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Managing Side Effects Of Cancer Treatment

Ayurveda, a traditional Indian medical system, is becoming increasingly recognized for its role in managing side effects of cancer treatment. Patients undergoing cancer treatments such as chemotherapy and radiation therapy often experience various side effects that can negatively impact their quality of life.

Side effects refers to any unintended or undesirable effects that occurs when a person takes any kind of medications, or undergo any medical procedure like surgery or commonly done cosmetic procedures in current era, and or uses any particular products. Side effects can be graded on a scale of mild to severe, and it can effect different parts of body in a different ways. Common examples of side effects are: 1) Generalized skin rash or itching. 2) Fatigue or drowsiness. 3) Breathlessness or heavy breathing. 4) Dizziness or lightheadness. 5) Nausea or vomiting. 6) Headache etc.

Different Treatment Modalities of Cancer

There are several, and different treatment modalities for cancer, which can be administered to the cancer patient alone or in combination for its synergistic effects depending on the stage of the cancer and overall general health status of the cancer patients. In current era, preferences of cancer patients regarding choice on different treatment modalities available of cancer is also taken into consideration based on statistics of benefits and side effects of different modalities available in cancer treatment research. Most common type of different treatment modalities for cancer treatment includes: 1) Radiotherapy/Radiation Therapy 2) Chemotherapy 3) Immunotherapy 4) Targeted Therapy 5) Hormone Therapy 6) Stem Cell Transplant. 7) Surgery.

What is ‘Chemotherapy’?

Chemotherapy is one of the most common type of cancer treatment modality in which different drugs are used to kill cancer cells. Different chemotherapeutic drugs work by attacking rapidly dividing cells in the body which also include cancer cells. So chemotherapeutic drugs doesn’t works well on slow progressing cancers. Chemotherapeutic drugs can be administered through different routes:
  1. Intravenous (IV) Chemotherapy – This is the commonest route of chemotherapeutic drug administration and involves administering the drugs in the veins, most probably in the arms. This route ensure maximum delivery of the drugs dosage.

  2. Oral Chemotherapy – This is one of the most preferable route of chemotherapeutic drug administration and involves consuming chemotherapeutic drugs via oral routes in form of pills, capsules or liquids. Oral route may not be as effective as intravenous route because some drugs are not well absorbed in the body when taken orally.

  3. Intrathecal Chemotherapy – This route involves directly injecting the chemotherapeutic drug in the cerebrospinal fluid which surrounds the brain and spinal cord. Intrathecal chemotherapy is the preferred route in cancer cases of lymphoma, leukemia or cancer which has metastasized to the central nervous system.
managing-side-effects-of-cancer-treatment
There are many different types of chemotherapy drugs divided in to different class, and each with its own mechanism of action and potential side effects. To deliver a particular chemotherapeutic drug single or in combination of multiple drugs depends on the type and stage of the cancer, and overall general health status and preference of the cancer patients.

Side-Effects of Chemotherapy

Chemotherapy can be an effective modality in cancer treatments but it can also cause or causes wide range of side effects. The specific side effects and its severity can vary widely depending on the chemotherapeutic drug administered, and dosage of the respective drug.

Severity of the side effects varies from patient to patient which is based on the fact of inherent ability to metabolize the chemotherapeutic drug which relies on individual genetic heterogeneity. Inherently or genetically one can be administered a particular dosage of drug without any side effects because of adequate metabolization capacity of the drug. And the same dose of the chemotherapeutic drug can prove fatal for another individual due to potential inherent or genetic capacity of slow metabolization of a given drug. It results in slow clearance of the same drug, and consequently it can result in over dosage.

Some common side effects of chemotherapy are:
  1. Nausea and vomiting: Nausea and vomiting are one of the commonest side effects of chemotherapy, as chemotherapeutic drugs can harm the rapidly dividing cells of gastric and intestinal linings. Nausea and vomiting can be difficult to manage conservatively and may result in reduction in dosage of the chemotherapeutic drug, or completely halting the regime so as to manage the nausea and vomiting.

