Do What You Can to Ease Side Effects From Treatment and Symptoms of Kidney Cancer

If you're being treated for kidney cancer, it’s likely that you will 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 symptoms and side effects. The information is listed in alphabetical order: 

Anxiety and depression

Many people feel blue, anxious, or depressed after being told they have cancer. These feelings are normal and may continue or come back throughout treatment. In addition, you may experience mood changes as a side effect of treatment, such as biological therapy. These changes in mood may be barely noticeable or very obvious to you or your family and close friends. Seek immediate help if you experience any of the following signs or symptoms:

• Extreme sadness

• Inability to stop crying

• Severe changes in mood

• Loss of interest in things you once enjoyed

• Thoughts of suicide

Taking these actions may ease your mental stress:

• Talk openly with your doctor about your concerns.

• Talk with your priest, minister, rabbi, or other spiritual counselor.

• Talk with your family or friends.

• Maintain your physical and social activities as much as possible.

• Keep active: Walk, golf, or ride a bike.

• Consider joining a cancer support group or finding a cancer “buddy” who can help you cope.

• Ask your doctor about medications for depression and anxiety.

• Consider getting a referral to a psychologist or psychiatrist.

Appetite changes

People who eat well during cancer treatment maintain their strength better, are more active, and are better able to lower their chance of infection. It’s important to remember that your body needs energy to heal itself. Maintaining your weight is a good way to know if you’re giving your body the energy it needs. When you’re being treated for cancer, a diet high in calories and protein is best.

The problem is that treatment, especially chemotherapy, can damage intestinal cells or affect areas of the brain that control appetite. Radiation can change the way food tastes to you, make it hard for you to swallow, or reduce your appetite.

Know that some people, however, can gain weight as a side effect from steroids or antinausea medications. If this is the case for you, focus on getting a balanced diet and increasing your activity level. Now is not the time to go on a restrictive, weight-reduction diet.

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, and cancer treatments cause you to use more protein than usual.

• If you are underweight, you can eat high-calorie foods to help you maintain your weight, such as 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. Drinking 1 to 2 liters of fluid every day is important to protect your kidney function. Always having a water bottle with you is an easy way to be sure you’re getting enough to drink. 

• In addition to water, fruit juices, and other liquids, try these foods to increase your intake of fluids: gelatin, pudding, soups, fruit bars, and ice cream.

• Eat small meals throughout the day instead of three large ones. Leftovers and ready-to-eat foods may make eating frequently easier.

• Keep healthy snacks handy, such as fresh fruits and vegetables, cheese sticks, or whole grains, to eat when you are hungry.

• Eat with friends or play your favorite music at mealtime to boost your appetite.

• Eat your biggest meal in the morning. Many people getting treatment for cancer find this is when their appetite is greatest.

• If you can, increase your activity level. Doing so may stimulate your appetite.

• Do your best to eat small, frequent meals and drink plenty of liquids. If you find that your appetite doesn’t improve in several days, talk with your doctor or nurse.

Bleeding problems

Certain kinds of cancer treatments, such as chemotherapy, may reduce your blood platelet count. Your doctor and nurse will tell you if the treatment you’re receiving will affect your platelet count. Without enough platelets, your blood may have difficulty clotting and lead to a problem called thrombocytopenia. If your doctor tells you that your platelet count is low, take these actions to avoid causing injuries that could lead to uncontrolled bleeding:

• Protect your skin from cuts, scrapes, and sharp objects.

• Shave with an electric razor.

• Use a soft toothbrush to prevent bleeding gums.

• Take steps to prevent constipation, which can lead to hemorrhoids that may bleed.

• Call your doctor if you develop a rash, bleeding, or bruising.

Bloating and swelling

Some chemotherapy and biological therapy drugs cause your body to retain water. This water retention will go away when your treatment ends. Sometimes, cancer can cause your body to retain water. In other cases, bloating may be due to lactose intolerance caused by the cancer. This is a condition where the body can’t digest or absorb the milk sugar called lactose. Tell your doctor and nurse about your side effects so that they can help you adjust your diet or recommend medications that will help.

Here’s what you can do for relief:

• If your bloating from water retention is severe, your doctor may prescribe a diuretic or water pill.

• If your bloating is due to lactose intolerance, it may help to buy lactose-free milk or to go easy on dairy products that contain lactose.

• Beano or other over-the-counter medications may help with these symptoms.

Breathing problems (shortness of breath or dyspnea)

There are many causes of shortness of breath in people with cancer. Some of these, such as a blood clot in the lungs or pneumonia, need to be treated right away. Breathing problems can also be a side effect of the biological treatment for kidney cancer, interleukin-2. If you develop breathing problems, you should let your doctor know right away.

