Managing Symptoms & Side Effects

Constipation is when your bowel movements occur less often, are small or incomplete, or your stool becomes hard and more difficult to pass. You also may have: 

• Leakage of liquid stool 
• Belly discomfort, stomach ache or cramps
• Swollen belly 

Causes

• Medications, especially pain and anti-nausea drugs
• Tumor in the belly or digestive tract
• Surgery
• Lack of activity
• Eating or drinking less 

What You Can Do at Home 

Do: 

• Keep a written log of your bowel movements so you can answer questions from your care team. 
• Go to the bathroom as soon as you feel the urge.
• Drink more fluids. Warm fluids in the morning may help get your system going. 
• Keep active, as directed by your care team. 
• Stay on a daily routine for eating meals and going to the bathroom. 
• If approved by your care team, eat foods high in fiber, such as whole-grain breads and cereals, raw fruits and vegetables, dry fruits such as prunes, and nuts.

Avoid: 

• Stool softeners or laxatives, unless approved by your care team
• Suppositories or enemas, unless approved by your care team
• Carbonated drinks
• Foods that cause gas, such as beans, broccoli and cabbage
• Dairy, such as milk, cheese and eggs

When to Contact Your Care Team

You should contact your cancer care provider if you have: 

• No bowel movement for 2 days (or a period of time discussed with your care team)
• Blood in your stool or anal bleeding
• Severe belly pain and/or vomiting
• Diarrhea 
• Not had anything to eat or drink for 24 hours

If constipation is an ongoing problem, ask your cancer care team about a bowel care plan that includes diet, bowel schedule and supplements/over-the-counter products. 

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Diarrhea is loose or watery stools, usually passed more frequently than your usual bowel movements. You also may feel cramping or belly discomfort. 

Causes

• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Radiation therapy
• Surgery 
• Tumor in the digestive tract
• Infection
• Nutrition supplements or liquid food replacement 
• Eating spicy, fatty or fried foods that upset your digestive system 

Risks

If you have diarrhea, your body is not getting the water and essential nutrients you need. Diarrhea can lead to dehydration and malnutrition.

What You Can Do at Home

Do: 

• Keep a log of times of your bowel movements so you can answer questions from your care team. 
• Take diarrhea medicine only if approved by your care provider.  
• Drink eight to ten glasses of clear fluids a day, including adult Pedialyte® 
• Start with a clear liquid diet of broth, popsicles and gelatin (Jello®). 
• As you improve, transition to a BRAT diet (bananas, rice, applesauce and dry toast) and high-sodium foods such as plain crackers and pretzels. 

Avoid: 

• Carbonated drinks
• Caffeinated drinks 
• Alcohol drinks
• Milk and milk products
• Spicy foods
• Greasy foods
• High-fiber foods such as fresh or dried fruits and vegetables 
• High-sugar foods such as cookies and rich baked goods

When to Contact Your Care Team

You should contact your cancer care provider if you experience: 

• Change in bowel habits such as diarrhea or loose stools
• Belly pain or a swollen belly
• Blood in your stool or anal bleeding
• Temperature greater than 100.5
• No urination in 12 hours
• Nothing to eat or drink in 24 hours
• Dizziness

If diarrhea is an ongoing problem, ask your cancer care team for support with diet/nutrition, supplements and over-the-counter products. 

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Feeling physically weak or fatigued is common during cancer treatment and can linger even after treatment ends. 

Fatigue can mean different things to different people. You may feel: 

• Tired, weary or worn out
• Decreased physical strength 
• No drive or interest to do anything 

Causes 

You may experience cancer-related fatigue and weakness for myriad reasons throughout your cancer care journey. Pain and other side effects can burden your body and drain your energy. Your body also requires energy to heal and regenerate healthy tissue. Causes of your fatigue and weakness may include: 

• Surgery
• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Radiation therapy
• Weight loss and/or malnutrition 
• Anemia (low red blood cell count)
• Loss of muscle strength  
• Lack of physical activity 
• Changes in hormones
• Infection
• Depression 

Risks

Fatigue and physical weakness can lead to frustration when not being able to do daily activities. They also can foster feelings of hopelessness and depression.  

What You Can do at Home

The best thing you can do is understand that fatigue is a normal part of having cancer. Everyone responds differently to treatment and recovers on their own timeline. 