  2. Hair loss: Hair is often a reflection of an individual personality, and a good managed and well groomed hair can boost confidence in an individual. During chemotherapy treatment hair can be adversely affected and leads to emotional trauma in the cancer patients. Chemotherapeutic drug damages the hair follicles because of its rapidly diving nature of the hair follicles, consequently leading to hair loss over the face, scalp and other parts of the bodies. Grade I and Grade II is the hair loss of less that 50% and more that 50% respectively.

  3. Diarrhea or constipation: Diarrhea as defined, is called frequent passage of loose stools with urgency, and range from passage of more than three unformed or loose stools in 24 hours. Constipation is defined as slow or hastened movement of feces through the large intestine. It results in infrequent bowel movement, and the passage of hard and dry stools after straining. Constipation can also be defined as passage of less than 3 stools per week and sensation of incomplete evacuation after stool or anorectal blockage. Both are major treatment related complication in the cancer patients receiving chemotherapy.

  4. Increased risk of infections due to lowered immunity: Chemotherapy is the mode of treatment that is used to kill cancer cells. However, drugs used in chemotherapy can also affects the cells of the immune system, and the same can lead to lowered immunity. The cells of the immune system are responsible to protect the body against different kinds of infections by fighting against different kinds of bacteria, viruses and fungi. But as chemotherapy damages the immune system by killing the immune cells or white blood cells, in that case the cancer patients are susceptible to different kinds of infections caused by bacteria, viruses and fungi.
Other types of types of side effects are loss of appetite, mouth sores or dry mouth, bruising or bleeding easily due to lowered platelet counts, Neuropathy, a condition where peripheral nerves are affected, skin rash or sensitivity to sunlight etc.

What is Radiotherapy or Radiation Therapy?

Radiotherapy, which is also known as radiation therapy is a form of cancer treatment which uses high energy beam or radiation to kill cancer cells. Radiation is administered to cancer cells in form of photons (mostly gamma rays) or high energy particles (protons, neutrons and electrons).

When radiation is administered, high energy photons or particles come in contact with the cancer cells then it causes ionization and further it generates free radicals that interact with sub-cellular structures of the cancer cells. This free radicals further interact with DNA and causes DNA damage. DNA damage further prevent the cancer cells from dividing and growing further. Normal cells are better prepared against DNA damage because of its intact DNA repair mechanism but not the cancer cells.

The radiation can be delivered to desired site of the body through external machine such as linear accelerator or directly to the site of cancer by placing a radioactive material near it, and the same is called brachytherapy.

Radiotherapy or Radiation Therapy can be used to treat different types of cancers like breast cancer, prostate cancer, brain cancer, lymphoma, leukemia etc. The specific type and the duration of the radiotherapy depends on the type of cancer, and its severity. The cancer patient overall general health and preferences are also taken into consideration.

Side-effects of Radiotherapy

Radiotherapy is one of the effective treatment modalities for the Cancer, but it is accompanied by its own class of side effects. The specific side effects and its severity depends on multiple factors like area of the body which has been treated with radiation and the type of radiotherapy protocol followed like IFRT, INRT etc., and the overall dosage of the radiation and patient’s general health, and also including multiple other factors. Some common side effects of radiotherapy are mentioned below:

  1. Skin changes: Skin changes is one of the most profound and commonest side effects experienced during or shorty after radiotherapy. Initially skin may show symptoms of redness and irritation like we see in sunburn cases, and as the case progresses skin may become dry and itchy. Later post-treatment skin can turn hyper-pigmented or hypo-pigmented followed by hair loss in the treated area like scalp or face. Radiotherapy can also cause peeling and flaking of the skin.
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  2. Fatigue: Fatigue is also one of the commonest side-effects of radiotherapy. It can be debilitating for the cancer patients during or after the treatment, and it can persist for several weeks or months even after treatment has been completed.

