Adjuvant chemotherapy is given to cancer patients after surgery to remove a primary tumor. Its job is killing unseen cancer cells, according to the American Cancer Society. Adjuvant chemotherapy can also be given after radiation therapy. Like other forms of chemotherapy, adjuvant chemotherapy has side effects.
Risk of Infection
Patients who undergo adjuvant chemotherapy often develop low white-blood-cell counts, which increase the risk of infection, according to the University of Florida Shands Cancer Center. If the patient develops a serious infection, the chemotherapy regimen may have to be stopped for a while. Cancer patients are often given medications such as filgrastim and pegfilgrastim to increase their white blood-cell counts.
Fatigue
Many patients become fatigued during adjuvant chemotherapy, according to the National Cancer Institute. The causes can include anemia, the chemotherapy medications themselves, infection and decreased appetite, according to the Shands Cancer Center. Managing the fatigue involves treating the cause while providing adequate nutrition and opportunities for rest.
Bleeding/Bruising
Chemotherapy can cause a decrease in blood platelets. This drop hinders the blood's ability to clot, increasing the likelihood of bleeding and bruising. This typically occurs six to 10 days after chemotherapy starts, according to the Shands Cancer Center. If necessary, the treating physician may prescribe a drug called oprelvekin to increase the platelet count or give the patient a platelet transfusion.
Gastrointestinal Problems
Adjuvant chemotherapy can cause gastrointestinal problems including nausea, vomiting and diarrhea, according to the National Cancer Institute. Medications to prevent nausea and vomiting include dolasetron and ondansetron. According to the National Cancer Institute, a change in diet may alleviate diarrhea.
Hair Loss
Hair loss usually begins two to three weeks after the start of adjuvant chemotherapy. Hair begins growing back a few weeks after chemotherapy is completed, according to the Shands Cancer Center. The hair that grows back may not be exactly like the hair that the patient had before. Some patients choose to shave their heads before their hair falls out to reduce the trauma and maintain some control. Patients usually cover their heads with scarves or wigs.
Reproduction Issues
Adjuvant chemotherapy may also cause problems with sexuality and fertility. Some women develop vaginal dryness, according to the National Cancer Institute. Women may also enter early menopause, which causes infertility. A male patient's sperm count may drop, causing a fertility challenge. Discussing these issues with caregivers may allow the patient to plan ways to preserve fertility or take medications to counteract the problem.
