How to Manage Kidney Cancer Treatment Side Effects

While side effects such as digestive issues, fatigue, and skin and hair changes can be uncomfortable and frustrating, there are ways to manage and even prevent some of them, especially when you recognize them early.

Notifying Your Care Team Early

Even if your care team tells you what to look out for, it can be challenging to know whether a side effect is serious. Something that seems minor could turn into a bigger problem, and figuring out which is which shouldn’t fall on you or your family, says David A. Braun, MD, a medical oncologist who treats kidney cancers at Smilow Cancer Hospital at Yale New Haven in Connecticut and an assistant professor of medicine at Yale School of Medicine.

He encourages his patients to notify their care team early if a symptom appears, rather than waiting to see if it goes away. “Always just call, and we can sort it out together,” he says.

There’s another reason to speak up early: It can help you continue with treatment. Even the most effective treatment can’t work as intended if side effects become so difficult that you have to stop taking it or keep interrupting treatment, Dr. Braun says.

Managing Digestive Side Effects

Nausea

Many people think nausea is an unavoidable part of cancer treatment that they simply have to accept. “One of the biggest advances over the last few decades is not just in cancer treatment itself, but in how we treat side effects,” says Braun.

If you notice that a treatment causes nausea almost every time you take it, don’t wait until symptoms begin. Braun recommends talking with your healthcare team about taking an antiemetic beforehand to help prevent nausea from developing.

• Eat smaller meals throughout the day, instead of three large ones, since an empty stomach can make nausea worse.
• Choose bland foods that are easy on your stomach, such as crackers, toast, clear broth, or plain yogurt.
• Sip liquids slowly throughout the day. Cold, clear liquids like ginger ale, broth, or tea may be easiest to handle.
• Avoid fried, greasy, or spicy foods, and eat foods cool or at room temperature so their smell isn’t as strong.
• Rest while sitting upright for at least an hour after each meal.

Loss of Appetite

Yet, when you have no appetite, a full plate can feel defeating, says Alison Tierney, RD, founder of Wholesome LLC, a telehealth nutrition practice supporting people through cancer treatment and survivorship, based in Oconomowoc, Wisconsin.

Make those bites count, Tierney says, by choosing foods that provide plenty of protein and calories in a small amount, such as:

• Smoothies with nut butter and ground flaxseed
• Hummus with soft pita
• Oatmeal made with soy milk
• Avocado on toast
• Bean-based soups

Diarrhea

Once you start treating diarrhea, the goal is to avoid overcorrecting. Braun says if a medication relieves diarrhea but causes constipation, notify your care team who can help fine-tune your treatment schedule or dosage, so that you’re not swinging from one problem to the other.

What you eat and drink can also help manage diarrhea. Tierney suggests the following dietary adjustments:

• Choose foods with soluble fiber, which helps firm up stools, such as oats, bananas, applesauce, peeled potatoes, and white rice.
• Drink fluids and replace electrolytes throughout the day to help prevent dehydration.
• Cut back on caffeine, sugar alcohols (sweeteners found in sugar-free gum, candy, and other diet products, often listed as sorbitol, xylitol, or mannitol), and very high-fat foods, including fried foods, pizza, and creamy sauces.

Mouth Sores

Tierney also recommends choosing soft, moist foods, such as:

• Smoothies
• Oatmeal
• Mashed potatoes
• Yogurt
• Blended soups

Coping With Cancer Fatigue

With fatigue, your total amount of energy is often less than what you’re used to, and Braun recommends thinking a little more consciously about how you’re going to use it wisely. He suggests these tips for budgeting your energy:

• Spend your energy on what matters most. Decide which activities are worth your energy, and let the other stuff wait.
• Plan around the big days. If you have an important event on Saturday, for example, schedule lighter activities on Friday, so that you have enough energy when Saturday comes.
• Keep moving, even a little. Modest activity, such as a short walk, can break the cycle of becoming less active and feeling even more tired.

Soothing Skin and Hair Changes

Most of these are manageable, and some can be prevented.

Hand-Foot Skin Reaction

Getting ahead of hand-foot skin reaction is especially important, says Braun, who recommends the following tips:

• Use a moisturizing cream containing 20 percent urea. You can find these over the counter in the moisturizing skin-care or foot-care section of most pharmacies. Apply it twice a day to help soften thickened skin and reduce callus buildup.
• Wear shoes that don’t rub. Shoes that pinch or repeatedly rub the same spots on your feet can make hand-foot skin reactions worse. Choose comfortable, well-cushioned shoes that reduce pressure and friction.

Still, notify your healthcare team if you start noticing these symptoms. Braun says that prescription steroid creams and other medications may help, and your healthcare team can adjust your cancer treatment if needed.

Other Skin Changes

• Use a thick cream or ointment, and apply it right after bathing, while your skin is still damp.
• Take short, lukewarm showers, instead of long, hot ones.
• Wash with a gentle, fragrance-free cleanser.

Hair Changes

Many people expect kidney cancer treatment to cause the same kind of hair loss that can occur with chemotherapy. Braun says that hair loss is much less common with kidney cancer treatment, though some people do get thinning of the hair with targeted therapies.

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