Do What You Can to Ease Treatment Side Effects and Symptoms of Bladder Cancer
You will most likely have physical concerns since your cancer may cause symptoms and you may have side effects from your treatment. In this article, you'll learn more about how to respond to some of the most common ones. Your reaction depends on the treatment you get. We've listed symptoms and side effects alphabetically so that you can easily find tips to ease the problems you are having:
Anemia (low red blood cell levels)
Chemotherapy and radiation therapy may damage blood-producing cells in the bone marrow. This can reduce levels of red blood cells. Red blood cells carry oxygen throughout the body. If your body doesn't have enough oxygen, you may feel fatigued.
Take these actions to feel better:
Anxiety and depression
Many people feel blue, anxious, or distressed after being told they have cancer. Taking these actions may ease your distress:
Most people with early-stage bladder cancer won't have any symptoms. But later-stage bladder cancer may cause a burning sensation when you urinate. Some of the treatments for bladder cancer may also cause bladder irritation. These treatments include radiation therapy, chemotherapy, and intravesical chemotherapy or immunotherapy, where the medication is put directly into your bladder. The irritation will usually ease about 2 weeks after treatment ends. You should call your doctor if you have this symptom.
These steps can also help relieve the discomfort:
Chemotherapy and radiation therapy may reduce levels of platelets in the blood, resulting in a condition called thrombocytopenia. Platelets are cell-like structures in blood that allow the blood to clot. If your doctor or nurse tells you that your platelet count is low, take these actions to avoid causing injuries that could lead to bruising or bleeding:
Both chemotherapy and radiation therapy can damage cells in the intestine. This can result in diarrhea. Diarrhea can sometimes cause dehydration. To prevent it, take these precautions:
Eat low-fiber foods, such as those in the BRAT diet (bananas, rice, applesauce, and toast).
Fatigue is a common cancer symptom. It's also a common side effect from chemotherapy and radiation treatments and after surgery to remove your bladder. You may feel only slightly tired, or you may suffer from extreme fatigue. Take these actions to help increase your energy level:
Hair loss (alopecia)
Losing your hair can be upsetting because baldness is a visible reminder that you are being treated for cancer. If you are having radiation to your pelvis for bladder cancer, you may lose your pubic hair, but not the hair on your head. It will grow back. You may lose the hair on your head if you are getting systemic chemotherapy. Try these coping tips:
Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair.
Chemotherapy and radiation therapy may damage blood-producing cells in the bone marrow. This can reduce levels of white blood cells, causing a condition called neutropenia. Low levels of white blood cells make you vulnerable to infections. If your doctor or nurse tells you that your white blood cell count is low, take these actions to stay healthy:
Call your doctor right away if you have signs of infection. These include a temperature of 100.5°F (38.1°C) or higher, chills, a cough, pain, a burning sensation during urination, or any sores or redness.
Insomnia (trouble sleeping)
It's natural for people undergoing cancer treatments to experience anxiety. Anxiety and stress are common reasons people have trouble sleeping. Trouble sleeping may be a side effect of chemotherapy or other drugs used during your treatment. Use these tips to improve your sleep:
Loss of appetite
You need to eat well during cancer treatments to maintain your strength and lower your chance of infection. A diet high in calories and protein is important when you're being treated for cancer and following surgery to remove the bladder. However, chemotherapy can reduce your appetite. It may even change the way food tastes. Ask your doctor for a referral to a registered dietitian if you are having trouble maintaining your appetite. Also, try these tips to stimulate your desire to eat:
If you can, eat foods high in protein several times a day. These foods include milk, cheese, cottage cheese, yogurt, meat, fish, eggs, beans, peanut butter, and nuts. Protein helps build and repair tissue. Cancer treatments cause you to use more protein than usual.
If you are underweight, eat high-calorie foods, if you can, to help you maintain your weight. High-calorie foods include margarine or butter, sugar, honey, jams, jellies, cream cheese, dried fruit, gravies or sauces, mayonnaise, and salad dressing.