Feeling short of breath may make you feel anxious, which can make breathing problems worse. Talk with your doctor or nurse about what can help. Also try these tips:

• Sit upright because it will give your lungs room to expand.

• Sleep with the head of your bed raised or sleep in a recliner.

• Use pursed-lip and abdominal breathing. Ask your doctor for instructions on how to do this.

• Avoid climbing stairs since that can tax your breathing.

• Avoid bending over when possible because it compresses your lungs and makes it harder to get the air you need. Squat down to pick things up from the floor. Wear slip-on shoes or sit on the stairs to tie your shoes, which makes it a shorter reach to your shoes than the typical chair.

• Ask family or friends for help with activities that make you short of breath.

• Avoid things that make your breathing worse, such as high humidity, cold air, pollen, and tobacco smoke.

• Ask your doctor or nurse to show you how to use relaxation exercises that may make it easier to catch your breath. 

Constipation

Constipation, which is difficult or infrequent bowel movements, can range from mildly uncomfortable to painful. Taking pain medications can lead to constipation so it’s wise to take these preventive actions. It can also result from chemotherapy. These same steps will give you relief if you are already constipated:

• Drink plenty of fluids, especially water and prune juice.

• Eat foods high in fiber, such as cereals, whole grains, fruits, and vegetables.

• Exercise.

• Take stool softeners or a laxative as prescribed.

Coughing

A persistent cough may increase pain, prevent adequate rest, and promote fatigue. Talk with your doctor about these options for relief:

• Ask about prescription cough suppressants.

• Learn deep breathing and effective coughing techniques.

• Find out whether an inhaler could help you.

• If you smoke, ask your doctor for help to quit. 

Diarrhea

Diarrhea, which is loose or frequent bowel movements, may lead to dehydration if you don’t take these precautions. Radiation and many chemotherapy drugs can cause bowel changes. These tips may help:

• Avoid milk and milk products.

• Avoid gas-producing vegetables, dried fruit, fiber cereals, seeds, popcorn, nuts, corn, and dried beans.

• Eat low-residue, low-fiber foods such as those used in the BRAT diet (bananas, rice, applesauce, and toast).

• Increase your intake of fluids, such as water and broth, to prevent dehydration.

• Ask your doctor about medications that may help.

Fatigue

Fatigue, or a feeling of tiredness, is a common symptom and side effect. It can be the result of anemia caused by a low level of red blood cells, which carry oxygen throughout the body. If your body does not have this oxygen, you may feel tired. A decreased red blood cell count can be caused by small amounts of blood loss, by the cancer itself, or by biological therapy, chemotherapy, or radiation. Other changes in your blood count can also cause fatigue. Tiredness can last four to six weeks after treatment ends. You may feel only slightly tired or you may suffer from extreme fatigue.

Taking these actions may help increase your energy level:

• Take short rests when you feel tired. Avoid long naps during the day so that you can sleep well at night.

• Add mild exercise, such as walking, to your daily routine. It may help you sleep better.

• Balance activity with rest. Save your energy for important tasks.

• Drink plenty of fluids to prevent dehydration, which can lead to tiredness.

• Take action to treat a poor appetite because eating improperly can make you tired. And as long as diarrhea isn’t a problem for you, it may help to eat plenty of fruits, vegetables, and complex carbohydrates, such as whole wheat bread.

• If your fatigue is severe or chronic, ask for help with routine tasks that can drain your energy, such as grocery shopping or housework. Some people reduce their hours at work.

• Talk with your doctor about medications or treatments that may help manage your anemia.

Hair loss (alopecia)

Losing your hair can be upsetting because baldness is a visible reminder that you are being treated for cancer. Chemotherapy may cause you to lose hair all over. Radiation can cause hair loss in the area treated. Keep in mind that your hair will probably grow back after treatment.

Try these coping tips:

• Consider cutting your hair before treatment starts.

• Think about getting a wig, hat, or scarf before your hair loss starts. That way, you can get a wig that matches your hair and you’ll be ready with head coverings, if you choose to use them.

• Because your scalp may be more sensitive to temperature and sun, protect it with sunscreen and hats or scarves.

Infection

Without enough white blood cells, your body may not be able to fight infection. Many types of cancer treatment, including chemotherapy, can cause a low white blood cell count, which is called leukopenia. This may also be a side effect from immunotherapy for kidney cancer. You may experience symptoms of infection, such as fever, chills, or inflammation at the site of an injury.

