With proper treatment, 4 out of 5 children with cancer today achieve complete cure. However, no treatment is free of side effects. Chemotherapy, which aims to inhibit the abnormal cell proliferation of cancer cells, can cause a variety of “collateral losses” due to its effect on healthy tissues, whose cells also proliferate rapidly (eg, skin, hair, etc.). bone).
Side effects do not occur in all children with cancer with the same intensity and severity. This depends on the type, frequency and duration of treatment, but also on temperament factors, which may be related to genetic predisposition of specific target organs to specific chemotherapeutic agents. The fact is, however, that they affect their quality of life and, more rarely, threaten their own healing.
Therefore, their prevention, where possible, but especially their timely and effective treatment, are of particular importance.
The most common side effects of chemotherapy
1. Bone marrow suppression (anemia, thrombocytopenia, neutropenia) and immunosuppression
As a result of chemotherapy the values ​​of white blood cells, hemoglobin and platelets decrease. The drop in white blood cells and the body’s defenses causes increased susceptibility to infections and requires alertness in case of fever, for immediate hospitalization and initiation of intravenous antibiotics or the administration of growth factors. The drop in hemoglobin causes fatigue and weakness and the drop in platelets causes bruising and bleeding, which also require hospitalization for blood transfusions.
2. Loss of appetite, taste disturbances, nausea, vomiting
They are usually treated with anti-emetic drugs, but when the objective feeling of nausea is enhanced by psycho-physical mechanisms that affect the vomiting center, the treatment becomes more difficult. We encourage children to eat as much as they want and can, even if they choose only specific foods that relieve them. Hypercaloric foods can prevent significant weight loss, and in more severe cases, an intestinal feeding tube or parenteral nutrition is required.
3. Stomatitis, other mucositis, disorders of the gastrointestinal tract (constipation, diarrhea)
Stomatitis is one of the most painful side effects, which in addition makes feeding difficult and in severe cases requires parenteral nutrition. Oral hygiene care and preventive use of oral solutions can help, but in severe cases hospitalization is required for intravenous administration of strong analgesics (non-steroidal anti-inflammatory and opioid).
4. Cardiotoxicity, nephrotoxicity, hepatic toxicity, dermal toxicity, neurotoxicity
They are serious side effects, requiring targeted medication and frequent hospitalization, but are usually prevented by laboratory supervision and preventive intervention.
5. Hair loss
It is the side effect that usually occurs first, perhaps the most innocent for health professionals, perhaps the most painful for children and their families, as it changes the self-image and affects the sense of identity, self-confidence and desire for socializing. In addition to the assurance that “hair will grow back”, it is more important to prepare children for the loss, before it happens, to leave them space and time to mourn, but also freedom of choice to deal with it (prosthetic hair, hats and colorful bandanas, or beautiful bare heads).
Childhood cancer systematically disrupts the lives of children and their families. The prospect of healing shows the light at the end of the road, but the treatment and its side effects make the journey even more difficult. In addition to medication, maintaining regularity in the new data (keeping in touch with school and friends, physical activity, and especially play!) Can reduce the discomfort of treatment side effects and be just as therapeutic.
Writes:
Eleni Dana Pediatrician – Oncologist
Deputy Director of Oncology Clinic for Children & Adolescents, Children MITERA
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