Q&A: Helping your child cope with chemotherapy side effects
Nausea. Headaches. Anxiety. The effects of cancer and cancer treatment are difficult to deal with for both children and their families. Fortunately, there are ways to ease some of the major side effects kids experience when going through chemotherapy.
The Katie Hageboeck Children's Cancer Research Fund Clinic at M Health Fairview Masonic Children’s Hospital is home to a dedicated team of physicians, oncology nurses, social workers, and certified child life specialists. We’re here to help you and your child manage the physical and emotional effects of chemotherapy ― whether they’re going through treatment at home or in our hospital.
We asked Erin Fritz, NP, a pediatric oncology nurse practitioner, and Hannah Schiro, a certified child life specialist, for their advice on easing side effects for children of all ages.
What are the most common side effects of chemotherapy?
Erin: The most common physical side effects are fatigue, nausea, vomiting, headaches, hair loss, and mouth sores. Chemotherapy can also lower a child’s blood counts and cause anemia. It’s also important to discuss the mental and emotional side effects of chemotherapy: social isolation, anxiety, and depression.
Hannah: Many children lose their hair during chemotherapy treatment, which can be a difficult emotional experience. We have a lot of educational materials available to help kids learn about the effects of chemotherapy and cope with hair loss — including a doll without hair, children’s books about hair loss, and a handout for families. We also offer keepsake boxes if patients would like to keep a lock of their hair before treatment.
What treatments are available to manage the physical side effects of chemotherapy?
Erin: We offer both medication and other therapies to ease side effects. Anti-nausea medicine, pain medicine, and a rinse for mouth sores can all help your child feel more comfortable during chemotherapy. We’ll work with families to prescribe appropriate medication before treatment starts. Most often, we recommend that kids take these medications on a scheduled basis. Sometimes, it can also help to take medications on an “as needed” basis. However, if they wait to take them as needed, it can often be too late to avoid the unwanted chemo side effects.
We’re lucky to have an integrative health team at our children’s hospital that offers alternative ways to ease some of these side effects. Every patient can meet with an integrative health specialist before starting treatment. Our integrative health specialists offer acupuncture, acupressure, massage, and other therapies to ease and even prevent some of the physical and emotional side effects of chemotherapy.
When do physical side effects occur?
Erin: When side effects occur and how severe they are both depend on the type of cancer a child is diagnosed with and their resulting treatment plan. Our patients with leukemia go through different phases of chemotherapy that vary in intensity. The more intense the treatment phase, the more severe the side effects kids experience. Chemotherapy for solid tumors tends to be shorter but more intense throughout. We want to make sure that kids and their families are prepared before starting a chemotherapy cycle. We take any preventive steps we can, for example starting medication or integrative therapies ahead of time.
How long do physical side effects last?
Erin: When a child leaves our hospital after an inpatient chemotherapy treatment, they usually need to continue a rigorous anti-nausea regimen for two to three days at home. After that, they typically feel much better until it’s time to come back in for their next chemotherapy cycle. At the end of treatment, they should feel better without side effects within a week or two.
What emotional support do we offer during treatment?
Erin: We have an outstanding social work team, and our social workers are trained therapists. Every patient connects with a social worker when they’re diagnosed and, when they finish treatment, our social workers can match them with a long-term therapist to continue that emotional support.
It’s also important for us to support children’s lives outside of treatment. There are many things our patients can’t do when they’re on chemotherapy, and it’s important that we make allowances for the things that they can do when possible. We want to support them in connecting with friends and having new experiences. It’s also important to make sure that not only our patients, but also their families are getting the support they need, and that’s another important piece of the care we provide.
Hannah: Our Child Family Life Services department works with patients and their families through the hospital, including inpatient, outpatient, and ancillary areas. This may include supportive check-ins, engaging in developmental or medical play, or providing activities for emotional expression.
It’s important to be open and honest with kids in an age-appropriate way, giving them simple explanations of what’s happening and why. We also want to support their families and let caregivers know it’s alright to take care of themselves. We’re here to help support and encourage their child and be another member of their team.
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