If your doctor tells you that your white blood cell count is low, take these actions to stay healthy:

• Avoid crowds or people with colds. Wear a surgical mask in these situations.

• Wash your hands often throughout the day to kill germs. Have those around you do the same. Bathe daily to keep the number of bacteria down.

• Don’t touch your eyes or nose unless you’ve just washed your hands.

• Avoid fresh, unwashed, uncooked fruits and vegetables and other foods, which may carry germs.

• Avoid fresh flowers and plants, which may carry mold.

• Call your doctor right away if you have any of these signs of infection: a temperature of 100.5 degrees or higher, severe chills, a cough or hoarseness, lower back or side pain, painful or difficult urination, or any sores or redness. Have a family member or friend take you to the emergency room if these symptoms are severe.

Insomnia (trouble sleeping)

Insomnia can be caused by anxiety, depression, or your cancer treatment.

Use these tips to improve your rest:

• Keep a regular bedtime schedule.

• Use your bed only for sleeping, not for watching TV or surfing the Internet.

• If you don’t fall asleep in 15 minutes, get up, do something else, and try again later.

• Avoid stimulants such as caffeine and tobacco, especially close to bedtime.

• Don’t eat, drink fluids, or exercise close to your bedtime.

• Avoid long naps during the day.

• Tell your doctor and nurse if you are having trouble sleeping at night or you’re taking naps during the daytime.

Menopausal symptoms

Some types of chemotherapy can damage the ovaries or cause menopausal symptoms in women who’ve not yet reached menopause. They include symptoms such as hot flashes, vaginal dryness, mood swings, and weight changes. Periods may become irregular or stop, and you may not be able to get pregnant. However, some women may still be able to get pregnant during treatment. Consider these tips to improve your symptoms:

• Talk with your doctor about birth control before treatment begins.

• 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.

• Report any unusual bleeding to your doctor.

• Continue with regular pelvic exams.

Mouth changes

Sores on your mouth and lips, called mucositis, may hurt and make eating an unpleasant experience. Radiation and several types of chemotherapy cause mouth sores. Radiation to your chest or neck may also cause dry mouth called xerostomia. In addition to mouth sores, you may experience a strange taste in your mouth from biological therapy. Taking these actions can either help prevent or ease some of these problems:

• Keep your mouth and lips clean and moist. Brush your teeth after meals and before bedtime; floss every day.

• Sip water frequently.

• Use sauces or gravy on foods to make them easier to eat.

• Eat soft and pureed foods that are easier to swallow if you have a dry mouth.

• Suck on sugar-free candies or fruit bars or chew sugar-free gum to increase moisture in your mouth and to help with changes in taste.

• Avoid alcohol and mouthwashes containing alcohol because they may irritate the sores.

• Avoid hot, rough, or spicy foods because they may irritate the sores.

• Avoid tobacco because it may irritate or make you more susceptible to sores.

• Ask your doctor about topical mouth medications.

• Take over-the-counter pain medication such as Tylenol (acetaminophen) if necessary.

• Call your doctor or nurse if your temperature reaches 100.5 degrees or higher.

Nausea or vomiting

Nausea or vomiting may result from almost all types of treatment for kidney cancer. It may be barely noticeable to severe. Understanding the different types of nausea may help:

• Acute-onset nausea and vomiting. This can occur within a few minutes to several hours after chemotherapy. The worst episodes tend to be five to six hours after treatment, and the symptoms end within the first 24 hours.

• Delayed-onset vomiting. This develops more than 24 hours after treatment.

• Anticipatory nausea and vomiting. This is learned from previous experiences with vomiting. As you prepare for the next dose of chemotherapy, you may anticipate that nausea and vomiting will occur as it did previously, which triggers the actual reflex.

• Breakthrough vomiting. This is vomiting that occurs despite treatment to prevent it. It requires other types of treatment.

• Refractory vomiting. This occurs after one or more chemotherapy treatments. Essentially, you’re no longer responding to antinausea treatments.

To prevent nausea, take these actions:

• Ask your doctor about getting a prescription medicine to control nausea and vomiting. Then make sure you take it as directed. If you are vomiting and cannot take the medicine, call your doctor or nurse.

• If you have bothersome nausea and vomiting even though you are taking your medicine, call your doctor or nurse. Your medicine can be changed.

To help ease nausea or vomiting, try these tips:

• Take drugs with food, as directed.

• Try eating foods and drinking beverages that made you feel better when you have had an upset stomach or have been nauseated in the past. These may be bland foods, sour candy, pickles, dry crackers, ginger ale, flat soda, or others.