  3. Difficulty in swallowing: Difficulty in swallowing or more scientifically termed as dysphagia can occur during treatment of head and neck cancers, lung cancer and esophageal cancer. The radiation can damage the tissues in the throat or can lead to post-radiotherapy fibrosis resultant difficulty in swallowing. Radiotherapy can lead to dysphagia in multiple ways like radiation given can cause inflammation and scarring of the oral cavity, throat, esophagus etc., and can consequently lead to difficulty in swallowing or dysphagia. Radiotherapy can also cause damage to the salivary glands or mucus secreting glands and can lead to dryness in the oral cavity or throat, and consequently the same can lead to dysphagia.

  4. Radiation pneumonitis: Radiotherapy to the chest may cause inflammation of the lungs and is called radiation pneumonitis, which can further cause shortness of breath and coughing. Radiation pneumonitis is one the most potential and debilitating side effects of the radiotherapy of the chest given in cases of lung cancer, lymphoma, esophageal cancer etc. In this radiotherapy is preceded by inflammation of the lung tissue followed by shortness of the breath and chronic coughing. Many cases of radiation pneumonitis may resolve gradually with time, and with some residual and persisting side-effects.
  1. Radiation induced ‘Coronary Artery Disease (CAD)’: Radiotherapy for different types of cancer, such as lymphoma, breast cancer, esophageal cancer etc. can lead to the risk of developing coronary artery disease (CAD). Radiation leads to the damage of bloods vessels or coronary artery in the heart, and then the same leads to build up of the plaque. Gradually the plaque buildup progresses and can lead to further narrowing of the arteries or the vessels. This can also happen many years after the radiotherapy treatment.
Other types of types of side effects are nausea, vomiting, hair loss etc.

Role of Ayurveda in ‘Managing Side Effects Of Cancer Treatment’

Ayurveda, as known is a traditional system of Indian Medicine, and has a holistic approach toward health and well-being of a person. Ayurveda pledges to achieve equilibrium between mind, body and spirit through different modalities like lifestyle changes, dietary recommendations, Panchakarma, Ayurvedic herbal remedies etc.

Ayurveda can effectively Managing Side Effects Of Cancer Treatment’like side effects due to radiotherapy, chemotherapy, targeted therapy etc. In many cases of specific side effects management Ayurveda can play a frontline role while in some cases of side effects management it will be integrated with different other treatment modalities like Homeopathy, Acupuncture etc.

Some of the ways Ayurveda can help to manage the side effects of cancer treatment are:

  1. Herbal remedies: Ayurveda science, and its texts have mentioned vast numbers of herbs occurring in the nature well beyond the comprehension of an individual medical mind. Many herbs can be used to relieve the symptoms of side effects, and can even ameliorate its long term debility. For example, Sariva (Hemidesmus Indicus) as mentioned in Ayurveda, is an herb that helps in Raktha Dushti (disorders related to impurities in blood). But as per Ayurveda, Chemotherapy, in its side effects create impurities in Raktha Dhatu. So Sariva (Hemidesmus Indicus) can help to ameliorate the side effects of chemotherapy by purifying the blood or by doing Raktha Suddhi. There are many more herbs mentioned in Ayurveda which can help to deal different aspect of side effects in Cancer Treatment.

  2. Lifestyle changes: Lifestyle management is one the most important aspect of Ayurveda intervention in cancer treatment related side effects management. It involves emphasizing over importance of diet, doing regular exercises and practicing different techniques of stress reduction. It can help in maintaining overall general health of the cancer patients.

    Cancer patients are generally inflicted by moderate to worse depression due to long days of treatment procedures involving multiple cycles of chemotherapy, many days in radiotherapy, and further even traumatizing surgery experience. After all this long treatment procedures survival is not so sure, so the cancer patients are quite mentally and emotionally depressed, and resultant they generate a feeling of fatigueness. Different techniques mentioned in Yoga and Dhayana (Meditation) can generate hope in the mind and so further will help in dealing with fatigue.

