infection, higher body mass index (being overweight or obese) and immobility (lack of use). Not everyone who has lymph node treatment develops lymphoedema.

Ways to Manage Lymphoedema:

• massage (manual lymphatic drainage),
• exercise
• skincare
• compression therapy (bandaging and/or compression garments)
• low level laser therapy
• other electrical or vibratory stimulation.

The treatment plan may include a combination of these methods. One of the most important components of lymphoedema treatment is self-management of this often chronic condition, in partnership with the treating medical or allied health professional. To assist in reducing the load on a compromised lymphatic system it is advisable to maintain a healthy weight, take good care of your skin by avoiding trauma and infection, participate in regular physical activity, seeking health professional advice before starting a new activity, monitor your limb regularly for change in size and feel and, most importantly, seek advice if you are concerned.

Visit the Australian Lymphology Association website

Visit The National Lymphoedema Practitioners Register of The Australian Lymphology Association website

Fatigue

It is common for those being treated for melanoma with treatments such as immunotherapy, chemotherapy, and radiation therapy to experience fatigue.

You may notice a feeling of intense tiredness or weakness that’s not usually relieved by rest or sleep. Fatigue is usually temporary however if it persists it may be due to something other than the treatment such as anemia. Anemia is caused by having too few red blood cells in the bloodstream resulting in reduced oxygen to tissues and organs. It is treatable by blood transfusion, iron replacement, or hormones that stimulate red cell production.

Ways to Manage Fatigue:

Activities and Rest:

• Keep a “fatigue diary” to monitor your patterns of fatigue. This will help you plan your activities for the time of day when you have the most energy.
• Plan your activities for the day to include regular periods of rest and some activities you enjoy.
• Find ways to save your energy — prepare meals sitting down instead of standing.
• Limit trips up and down the stairs. Ask someone to help with any physical tasks.
• Try to maintain rhythm in your movements as this helps save energy.
• Plan a short period of light activity each day, such as a walk or a stroll. You may actually feel more tired if you are completely inactive.
• Rest your eyes periodically.

Shape your Environment:

• Work in a well-ventilated and well-lit room.
• Arrange your environment to minimize bending or reaching.
• If the room is hot or humid, lower your pace.
• Use music for relaxation or stimulation.

Nutrition and Fluids:

• Eat a balanced diet with an emphasis on complex carbohydrates such as dried beans and peas, whole-grain breads and cereal, oatmeal, polenta, brown rice, vegetables, and whole-grain pastas. Complex carbohydrates provide long-lasting energy as well as important vitamins and minerals.
• Drink at least 8 glasses of fluids a day, unless restricted by your doctor. This will help flush out the by-products of cell destruction that may cause fatigue.
• Avoid foods and beverages that contain caffeine, especially in the evening.