• Keep a log of your symptoms. Your care provider may be able to identify and treat the cause of your fatigue. 
• Eat a healthy, balanced diet
• Take vitamin, mineral or electrolyte supplements if approved by your care provider
• Drink 8 to 10 glasses of liquid a day 
• Practice simple activities that you enjoy 
• Walk, stretch, or exercise daily, as allowed by your care provider
• Consider meditation, yoga, or a restorative nap 
• Allow yourself to have a bad day

When to Contact Your Cancer Care Provider

• You are unable to do your everyday activities
• Your fatigue leads to depressive thoughts  

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Insomnia is when you have trouble falling or staying asleep through the night. It’s recommended that the average adult sleep at least seven hours a night. Symptoms of cancer and side effects of treatment can affect your ability to get a full night’s sleep. If you previously experienced insomnia, you may find it worsens following your cancer diagnosis. 

Causes 

• Cancer treatments including chemotherapy targeted therapy, immunotherapy
• Hormone therapy
• Radiation therapy
• Surgery
• Medications for cancer side effects
• Uncontrolled pain
• Nausea 
• Fever 
• Reduced physical activity during the day 
• Anxiety
• Depression
• Muscle cramps
• Changes in hormones, night sweats and/or hot flashes 

Risks

Cancer treatment can leave you fatigued. If you are not getting enough sleep, this can add to your fatigue. Lack of sleep can leave you too tired to do daily tasks or things you enjoy. 

What You Can Do at Home

Do: 

• Practice relaxation techniques.
• Exercise regularly, with approval from your care provider.  
• Only take short naps of 30 minutes or less during the day. 
• Take medications on a schedule. 
• Keep a sleep diary or use a sleep app to track the times you sleep and wake up, and any conditions that bothered you. 

Avoid: 

• Drinking beverages with caffeine in the late afternoon or evening.
• Drinking alcoholic beverages. 
• Exercising in the evening.
• Spending waking hours in your bed.  
• Using your electronic devices right before bedtime. 

When to Contact Your Cancer Care Provider

• You are sleeping very little or not at all
• You experience confusion or disorientation  

Talk to your care provider. They may be able to address the cause of your insomnia or prescribe medication to help.  

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Your appetite and desire to eat can be impacted by the cancer itself, or from surgery or treatment. Fueling your body with fluids, calories and nutrients is essential so you can maintain a healthy weight throughout treatment. 

Causes

• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Radiation therapy
• Cancer in the digestive tract
• Pain 
• Stress 
• Depression 
• Nausea and vomiting
• Constipation and diarrhea 

Risks

Loss of appetite can cause you to eat and drink less. This can lead to dehydration, malnutrition, fatigue and weight loss. 

Severe weight loss can impact whether you can continue to undergo treatment.

What You Can Do at Home

Do: 

• Stick to a regular meal schedule
• Eat small snacks every 2-3 hours throughout the day  
• Sip liquids with calories throughout the day
• Remain physically active (as approved by your care team)

Try: 

• High-calorie, high-protein foods such as supplement shakes, pudding, nuts, protein/granola bars, canned chicken or tuna
• Bland foods, such as crackers, cereal and dry toast
• Hard candy to get rid of any bad taste in your mouth

Avoid: 

• Sugar-free or diet foods and drinks
• Greasy or fried foods 
• Foods that do not appeal to you 
• Only eating if you’re hungry 
• Drinking during meals (which can fill you up)

When to Contact Your Care Team

You should contact your cancer care provider if you: 

• Have not eaten solid food in more than 1 day 
• Have less than 4 cups of liquid or ice chips in a day 
• Vomit for more than 1 day 
• Have difficulty swallowing
• Have not taken your medicines or can’t keep them down 
• Have not urinated for 1 day
• Have no bowel movement for 2 days
• Feel dizzy or confused
• Lose more than 3 pounds in a week

Be sure to talk to your cancer care team about any loss of appetite. You may benefit from meeting with an oncology nutritionist or registered dietitian who can personalize a meal plan for you. There also are medications that can help stimulate your appetite or changes to your treatment plan that can help.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Nausea is having an upset stomach and feeling like you may vomit (throw up). Both nausea and vomiting are common during cancer treatment, and can come with lack of appetite, acidic mouth juices and increased saliva, and feeling clammy or sweaty. 

Causes

• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Surgery 
• Radiation therapy
• Cancer in the digestive tract
• Medication 

Risks

Feeling nauseous or vomiting reduces the amount you eat and drink. This can lead to dehydration and weight loss and impact your cancer treatment plan. 

What You Can Do at Home

Do: 

• Keep a record of times you feel nausea or vomit so you can answer questions from your care team. 
• Eat small snacks to keep something in your stomach throughout the day.  
• Sip liquids throughout the day. 
• Sit upright for the first hour after each meal.
• Distract yourself by reading, watching a show or listening to music when you feel nauseous. 
• Eat a small meal or snack before treatment, if allowed by your care team. 