Cancer side effect management in Ayurveda

1. Chemotherapy Side-Effect Management in Ayurveda

The most common chemotherapy related side effects are nausea and vomiting, hair loss, constipation and diarrhea, and increased risk of infection due to chemotherapy. Side-effects of chemotherapy can lead discontinuation in the treatment and negatively impact the patient’s quality of life. Let’s further discuss few symptoms of chemotherapy related side effects and how effectively can Ayurveda help in its management.
  • Ayurvedic Management of ‘Nausea and Vomiting’ in Chemotherapy Related Side-Effects: – Nausea and Vomiting are termed as Praseska ((प्रसेक) and Chardhi (छर्दि) in Ayurveda respectively. Dosha and Dushya samprapti is same for both nausea and vomiting as mentioned in Ayurveda, so as the treatment modality. Different drugs mentioned in Ayurveda for chemotherapy related ‘nausea and vomiting’ management are Haritaki (Terminalia Chebula) powder, Dhatriavleha, Parpata Kwath (decoction), Jambavadi Kashay, Rudhirchardihar Yoga etc. Cancer patient’s experiencing nausea and vomiting due to chemotherapy should consume light and easily digestible food, and so ‘Yusha Kalpanas’ are mentioned in Ayurveda. Yusha Kalpana helps in agni vriddhi and dosha pachana consequently relieving Nausea and Vomiting symptoms in cancer patients.

  • Ayurvedic Management of Hairloss in Chemotherapy Related Side-Effects: – As per ayurvedic concept, Hair or kesh is an updhatu of Asthi Dhatu. Hair is mainly composed of Parthiv Mahabhoot and is a Pitraj Bhava, as mentioned in Ayurvedic Texts. Complete hairloss in chemotherapy receiving patients can be called as to have developed ‘Khalitya Roga’, as mentioned in Ayurveda. Different ayurvedic treatment modalities can be used to prevent or help in rapid hair gain after hair loss in chemotherapy receiving patients. Murdha Tel or Oil is practice of regular applying ayurvedic medicated oil over the scalp like Chitrakadya Oil, Irimedadi Oil etc. Different lepa or topical applications as mentioned in ayurveda can help rapid hair growth like Gunja Lepa, Hastidanth Masi Lepa, Dugdhika – Karvira Lepa etc. Leech Therapy can also help in such cases.
  • Ayurvedic Management of Diarrhea or Constipation in Chemotherapy Related Side-Effects:– As per ayurvedic concept Diarrhea can be called as Atisar (अतिसार). Atisar (Diarrhea), as per ayurveda happens when aggravated doshas afflicts the power of digestion. Different kalpas or medications are mentioned in Ayurveda can help in or relieve chemotherapy side-effects related Atisar (Diarrhea) like Pathyadi Kwath, Kutjadi Kashay, Panchamulyadi Takra, Kutaj Putapak, Shyonak Putapak, Kutaj parpati Vati etc. For treatment in Atisar or diarrhea different Pramathya Kalpana is mentioned which be effectively used in cases of chemotherapy side-effects.
Ayurvedic Management of increased risk of infections due to lowered immunity in Chemotherapy cases and rest all other cancer side-effects can be effectively managed through Ayurveda, so the patient can continue his Chemotherapy and can have a better standard of living.

