Individuals that experience symptoms associated with occupational diseases should seek medical advice as soon as they notice symptoms. The sooner these types of diseases are diagnosed and treated the better the prognosis is for patients.

There are doctors who specialize in occupational medicine but they are very rare. Of the 800,000 physicians in the United States only 10,000 of them specialize in occupational medicine.

The first point of contact for most individuals is the family physician. This physician should do a thorough screening and can assist patients in recognizing the possibility of an occupational illness. Providing the physician with information about workplace irritants will help attain an accurate diagnosis.

Individuals should also consult the “materials supervisor” at the workplace. This person should be able to give detailed information via a “materials safety data sheet” about the types of toxic compounds found at the work site.

Occupational illnesses tend to be diagnosed infrequently however, they are responsible for approximately 860,000 illnesses annually. These illnesses lead to 60,300 deaths in the United States every year. Detecting, diagnosing and treating these diseases in the earliest stages may increase the chance of reversal and/or survival.

It is also important to be aware of dangerous substances prior to beginning a job and to ensure that proper protection is available. Prevention is the best means to avoid lung and respiratory disease and proper equipment may keep workers safe from dangerous airborne particles. Respirators, proper ventilation and other types of equipment should be provided on the job.

Once a cancer patient’s treatments have ended, there is still a chance that he or she can experience side effects. Some side effects can continue after treatment or surface months or years after treatment. There is not a lot of concrete information that is known about cancer treatment side effects, but they can vary by treatment type and individual circumstances. 
 
Physicians aren’t sure why these effects occur late. Some doctors think the side effects may have been there during treatment, but they weren’t noticed because the body was counteracting them and after treatment the body no longer does this, thus they begin to emerge later. 
 
Side effects that are apparent during cancer treatment can continue to last months or years afterward. Most long-term effects reduce over time or completely disappear. An example of a long-term side effect is peripheral neuropathy. It can occur during chemotherapy treatment and continue months or years after treatment has been completed. 
 
What Chemotherapy Treatments Cause Late Side Effects? 
 
In general, chemotherapy treatments are more likely to cause late effects than other types of cancer treatments. Not all cancer patients may experience long-term or late effects and different chemotherapy drugs may cause various effects. 
 
Some of the following are long-term side effects from chemotherapy treatment: 
 
 

• fatigue 
• neuropathy 
• chemobrain 
• heart failure 

• kidney failure 
• infertility 
• liver problems 
• menopausal symptoms 

 
Some of the following are late side effects from chemotherapy treatment: 
 

• cataracts 
• osteoporosis 
• chemobrain 
• reduced lung capacity 
• lung disease 

• infertility 
• liver problems 
• second primary cancers 
   
   
   

More Information About Managing Chemotherapy Side Effects 
 
If cancer patients need more information, or have questions on how to manage chemotherapy side effects, they can contact The American Cancer Society at 1-800-ACS-2345, or read an online booklet, Understanding Chemotherapy: A Guide for Patients and their Families, at the following web address: http://www.cancer.org/docroot/ETO/ETO_1_5x_Guide_for_Patients_and_Families.asp 
 

Chemotherapy drug treatment can cause a patient to experience rashes on the back, chest, arms, neck or face that may look like a rosacea or acne type condition. A patient usually experiences rash side effects that are mild to moderate. Rash side effects do come with an infection risk factor. In some cases if the rash is serious, the treatment drugs may be reduced, delayed or terminated.

Drugs That Cause Rash

Some of the medications that increase the likelihood of a rash are Tarceva (erlotinib) and Erbitux (cetuximab). They may cause an acne-like condition that arises in the second week of the cancer treatment, but may start to diminish by the fourth week of treatment. The rash goes away once the treatment has been completed.

These medications are directed toward the epidermal growth factor receptor (EGFR) and inflammation occurs that often causes an acne-like skin reaction.

Drug Treatments to Reduce Rash Side Effects

There are no real firm standards on what can be used to treat rashes for chemotherapy patients; however, following are some medications used to help reduce rash side effects during chemotherapy drug treatment:

– antihistamines such as Benadryl and Atarax to lessen itching
– topical corticosteroids
– antibiotics (oral or topical)
– Elidel being researched to control EGFR-related rash side effect

Why do the side effects occur in specific parts of the body?

