Coping With the Acute Physical Side Effects of Stomach Cancer Treatment

Stomach (or gastric) cancer treatment can take a heavy toll on the body, causing a wide range of physical side effects from mild discomfort to severe pain. The side effects can vary depending on the type of treatment, your pain tolerance and physical condition. As a cancer patient, it is natural to feel anxious and scared about the road ahead. However, by learning more about the possible physical side effects and how to manage them proactively, you can learn how to live with them and go into treatment with greater confidence. Taking the time to prepare yourself mentally and physically can go a long way in helping you cope with the challenges that lie ahead.

Surgery, chemotherapy, radiation therapy and other forms of gastric cancer treatment can bring about a number of physical challenges. Below are six common side effects and some tips on coping with them.

Fatigue

Many cancer treatments, including chemotherapy and radiation therapy, involve attacking cancerous cells that are dividing uncontrollably. Unfortunately, this also damages healthy cells, forcing the body to work even harder to repair the damage caused and replenish these cells. As a result, patients undergoing cancer treatment often complain of extreme and constant tiredness, known as fatigue. While it is normal to experience treatment-related fatigue, it can affect your day-to-day life and impact your ability to cope with treatment.

Apart from getting plenty of rest whenever you can, other ways to manage fatigue include:

• Starting or maintaining an exercise regimen has been associated with reducing cancer-related fatigue during and after active treatment across many different cancer types. Stronger evidence suggests exercise does not increase fatigue.
• Sticking to a nutritious diet of foods and drinks that maintains calorie intake can increase your energy levels.
• Practicing mind–body exercises, such as mindful yoga and other relaxation techniques have been found to be associated with reduced fatigue in cancer patients.
• Meeting with a specialist, such as a counselor, psychologist, or psychiatrist, who can help manage fatigue using methods like cognitive behavioral therapy.
• Prehabilitation (preparing patients physically before undergoing surgery): using a combination of these methods in the preoperative phase prior to surgery may also reduce the number and severity of postoperative complications.

Pain

Surgical procedures, such as a gastrectomy and other forms of gastric cancer treatment, can cause pain throughout the body, which may worsen if not addressed properly. In most cases, this pain can be controlled with medication.

Opioid options for gastric cancer pain management include:

• Tramadol
• Hydrocodone
• Morphine
• Oxycodone
• Methadone
• Buprenorphine
• Fentanyl

Generally, opioids remain the mainstay for the treatment of chronic visceral pain seen during cancer progression. However, there are non-opioid options for gastric cancer pain management available, which include:

• Acetaminophen (also known as Tylenol)
  This can be used as a first-line pain relief for mild to moderate pain relief.
• Non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., celecoxib)
  These drugs are commonly used to relieve pain and inflammation. COX-2 inhibitors are the better option as they may be associated with fewer gastrointestinal side effects (e.g., gastritis, gastrointestinal bleeding or ulcers).
• Lidocaine patches
  Lidocaine patches can help relieve numbness, tingling, and pain, which can help relieve your discomfort in addition to other pain treatments.
• Nerve blocking injection
  These are treatments that block the delivery of pain signals from the nerves to the brain. However, multiple rounds may be required.
• Palliative radiation therapy
  Radiation therapy targeted at growing or residual masses may halt growth and ameliorate pain. Additional studies are evaluating stereotactic radioablation of the celiac plexus (nerves responsible for delivering pain signals from the abdomen to the brain) for abdominal pain.
• Spinal cord stimulators
  This is an implanted device that delivers small amounts of electricity to the spinal cord for pain relief.
• Intrathecal drug delivery system
  This is a small pump that delivers pain medication directly to your spinal cord, which can be used if your pain is not responsive to opioid treatment. Non-opioid options include ziconotide, which blocks pain signal transmissions, and the muscle relaxant baclofen.

If you find yourself experiencing pain as a result of treatment, don’t suffer in silence. Reach out to your cancer specialist or other members of your cancer care team. Apart from prescribing appropriate types of medication, they may also recommend alternative therapies, such as acupuncture, depending on their assessment of your pain.