2. Radiotherapy Side-Effects Management in Ayurveda

Radiotherapy is one the major treatment in cancer, but it can also cause wide range of side effects like skin irritation, fatigue, osteoradionecrosis, nausea and diarrhea, fibrosis, dysphagia etc. Ayurveda being a traditional system of Indian Medicine can offer a vast number natural and effective remedies in radiotherapy related side effects management in Cancer Patient.
  • Ayurvedic Management of Fatigue in Radiotherapy Related Side-Effects: – As per Ayurveda in general sense Fatigue is referred as Angamarda (अङ्गमर्द). Angamarda (Fatigue) as mentioned in Ayurveda in evident by feeling of excessive sleepiness, heaviness in head, eyes etc., frequent yawning and joint pain. Most effective and easy treatment for Angamarda (Fatigue) in ayurveda is Abhyanga (Massage therapy). Ayurvedic massage, known as Abhyanga, can help relieve muscle tension, improve circulation in the body, and reduce stress and somnolence. Different drugs are mentioned in Ayurveda which can help in Angamarda (Fatigue) are Vidarigandha (Desmodium Gangeticum), Kantakari (Solanum Xantocarpum), Eranda (Ricinus Communis) etc.
  • Ayurvedic Management of Skin Changes in Radiotherapy Related Side-Effects: – As per Ayurveda skin changes in Radiation Therapy can be called as Dagdha Vrana or burn injury wound, in this case radiation burn injury to the skin. Different treatment modalities as mentioned in Ayurveda can be used for Dagdha Vrana (Radiation burn injury) like application of paste of Laja (parched paddy), Yasthimadhu (Liquorice), Sariwa (Hemidesmus Indicus) with cow’s milk over affected skin. Mixture of Vidarikanda (Pueraria tuberosa), Prishniparni (Uraria picta), Manjistha (Rubia Cordifolia), Lodhra (Symplocos racemosa), Chandan (Sandalwood) and Vata (Ficus benghalensis) prepared with Ghee (Clarified Butter) can effectively be used as a local application in cases of Dagdha Vrana (Radiation burn injury).
  • Ayurvedic Management of Radiation Pneumonitis and Coronary Artery Disease in Radiotherapy Related Side-Effects: – Radiation Pneumonitis and Coronary Artery Disease developing post-radiotherapy in cases of lung cancer, breast cancer, lymphoma etc. is one of the major debilitating disease. Ayurvedic intervention is such cases should be started at the earliest as in the case of long term disease course does not offer good prognosis. Radiation Pneumonitis can be considered as ‘Parshvashool’ in Ayurveda. Different herbs like Pushkarmool (Inula Racemosa), Kantakari (Solanum Xantocarpum) etc. can prove beneficial in Parshva Shool (Radiation Pneumonitis) cases. For coronary artery disease in radiotherapy related side effects can be dealt in Ayurveda through Guduchi (Tinospora Cordifolia), Hridayarnavarasam etc. Treatment should be initiated strictly under guidance of registered Ayurveda Cancer Specialist.
The side effects of radiation over different parts of the body can be effectively management through Ayurveda. So ‘Modern Treatment Related Cancer side effect’ management in Ayurveda can be done efficiently.

About Team ‘Cancer In Ayurveda’

We at Team ‘Cancer In Ayurveda’ believe that every patient is unique and requires personalized care. Our patient-centric approach involves taking the time to understand the patient’s condition, medical history, and lifestyle. Based on this understanding, our doctors at Team ‘Cancer In Ayurveda ‘create a personalized treatment plan that incorporates the best of what Ayurveda has to offer.

We at Team ‘Cancer In Ayurveda’ use a combination of Ayurvedic herbs, Panchakarma, and modern parameters to provide patients with the best possible care. Kindly connect with us!!!

1. Chemotherapy

The most common chemotherapy – induced side effects are nausea and vomiting, fatigue, decreased appetite, changes in taste, hair loss, dry mouth, and constipation. Side-effects of chemotherapy can influence the continuance of treatment and, have a negative impact on a patient’s quality of life. Identification of new treatments to ameliorate chemotherapy-induced side effects is necessary to improve quality of life amongst cancer patients. All the side-effects can be effectively managed through Ayurveda so that the patient can continue his Chemotherapy and can have a better standard of living.

2. Radiotherapy

Acute response of the radiation over skin and mucosa is redness, inflammation, and shedding of skin over dry and moist surfaces, which manifest as inflammation of mucosa, itching, hypersensitivity, pain, ulcers in the mucosa. Radiation over salivary gland may result in cell death, manifesting as swelling and tenderness after 1st session of radiotherapy, progressing to xerostomia (mouth dryness) and subsequent severe dental caries. Recovery of salivary gland function, it occurs, takes months or years. Acute radiation toxicity presents as anorexia, nausea, vomiting, abdominal cramps, and diarrhea about 2-3 weeks after radiation therapy. The side effects of radiation over different parts of the body cane be effectively management through Ayurveda.
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