• Do not eat foods that are fatty or fried, very spicy, or very sweet.

• Eat foods that are at room temperature or cold. The smells from hot foods may make your nausea worse.

• Ask your doctor or nurse if he or she can help you learn a relaxation exercise. This may make you feel less anxious and more in control, and decrease your nausea.

• Ask your doctor or nurse about using acupressure bands on your wrists, which may help decrease your nausea.

Nerve damage (peripheral neuropathy)

If you have numbness, tingling, or weakness in your hands and feet, you may have nerve damage called peripheral neuropathy. Some types of chemotherapy are known to cause this. Other signs of this problem are ringing in your ears or trouble feeling hot or cold.

If you have symptoms such as these, take precautions to protect yourself:

• Clear your home of clutter and avoid throw rugs so that you don’t trip or fall.

• Use warm, not hot, water for bathing to prevent burns. Consider using a shower chair or railing.

• If your daily activities become too difficult, ask your doctor for a referral to an occupational therapist or a physical therapist. They can help teach you new ways of doing things so that you can stay as active as possible.

• Take extra care when driving (you may have trouble feeling the gas and brake pedals). Ask friends and family to drive you places.

Pain

Bone pain can be the result of biological therapy, such as interferon-alpha, for kidney cancer. Try these tips to ease muscle, joint, or bone pain:

• Take aspirin or ibuprofen to help relieve headaches and muscle cramps. Check with your doctor before taking these medications to make sure they are safe for you.

• Take other pain medications regularly as directed by your doctor; don’t wait for your pain to become severe. (Take steps to avoid constipation, a common side effect of pain medications.)

• Change your activity level. See if you feel better if you rest more or move around more — either may help.

• Distract yourself with music, funny videos, or computer games.

• Use heat, cold, relaxation techniques (such as yoga or meditation), or guided imagery exercises. Ask your doctor or nurse where you can learn more about these.

If you are recovering from surgery, expect to be somewhat uncomfortable for a few days but medicine should control the pain. Discuss the pain-control plan with your doctor. Ask to make adjustments after surgery, if necessary.

If you are following your recommended pain management regimen and your pain still isn't controlled, alert your medical team. You may need an adjustment in the amount or type of your pain medication or a referral for a more in-depth pain assessment. 

Changes in sexual desire

Feelings of depression from having cancer or fatigue from many types of treatment can have a negative impact on your sexual desires. Taking these actions may help you cope with these changes:

• Talk with your partner about changes in your desire or ability to have sex.

• Explore new ways to share affection and intimacy.

• Discuss sexual problems with your doctor or with other members of your health care team. They may be able to refer you to a counselor who specializes in sexual problems or to a sexual rehabilitation program.

Skin changes

Radiation treatment can cause dry or red skin in the area being treated. Also, you may have dryness, itching, or a rash in the area of biological therapy injections. Here’s what you can do for relief:

• Use topical ointments and steroid creams for itchy skin rashes.

• Protect your skin from sun exposure, especially between 10 a.m. and 3 p.m., by wearing sunscreen of at least SPF 30.

• Ask your doctor or nurse what kind of lotion you can use to moisturize and soothe your skin. Don’t use any lotion, soap, deodorant, sunscreen, perfume, cosmetics, or powder on your skin for two hours after treatment.

• Wear loose, soft clothing over the treated area.

• Don’t scratch, rub, or scrub treated skin.

• Don’t bandage skin with tape. If you must bandage it, use paper tape and ask your nurse to help you place the dressings so that you can avoid irritation.

• Don’t apply heat or cold to the treated area. Bathe only with lukewarm water.

• If you must shave the treated area, only use an electric shaver. Don’t use lotion before shaving, and avoid hair-removal products.

To prevent injection-site problems, rotate the injections to a different spot on the body each time.

Trouble thinking and remembering 

You may have mild problems with concentration and memory during and after chemotherapy or biological therapy. Fatigue can aggravate the problem. Taking these actions may help:

• Make lists and write down important information.

• Use other tools to help organize your life, such as calendars, pill dispensers, or alarm clocks.

• Ask your doctor about nutritional supplements that may help with memory.

Tell your medical team about any cognitive changes. Your team can assess any cognitive concerns and suggest treatments that can help you and your family manage the changes. 

Urination changes

Some treatments for kidney cancer may cause changes in urination. For instance, taking the biological therapy interleukin-2 for kidney cancer may cause an unusual decrease in urination. Chemotherapy may cause burning with urination. Also, remember that drinking adequate fluids every day will help you:

• Prevent decreased urination due to dehydration

• Reduce the risk of developing a urinary tract infection