Try: 

• Clear liquids, such as apple juice, broth, ginger ale
• Foods that are easy to eat, such as popsicles, gelatin (Jello®), pudding, yogurt, milkshakes
• Bland foods, such as crackers, cereal or dry toast
• Cold or room-temperature drinks and food 
• Hard candy to get rid of bad taste in your mouth

Avoid: 

• Greasy or fried foods 
• Low-fat foods because you need the calories 
• Foods that do not appeal to you 

When to Contact Your Care Team

You should contact your cancer care provider if you: 

• Inhale or choke on your vomit 
• Vomit 4-5 times in 1 day
• Vomit for more than 1 day
• Vomit with blood (can look like coffee grounds)
• Have not eaten in more than 1 day
• Have less than 4 cups of liquid or ice chips in a day 
• Have not taken your medicines or can’t keep them down 
• Feel dizzy or confused
• Are losing weight

Be sure to talk to your cancer care team about your nausea and vomiting. There are medications or changes to your treatment plan that can help. 

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Managing your pain is important when you have cancer. Pain can range from overall discomfort to feeling something severe and debilitating. 

Be sure to talk to your care provider about pain. There are medications and combinations of medications that can lessen the pain. It’s likely that the type and amount of medication will be adjusted as needed throughout treatment. 

Causes

• Pain from the tumor or tumors
• Pain from cancer that has spread
• Chronic pain or pain prior to cancer diagnosis 
• Surgery 
• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Radiation therapy

Risks

Pain that is not controlled can leave you exhausted and unable to do normal, daily activities. Uncontrolled pain also can cause insomnia (loss of sleep), anxiety and depression – especially for people who already have these conditions.  

What You Can Do at Home

Do: 

Keep a symptom diary. Log in a journal or an app: 

• Where you feel pain
• Time that it started
• How long it lasted 
• How often it occurred 
• How it rates on a scale of 0 (no pain) to 10 (highest)
• Were you able to find any relief and if so, what worked
• Remain physically active, as approved by your care provider. This will help keep your mind off pain and help prevent constipation.
• Stay ahead of the pain. Take your pain medicine exactly as prescribed. Don’t wait until you feel severe pain to take your medication. 
• Follow the warnings on your pain medication bottle. 

Avoid: 

• Breaking or crushing pills, unless approved by your care provider. 
• Driving or other activities prohibited when taking your pain medication.
• Waiting until you are out of medication to ask for more.
• Stopping your medication without talking to your care provider. 
• Avoid taking more pain medication than prescribed.
• Living with unbearable pain. Always ask your care provider for help. 

When to Contact Your Care Team

You should contact your cancer care provider if you: 

• Have new pain
• Have pain that is getting worse 
• Have pain in a new location 
• Find pain medication isn’t helping 
• Are nauseous or vomiting 
• Become constipated 
• Are disoriented or confused 

Be sure to talk to your cancer care team about pain. Your supportive care specialist can refer you to a pain management expert, if needed. 

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice. 

Sometimes people with cancer or undergoing cancer treatment may become short of breath or feel like breathing is difficult. This shortness of breath (called dyspnea) can make it difficult to do your usual activities. Depending on the cause, it also may be accompanied by a cough.  

Causes 

• Cancer treatments including chemotherapy, targeted therapy, immunotherapy
• Surgery
• Radiation therapy
• Muscle weakness 
• Fatigue due to weight loss, anemia or lack of physical activity 
• Uncontrolled pain
• Anxiety 
• Pneumonitis (inflammation of the lungs)
• Pneumonia
• Fluid in the lungs, chest or other locations 
• Tumor in the lung or chest/blocked airway

Risks If you are short of breath, you may not be getting enough oxygen into your lungs and bloodstream. 

Don’t wait until your next appointment to tell your care provider about shortness of breath. If you keep having trouble breathing, there are medicines that can help. It also may be a sign of a serious problem or lead to losing consciousness or cardiac arrest. 

What You Can Do at Home

• Try to stay calm. Anxiety can make breathing worse. 
• Do not lie flat. Sit propped up in bed, couch or chair at a 45° angle or greater. 
• Try pursed lip breathing. Inhale deeply through your nose and exhale through pursed lips for twice as long as your inhale.  

When to Call 911

If you have any of the following symptoms:

• Shortness of breath that starts suddenly and doesn’t get better
• Bluish-colored skin or lips
• Trouble talking
• Chest pressure or pain
• Dizziness

When to Contact Your Cancer Care Provider

• Shortness of breath when resting, eating, talking or being active
• Faster breathing
• Racing heart (track your wrist or neck pulse rate/beats per minute)
• Wheezing
• New cough or cough that is getting worse
• Coughing up yellowish-green or bloody phlegm
• Fever
• Confusion or mental disorientation 

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.