In 1956, doctors achieved the first cure using chemotherapy when they successfully treated a rare metastatic tumor called choriocarcinoma, according to the American Cancer Society, or ACS. Research continues to develop chemotherapy agents that more precisely target cancer cells and cause fewer negative side effects. Bowel cancer patients whose cancer has spread benefit from chemotherapy before and after surgery and radiation to destroy any remaining cancer cells in the body. Long-term side effects of chemotherapy in bowel cancer affect multiple body systems.
Alopecia
Chemotherapy affects rapidly dividing cancer cells as well as other rapidly dividing cells in the body such as hair cells. The American Cancer Society reports that hair loss over the entire body is a long-term effect of chemotherapy. The hair follicles can be permanently damaged, affecting future hair growth.
Mucositis
Because chemotherapy agents affect rapidly dividing cells, the mucous membranes that line the gastrointestinal system become inflamed and irritated, a condition called mucositis. Characterized by pain, redness and ulcers, mucositis occurs throughout the entire gastrointestinal tract. Mouth sores and pain prevent eating, inflammation of the esophagus causes indigestion-like symptoms and irritation of the lining of the bowel leads to diarrhea. These problems can become chronic. Anorexia and weight loss often accompany mucositis.
Bone Marrow Suppression
According to Donna D. Ignatavicius, M.S., R.N., and M. Linda Workman, Ph.D., authors of the 2006 edition of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care," chemotherapy interferes with normal bone marrow function, decreasing production of red blood cells, white blood cells and platelets. Red blood cells transport oxygen to the body, white blood cells fight infection and platelets prevent bleeding. The long-term effects of chemotherapy on bone marrow include anemia, infections and bleeding.
Anemia causes patients to feel tired, weak and out of breath. Chronic anemia can damage a patient's heart and lead to congestive heart failure. Patients may need blood transfusions to replenish low red blood cells.
Patients with bone marrow suppression experience frequent opportunistic infections. Opportunistic infections arise when the body's naturally present bacteria overrun its defenses. People with active infections become vulnerable to another secondary or hibernating infection such as shingles, a painful viral infection that affects the nerves.
When the bone marrow cannot produce enough platelets, prolonged bleeding becomes a complication. Patients with thrombocytopenia, or low platelets, bruise easy and are at risk for bleeding if a serious injury, such as a fractured hip, occurs. Transfusions of platelets may be necessary to treat chronic thrombocytopenia following chemotherapy.
Infertility
Infertility is another long-term effect of chemotherapy for bowel cancer. Chemotherapy can destroy spermatocytes, the cells that give rise to spermatozoa, preventing normal sperm development. Ova, or eggs, can be affected as well. Infertility can be a chronic problem after cancer treatment.
References
- American Cancer Society: What Are the Possible Side Effects of Chemotherapy?
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius, M.S., R.N. and M. Linda Workman, Ph.D.; 2006