Get plenty of fluids to help control your body temperature and improve food elimination. In addition to water, fruit juices, and other liquids, try these foods to increase fluids: gelatin, pudding, soups, Popsicles, and ice cream.
Memory or concentration problems ("chemo brain")
You may have mild problems with concentration and memory during and after chemotherapy. Symptoms can include trouble concentrating, short-term memory lapses, trouble multitasking, and trouble with remembering names. Fatigue can make the problem worse. Taking these actions may help:
Be certain to alert your medical team if you have these symptoms, and ask what can be done to help improve cognitive health. Cognitive interventions may be especially important after treatment ends.
Nausea or vomiting
Some people who have chemotherapy or radiation experience very little nausea. For others, nausea or vomiting is severe. To prevent and control nausea or vomiting, try these tips:
Eat bland foods that are easy on the stomach, such as applesauce, bananas, rice, pudding, or crackers.
Pain is a common side effect of cancer treatments. For instance, you may have pain after surgery to remove your bladder. Pain can also be caused by the cancer itself. For example, the growth of the cancer may put pressure on nerves in the area of the bladder. Call your doctor right away if you're in severe pain. Medicines can be very effective at easing pain. Here are a few extra tips to ease the pain:
Sexual problems in men
If you've had a radical cystectomy to remove your bladder and also had your prostate gland removed, you will no longer be able to impregnate a woman. And, you may have problems getting and maintaining an erection, called erectile dysfunction. You may also have this problem if you've had radiation therapy. If you've had bladder reconstructive surgery, it may also damage the nerves that allow you to have an erection. Feelings of depression from having cancer or fatigue from other treatments can also have a negative impact on your sexual desires.
Here are some ways you may cope better:
Talk with your doctor about medical ways to restore erections. Your options may include medications such as Viagra, penile implants, injections, or vacuum devices.
Sexual problems in women
If you've had a radical cystectomy to remove your bladder and had your uterus, ovaries, and fallopian tubes removed, you will no longer be able to become pregnant. You may also have menopausal symptoms, such as hot flashes or vaginal dryness. Receiving radiation treatment may also cause vaginal dryness.
Here are some ways you may cope better if this is an issue for you:
Discuss with your doctor ways to manage menopausal symptoms, such as using lubricants for vaginal dryness, doing mild exercise, and talking with an accredited psychotherapist about mood swings or signs of depression.
Radiation treatments can damage skin cells and cause the skin to get dry, red, or irritated. Here are a few ways to protect your skin:
Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don't use skin products, including lotions, soaps, deodorants, perfumes, or powders, for 2 hours after radiation treatments since your skin will be extra sensitive.
Incontinence is the inability to control the flow of your urine. This may be caused from the tumor itself. Or it may be a side effect of radiation.
Not being able to control your urine can lead to anxiety, and loss of self-control or self-esteem. Take heart. There are treatments available. Start with these steps:
Keep track of your symptoms so that you can let your doctor know exactly what is happening. Record how many incontinence pads you use, what activities cause incontinence, how frequently you urinate, if you have frequency or urgency, how strong your force of urine stream is, if you feel that you are emptying your bladder well, and what types and how much fluid you are drinking.
Talk with your doctor about how to do Kegel exercises to help with stress incontinence. These exercises strengthen the pelvic floor muscles. Here's how to identify these muscles. Try stopping your urine stream while you are urinating. The muscle you use is the one you want to strengthen. To perform Kegel exercises, simply repetitively contract and relax that muscle at least 20 times every day. These exercises are the most helpful when the catheter is removed after radical surgery. They are not as effective in men who have had radiation treatment.
It's helpful to keep a log of your side effect symptoms — physical, cognitive, and emotional changes. A written list will make it easier for you to remember your questions at your appointments. It will also make it much easier for your medical team to identify appropriate treatments for your side effects. Bring a family member or close friend with you to doctor's appointments to help deal with the medical information and remember all your questions.