Managing Chemotherapy Side Effects

Breast Cancer: Managing Chemotherapy Side Effects

Therapy for Managing Chemotherapy Side Effects

Side Effects Overview

Cancer medicine has come a long way, especially in the area of chemotherapy. But serious side effects are still a topic of concern. The number and intensity of side effects vary from person to person. What you experience may be very different from what another chemotherapy patient experiences. Some of the most common side effects that can affect your daily life are fatigue and nausea. You may also experience more long-term side effects such as sexual dysfunction, muscle and nerve damage, and problems with memory.

Chemotherapy patients are looking for ways to deal with these side effects. That’s where complementary medicine plays a role. Complementary medicine refers to any treatments that are not a part of standard approaches, including chemotherapy. As the name implies, complementary medicine is just a complement. It’s used in addition to standard treatments. The main purpose of complementary medicine is to combat typical side effects. It’s mainly used to relieve stress, improve sleep, enhance quality of life, reduce pain, and promote emotional, physical, and spiritual well being.

According to the 2007 National Health Interview Survey (NHIS), 65 percent of cancer respondents used or experimented with complementary approaches during their treatments. But other surveys have shown that patients often do not discuss their use of these approaches with their doctors. You should always speak with your oncologist before undergoing any complementary medicine practice, as some practices could interfere with your standard treatment.

Here are some of the most common complementary medicine approaches used to help manage the side effects of chemotherapy:


Acupuncture is an ancient Chinese practice that many believe can be helpful in dealing with some of the side effects of chemotherapy, including nausea. Thin needles are inserted into the skin at specific locations and are left in place for a few minutes. The main purpose of acupuncture is to restore balance and promote healthy energy throughout the body.

Things to Consider:

  • Effort Level: You will need to spend a portion of time researching a certified acupuncture practitioner that’s trained in handling chemotherapy patients. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) directory can help you find a certified acupuncturist in your area.  
  • Costs: The cost of receiving acupuncture varies by location and practitioner. The cost of a session is normally conducted hourly. It may be fully or partially covered by your health insurance plan. 
  • Time: You will have to designate a specific amount of time to seeing your acupuncture practitioner. Depending on your needs, visits can range from weekly to monthly sessions.

Exercise and Physical Activity

Exercise and physical activity are beneficial for weight management and may help with the prevention of cancer. Light cardio — for instance, walking at a brisk pace — and strength training with small weights can improve your overall health. Exercise can also offset some of the feelings of weariness and anxiety caused by chemotherapy. It can boost energy, appetite, and improve quality of sleep. As always, make sure to discuss any physical fitness program with your oncologist.

Things to Consider:

  • Effort Level: The amount of effort you spend dedicated to exercising will depend on what you’re looking to get out of your regimen and your own motivation level. If you’re a self-motivated individual, you can schedule workout routines and plans to do on your own time at home. Exercise plans can be found almost anywhere, from websites to workout DVDs to YouTube videos. If you’re worried about not sticking with an exercise regimen, you may consider investing in a gym membership or signing up for classes such as yoga, Pilates, or dance. You’ll want to find a gym that is close to your home and one that has flexible hours of operation. 
  • Costs: Again, the amount of money you spend on exercise and physical activity depends on your needs. If you’re looking to work out on your own, then the actual cost can be nothing at all. On the other hand, the price of a gym membership varies by location. Working with an exercise specialist, physical therapist, or exercise physiologist can also be beneficial but costs money. The American Cancer Society says working with a specialist can be helpful for finding a regimen that meets your needs.
  • Time: You’ll want to devote time each week to being physically active. You may find it challenging to schedule time for exercising, especially as your calendar fills up with regular appointments. But exercising should be considered an important part of your treatment plan.  

Herbal Supplements

Herbal supplements are those that that come from plants, including acai berry, ginger, and garlic. Traditional Chinese medicine utilizes a mixture of herbal compounds. Two of the most common herbal formulations used for breast cancer treatment side effects are Danggui (Angelica sinensis-radix) and Ren Shen (Panax ginseng-radix). These formulas have been shown to help with toxicity, psychosocial stress, and fatigue. Other herbs have been shown to help manage hot flashes, nausea, and vomiting.

Not enough research has been conducted to know the exact results of certain supplements, or how these supplements interact with chemotherapy, anti-hormone, and over-the-counter medicines. Culinary herbs in small or limited quantities are generally safe, but the use of herbs as long-term supplements can be dangerous. For example, when used in the long-term, garlic can increase the risk of bleeding during surgery. More research on herbal supplements is needed to address some of the most prominent concerns, including quality control and standardization of practice.

