When I talk with my patients about chemotherapy, naturally a part of the conversation is side effect management. So let’s talk about it right now. Generally, depending on stage, the optimal chemotherapy or systemic therapy for colon cancer is based on a backbone of more traditional cytotoxic drugs often referred to by patients as chemo and more modern biologic drugs that we have used over the past few years which are not traditional chemotherapy drugs but have very specific side effects. So when I discuss chemotherapy side effects with my patients, they are the general side effects.
That everybody should be aware of such as fatigue, generalized weakness, lack of energy, nausea and vomiting, but it is important to realize in 2013, we have very, very good medication to control most of the side effects so although we do mention them, it is more for the patient to be aware that these kind of occur, so the patient can bring those up so we can manage them. Nausea, fatigue, mouth sores, change in bowel habits, could be diarrhea or constipation and you know infectious risk, bleeding risk because of effects on the bone marrow, white.
Blood cell count will drop, platelet count will drop, the occasional patient might need red blood cell transfusion. Hair loss will depend on what chemotherapy agent is used, so it is actually not very common in most frontline regimens for colon cancer patients, but down the road it will happen. It is important to know the hair will grow back after that chemotherapy is completed. More rare side effects such as dysfunction of the heart, these are also temporarily, but we will talk about those with the patient. The biologic drugs that we have are geared toward the blood vessels to attack the blood vessels of the.
Side Effects of Chemo for Colon Cancer
Tumor and its supply. The approved drug is called bevacizumab obviously because how it works it affects blood cells. It does interfere with wound healing, so we don’t use it six weeks before or after surgeries and there is a small but real risk of serious complications such as bowel perforation where you get a hole in your bowel or major bleeding events, but those are really rare and we try to select the right patient for the treatment. Another class of drugs that affects specific protein called EGFR on the tumor cells is called cetuximab.
Or panitumumab. These are very difficult names but important to know that they have antitumor effect. They have very characteristic side effects such as a rash which might be very mild to actually very, very advanced, where the patient has to be treated with antibiotics and lotions. The good news for the patient is I always tell them it has been shown if you do develop a rash, then you are more likely to respond to the therapy. Other side effects such as diarrhea and magnesium level changes, we are usually able to monitor and manage.