Healthy cells in certain parts of the body are especially sensitive to chemotherapy drugs. The parts of the body that seem to be prone to side effects are the parts that have rapidly dividing cells. Chemotherapy drugs attack these cells and can result in various side effects based on the drug type, dose and route in which the patient receives the drugs.

The following cells are prone to side effects:

• the bone marrow cells (which makes blood cells)
• hair follicles cells
• cells that line the mouth and throat
• cells that line digestive system

Chemotherapy treatments are normally given in a group of sessions. The sessions are followed by a period of rest. The chemotherapy sessions kill the cancer cells and the rest periods allow the healthy cells to recover.

Chemotherapy
drug treatment can cause a patient to experience constipation, or the
uncomfortable passage of hard, dry stools that are infrequent. Some
symptoms include bloating, cramping, increased gas and pain. About 50
percent of cancer patients experience constipation. Other side effects
can occur from this condition such as decreased appetite and nausea.

Drugs That Cause Constipation

Some of the medications that increase the incidence of constipation are
opioid pain medications and chemotherapy drugs such as vincristine and
vinblastine.

Other Causes of Constipation

Other than medications there are other factor that can lead to an increase in the likelihood that a patient experiences constipation such as depression, decreased fluid or food intake, dehydration, low fiber diet and lack of physical activity.   

Drug Treatments to Reduce Constipation 

Following are some medications that may help reduce constipation during chemotherapy treatments:

• Psyllium (Metamucil) 
  – Docusate sodium (Colace)   
  – Bisacodyl (Dulcolax)  
  – Sorbitol and sodium phosphate (Fleet’s enema) 
  – Glycerin suppository 
  – Magnesium hydroxide (Milk of Magnesia)  
  – Senna (Senokot)  
  – Lactulose (Chronulac)  
  – Magnesium citrate 

Non-Drug Treatments to Reduce Constipation 

Following are some non-drug methods to help reduce the incidence of constipation during chemotherapy drug treatment: 

• stay physically active
• try to drink at least 3 quarts of fluids per day
• try to eat high-fiber foods
• patients to tell their doctor if they don’t have bowel movement for more than three days

Diarrhea

Chemotherapy drug treatment can cause a patient to experience diarrhea, or the passing of an increased amount of a watery or loose stool multiple times throughout the day. Some symptoms include bloating, cramping, increased gas and pain. About 3 out 4 cancer patients experience diarrhea during chemotherapy treatment due to the attack on the cells in the digestive tract.

Drugs That Cause Diarrhea 

Some of the medications that increase the incidence of diarrhea are
dactinomycin, doxorubicin, docetaxel, methotrexate, irinotecan,
5-fluorouracil, antibiotics or antacids.

Also the dose of the chemotherapy drug can play a role in whether or not a patient experiences diarrhea.

Diarrhea
can lead to dehydration and is a common side effect of irinotecan
(CPT-11). Patient’s should tell a physician when diarrhea occurs and
follow his or her instructions to stop the condition.

Other Causes of Diarrhea

Other than medications there are other factors that can lead to an increase in the likelihood that a cancer patient experiences diarrhea such as
stress, anxiety, food allergies, when a patient receives radiation and
chemotherapy simultaneously, stomach tumor, nutritional supplements and
the length of treatment.

Non-Drug Treatments to Reduce Diarrhea

Following are some non-drug methods to help reduce the incidence of diarrhea during chemotherapy drug treatment

• : 
   
  – stay physically active 
  – try to drink at least 8-10 glasses of fluids per day (i.e. water, Gatorade, broth) 
  – try to eat small portions of low-fiber foods frequently (i.e. banana, rice, bread, chicken) 
  – avoid greasy, fatty, fried foods 
  – avoid vegetables and fruits 
  – limit caffeine beverages and extremely hot or cold beverages 
  – avoid whole grain bread, cereal, nuts, popcorn 
  – avoid gas-forming foods and beverages 
  – avoid alcohol, lactose-containing products and supplements

Over-the-Counter Medications to Reduce Diarrhea

Following are some over-the-counter medications to help reduce the incidence of diarrhea during chemotherapy drug treatment: 

• Kaopectate®II caplets 
  Maalox®anti-Diarrheal caplets  
  Loperamide (Imodium®)  
  Pepto® Diarrhea control (follow instructions on container)

Chemotherapy drug treatments can be effective, but they also seem to be linked to intense fatigue. Drugs that often cause cancer-related fatigue are vinblastine, cisplatin and vincristine.

