Cancer Therapy, Definitive: Risks

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Surgical therapy can be both disfiguring and disabling. Many normal tissues can be adversely affected by radiotherapy. Side effects that commonly occur shortly after a treatment cycle include nausea, vomiting, fatigue, loss of appetite, and bone marrow suppression (a decrease in the cells that provide defense against infections and those which carry oxygen to cells).

Radiotherapy can also cause difficulty swallowing, oral gum disease, and dry mouth. Additionally, radiation therapy can cause damage to local structures within the irradiated field.

Chemotherapy commonly causes bone marrow suppression. Additionally, a cell called platelets—important for normal blood clotting—may be significantly lowered, causing patients to bleed. This may be problematic enough to limit the treatment course. Bone marrow suppression can increase susceptibility to infection and also cause infertility. Patients commonly have bouts of nausea and vomiting shortly after a treatment session. Rapidly multiplying normal cells are also affected such as skin cells (causing blistering and ulceration) and hair cells (causing loss of hair, a condition called alopecia).

Biologic therapies can cause patients to develop suppression of cells that help the body fight against infection. Administration of certain chemicals that have anti-cancer effects can cause heart damage. Injection of killer immune cells (lymphokine-activated killer cells) may cause bone marrow suppression, and the host may reject the newly introduced cells.

— Laith Farid Gulli, M.D.; Nicole Mallory, M.S.