And if side effects do occur, what should I do?

Before starting treatment, your doctor and nurse will tell you about the possible side effects and recommend guidelines to help you cope with them. In any case, and as a reminder, below are some tips on what to do depending on the symptom:

Nausea and vomiting

• Unlike other side effects, nausea and vomiting can be prevented with specific medications (antiemetics). If the chemotherapy treatment you have been prescribed may cause this effect, your doctor will tell you in advance what medication you can use to prevent it or reduce its intensity. It is very important that you carefully follow the instructions we give you on how and when to take these antiemetics, as failure to do so may reduce their effectiveness. If symptoms persist despite medication, contact your doctor or nurse, who will assess whether it is necessary to modify your treatment.
• Follow the dietary advice explained later in this document.

Diarrhoea

• Reduce your consumption of fibre-rich foods, such as vegetables, wholemeal products, and fruits such as oranges, tangerines, pineapples, kiwis, etc. Fried foods, milk and dairy products are also not recommended.
• Increase your fluid intake (water, soups, herbal teas, apple juice, carrot juice, rice water, etc.).
• We recommend an astringent diet: boiled rice and carrots, white fish or skinless chicken, boiled or steamed, and toast.

Constipation

• If you were already experiencing this problem, consult your doctor to see if you should continue your usual medication.
• If constipation has developed during treatment, it may be possible to resolve it by making small changes to your diet, such as increasing your intake of fibre-rich foods, for example:
• Whole grains
• Fruit (kiwi fruit, in addition to its nutritional qualities, has laxative properties and can be eaten 2 or 3 times a day.
• Vegetables
• It is important to drink plenty of fluids. At least 1.5 litres per day.
• A good complement to these remedies is to take a daily walk or do moderate physical exercise.

Mucositis (alteration of the oral mucosa)

• Irritation of the mucous membranes manifests itself through pain, inflammation and redness of the area, sores and pain when swallowing.
• When your treatment may cause mucositis, your doctor will prescribe the most appropriate products to reduce the effects. In any case, if symptoms appear, try to avoid eating or drinking acidic, salty or spicy foods and beverages. Also avoid very hot foods.
• Do not forget to follow the oral and dental hygiene habits explained below.
• It is very important that you carefully follow the treatment prescribed by your doctor, as mucositis is a potential source of infection.

Hair loss

• Hair loss, like the other side effects of chemotherapy, is temporary. This means that once the treatment is complete, the hair will grow back naturally.
• Hair may fall out completely or partially and usually falls out 2 to 3 weeks after starting the first cycle of chemotherapy. Your doctor will tell you the likelihood of this happening. If this happens, there are a few measures you should take into account:
• Avoid brushing your hair roughly.
• If you must use a hand dryer, set it to a gentle temperature.
• Do not wear your hair in ponytails or buns.
• There are hair products, such as dyes, bleaches, hairsprays, fixatives, etc., which under normal circumstances may be harmless, but which can have negative effects during treatment. Avoid using them.
• If the treatment causes hair loss, consider wearing a wig.
• If you make this decision, we recommend visiting a specialised centre before starting treatment, as they will be able to tailor the wig to your hair type and the style you like best.
• We have a number of references for specialist centres at your disposal. Please do not hesitate to contact us.

Fatigue

• This is probably the most common effect of chemotherapy treatments. Fatigue does not necessarily or exclusively manifest itself as physical tiredness, but also as difficulty concentrating or performing intellectual or physical tasks that could previously be carried out normally.
• In fact, the cause of fatigue is not known with certainty, and it can also occur in varying degrees. In general, it depends on factors such as age, gender, the degree of anaemia caused by the treatment (chemotherapy affects the number of red blood cells), the duration of treatment, nutrition, etc.
• The following recommendations will help improve your condition if you suffer from this effect:
• Plan daily rest periods.
• Try to organise your activities so that you can carry them out at times of the day when you feel most rested, or after adequate rest.
• Inactivity will not help improve your condition. It is preferable to try to do some kind of gentle physical activity on a regular basis. For example, walking, swimming if you know how to swim, etc.

Infections

• This treatment affects the body's ability to produce white blood cells, which are its natural defence. For this reason, your body is more susceptible to certain infections.
• The most common symptom of an infection is an increase in body temperature, so you should always inform your doctor or nurse if you have a fever.
• If your body temperature reading is 38º or higher, we recommend heading straight to the emergency department, where they will be able to analyse the causes of the fever and advise you on how to proceed.

Alterations in sexuality and reproductive function

• Some chemotherapy treatments can cause menstrual irregularities in women of childbearing age, ranging from irregular periods to amenorrhoea (cessation of menstruation). Like all other side effects, this is a temporary phenomenon.
• In addition, damage to reproductive cells (sperm in men and eggs in women) may occur. For this reason, it is essential to speak with your doctor before planning a pregnancy, regardless of which member of the couple is undergoing treatment.
• In any case, it is advisable to use contraception for the duration of the treatment.