Things to Consider:

  • Effort Level: Before taking any herbal supplements, you will need to spend time researching which supplement, if any, is best for managing your side effects. You will also want to schedule time to talk with your oncologist before taking any supplements. Some supplements can counteract or even interfere with the effectiveness of chemotherapy. The FDA does not regulate dietary supplements as safe unless a consumer claim has been made. 
  • Costs: The costs of taking herbal supplements vary on what you’re looking to take and how often you’ll be taking them. You’ll want to verify that you’re getting these supplements from a reliable source.
  • Time: The time spent taking a supplement should be minimal and shouldn’t be a major factor in deciding whether taking supplements is something you want to consider. But finding the proper supplement and obtaining them from a reliable source can take some time.


Massages, or the application of kneading and rubbing on the muscles and joints, is a common practice of relaxation for cancer and non-cancer patients. According to the Mayo Clinic, the four most common types of massages are Swedish, deep, sports, and trigger point. For managing your chemotherapy side effects, you’ll likely want to have a Swedish massage, or a relaxing, full-body massage. Massages are generally used to treat stress and anxiety, but can also help in terms of improving mood, stimulating relaxation, and controlling pain. Although the idea of a massage may be relaxing, special precautions should be taken as a chemotherapy patient:

  • If you’re also undergoing radiation, you should not have a massage applied to that specific area.
  • If you’ve had surgery on your axillary lymph nodes, you’ll want a massage therapist who specializes in lymphedema.
  • If your platelet levels are low from chemotherapy, you should avoid a deep tissue massage.

Things to Consider:

  • Effort Level: Again, you’ll need to designate a significant amount of time finding a certified massage therapist that is comfortable handling chemotherapy patients. Massage therapists are licensed by each state. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) website can help you find a therapist in your area.
  • Costs: Receiving a proper massage from a trained massage therapist can also be quite expensive. The costs of massages are typically conducted on an hourly basis. It is also generally expected that you’ll tip your therapist after each session.
  • Time: The time required for a massage can vary, normally between 30 to 90 minutes. Depending on your needs, your visits may be weekly or monthly.

Medical Marijuana

From a political standpoint, medical marijuana is a controversial subject. As of October 2014, 23 states and the District of Columbia allow for “comprehensive public medical marijuana and cannabis programs.” Eleven additional states allow for the limited use of medical marijuana.

Clinical studies have found that medical marijuana can help in treating pain as well as neurological disorders for chemotherapy patients. It can also help with nausea and vomiting, as well as restoring your appetite. But more research is needed to confirm these results. The U.S. Food and Drug Administration has not approved medical marijuana.

Things to Consider:

  • Effort Level: One of the biggest obstacles to medical marijuana is its legality. It may not be a legal form of medicine in your state. Two other major obstacles are cost and standardization. You’ll want to verify that the source you are getting the drug from is reliable.
  • Costs: The exact cost of medical marijuana varies depending on location and level of use. The demand for the drug, either in your state or nationally, can also dramatically affect the cost. As of today, health insurers refuse to cover the drug since the FDA has not approved it. 
  • Time: The use of medical marijuana can be for either short-term or long-term use. You may have to schedule extra visits to your hospital or cancer treatment facility to receive the drug.


A spiritual and meditation practice, yoga utilizes a mix of physical poses and stances with a structured breathing regimen. The main purpose of yoga is to provoke a balanced mind, spirit, and body. During a yoga class, the instructor will lead you through a series of poses and deep breathing exercises. Research has shown that practicing yoga generally improves one’s outlook and quality of life. And while more research still needs to be conducted on why, yoga can be a beneficial part of the healing process.

Things to Consider:

  • Effort Level: Because yoga has increased in popularity with the general public, finding the right yoga class or instructor may take a while. You’ll want to find someone that you’re comfortable with, especially because they will need to know about your physical limitations as a cancer patient undergoing chemotherapy. Your instructor may lead you through new or slightly different poses than the rest of the yoga students. Also, not all yoga classes are the same. When you begin looking for a yoga class, avoid any advanced classes or ones that require more advanced techniques, such as “ashtanga.” You should never feel any pain while doing yoga. And you should never strain your body into a position that’s uncomfortable.
  • Costs: The cost of a yoga class depends on location. Many gyms offer yoga classes as part of membership. Going to a separate yoga studio is another option. Yoga DVDs and online videos are also widely available. However, it may be best to go to at least a few classes first to understand the practice of yoga and what it entails before doing it on your own.  
  • Time: A yoga class typically lasts anywhere from 30 to 90 minutes. Classes can meet up to several times a week, but you’ll want to find a routine that works best for your needs and lifestyle.

Next Consideration:

Patient Perspectives