The severity of fatigue may vary by individual, but almost 90 percent of cancer patients experience some level of fatigue related to cancer treatment at some time during therapy. It is also known that the symptoms from fatigue can last for months or years after cancer treatment.

Specifically, fatigue can be caused by cancer-related anemia or low thyroid function and can intensify with emotional distress or depression related to the cancer treatment. A patient with fatigue may feel weak, forgetful, have decreased energy level and an inability to concentrate.

Drug Treatments to Reduce Fatigue

Physicians treat cancer patients that suffer from fatigue in a similar way to patients with anemia. Doctors use drugs that produce hormone and stimulants such as Ritalin (methylphenidate) and Provigil (modafinil).

Other Treatments to Reduce Fatigue

None-drug treatments such as exercise, diet and conserving energy have been shown to reduce fatigue.

Exercise

Doctors put their patients on a low-intensity exercise regimen to avoid the loss of too much muscle mass that can lead to fatigue more easily than someone that does some sort of physical activity. Too much high-intensity exercise is not good for cancer patients since it can put the immune system at risk.

Diet

Cancer patients can monitor their diet to help reduce fatigue. If a patient doesn’t maintain the proper nutrition by eating the right foods, this will contribute to fatigue. It is recommended that a cancer patient gets at least 15 calories per pound of his or her body weight. Proper amounts of protein are also important to help rebuild and repair body tissue. The recommended amounts of protein are 0.5 to 0.6 grams for every pound of body weight. Patients should have a minimum of 64 ounces of fluids per day and limit their intake of alcoholic and caffeine beverages. It is recommended to supplement their diet with a multivitamin that gives them 100% of the recommended daily nutrients.

Conserve energy

Cancer patients should organize their tasks ahead of time and try to schedule rest periods to help save energy throughout their day. The following are some recommendations to conserve energy:

– Take time in the day to rest
– Take multiple short naps or breaks instead of one long break
– Save energy for important tasks
– Get help to delegate some tasks
– Moderate pace is better than rushing through tasks

Some chemotherapy drugs can cause sores in the mouth or throat because they inhibit the replacement of the healthy cells. The condition that causes sores in the mouth is known as stomatitis, and a comparable condition in the throat is known as pharyngitis.  

The lining of the mouth starts to become pale and dry. As time goes on, the mouth and throat may become red, sore and inflamed. The patient may have trouble eating, talking or swallowing. Eventually, the condition can lead to painful, bleeding ulcers and possibly infection. This condition normally develops approximately 5 to 14 days after chemotherapy treatment has taken place. These conditions eventually heal once chemotherapy treatment has ended. 
 
It has been determined that up to 75 percent of patients who receive high-does chemotherapy get oral mucositis and approximately 40 percent of patients that receive standard-dose chemotherapy experience this side effect. 

  
Drugs That Cause Oral Mucositis 
 
Some chemotherapy drugs such as methotrexate and 5-FU have shown to cause a higher incidence of oral mucositis than some others. If the patient is treated early, it can lessen the severity of the symptoms. 
 
Treatments to Reduce and Relieve Incidence of Oral Mucositis 
 
There are some common none-drug treatments to help reduce the severity of oral mucositis. 

Following are some steps that can be taken to help the healing process: 

– Keep the mouth clean and moist 
– Brush teeth with a soft toothbrush or swab 
– Stay away from mouthwashes; rinse with salt or baking soda solutions 
– Stay away from foods and juices that are acidic 

There are some medications that have been recommended and administered to cancer patients to help alleviate pain from oral mucositis. They include the following: 
 
– Tylenol liquid (acetaminophen) – helps relieve pain but doesn’t heal sores 
– Kepivance (palifermin) – this drug is used for severe cases of oral mucositis in patients with  
  blood cancers 
– Gelclair (hyaluronate)- relieves pain by creating a protective barrier and coating the oral  
  mucosa 
– Saforis (glutamine) – a new drug known to be effective in preventing and treating oral mucositis