Nausea and vomiting

Nausea and vomiting are common side effects of most cancer treatments and often occur together. While it is normal to feel sick in the stomach and throw up, this can lead to more serious complications, including malnutrition and dehydration, if left untreated. If you’re experiencing prolonged bouts of nausea and vomiting, seek medical attention. Your doctors may prescribe medication to help you keep food and fluids down.

Besides that, remember to take small sips of water to keep yourself hydrated. Avoiding overly sweet, fatty, greasy, spicy, or strong-smelling foods can also help, as these could potentially make you sick. Before your chemotherapy session, try having light snacks, like crackers or toast, before the session starts. For radiotherapy, a short period of fasting may be recommended for at least a few hours, or may start after midnight on the day of treatment. Waiting at least an hour after treatment before eating or drinking again can help prevent nausea and vomiting too.

Loss of appetite

Developing an aversion to certain types of food or even the smell of food itself is a normal response to gastric cancer treatment. Chemotherapy and targeted therapies can make your mouth feel dry or your throat feel sore. This can make swallowing difficult and possibly put you off from eating. Experiencing bouts of nausea and vomiting can also make it hard to keep food down.

If you’re losing your appetite after cancer treatment, try taking several small but nutrient-dense meals throughout the day. Sticking to a regular eating pattern, as opposed to waiting until you’re hungry, will ensure that your body is getting the nourishment it needs. To help you meet your dietary needs easily, meal replacement shakes such as Boost or Ensure may be recommended. Light physical activity, like short walks, can also help to stimulate your appetite. Don’t forget to keep yourself hydrated too! If necessary, medications can be considered to help stimulate your appetite, including corticosteroids, megestrol acetate, dronabinol and olanzapine.

Constipation or diarrhea

During treatment, many cancer patients experience changes in their bowel movements, either in the form of constipation or diarrhea.

Constipation happens when you have infrequent bowel movements and stool that is dry, hard and difficult to pass. While it is a normal occurrence even among those without cancer, constipation can damage your intestine or rectum if not treated promptly. It can also lead to bowel obstruction and disrupt your body’s absorption of medicine. If you experience constipation due to gastric cancer treatment, please consult your care team. They can prescribe stool softeners or other laxatives and advise you on light exercises, which can help your gut muscles relax for stool to pass more easily through the large intestine.

In contrast to constipation, diarrhea means having frequent bowel movements and soft, loose, or watery stool. You may also experience abdominal cramping and pain. Because the body is not absorbing enough water and nutrients, the dangers of severe or prolonged diarrhea are dehydration and malnourishment that can be life-threatening. To manage diarrhea caused by gastric cancer treatment, your doctors may prescribe anti-diarrhea medication.

Drinking plenty of fluids and taking small, frequent meals that are easy on your stomach also helps. Bland foods like bananas, oats and toast are recommended. In particular, the BRAT diet focuses on bananas, rice, applesauce and toast, and can help manage chemotherapy-related diarrhea.

Hair loss (Alopecia)

Hair loss, also known as alopecia, is a common side effect of chemotherapy, radiation therapy (only if targeted at an area with hair), and targeted therapy. These cancer treatments work by attacking rapidly-dividing cancer cells. Unfortunately, they also kill other rapidly-growing cells in your body including those in your hair roots. This can make the hair on your head and other parts of your body fall out.

While hair usually grows back after treatment has ended, losing your hair can be a big physical change that affects your self-image and quality of life. Remember to be kind to yourself, and that you are not alone. Sharing your feelings with a trusted family member, friend, or counselor may provide some comfort. Talking to other patients with cancer who have also experienced treatment-related hair loss can be helpful too.

Experiencing physical side effects from gastric cancer treatment can be a difficult and overwhelming experience. These side effects can be so profound that they can affect your self-image and make it challenging to carry out your day-to-day activities.

In order to deal with these changes, shifting your perspective and finding ways to incorporate things that can make the transition easier may be helpful. This includes seeking support from loved ones and focusing on activities that bring you joy. Understanding what the changes are and what to expect can help you feel more in control of your situation. If they worsen, you can also discuss how to best manage your symptoms with your palliative care team. These are experts who will prioritize improving your quality of life and comfort, to help you through your treatments. Though it may be a challenging journey, remember that you are stronger than you think.

Learn more: Coping with the Emotional Side Effects of Gastric Cancer Treatment