Targeted drugs have side effects, just not the same as traditional chemotherapy drugs. In general, the adverse effects of the same class of targeted drugs are almost the same, mainly related to their mechanism of action. These adverse reactions can cause discomfort or inconvenience to patients in their daily lives and make it difficult to adhere to the medication, but they are not very life-threatening. Patients are hereby reminded that:
- Adverse reactions may occur while taking targeted drugs, but they are generally mild to moderate and mostly tolerable;
- Even more serious adverse reactions can be resolved by dose adjustment and symptomatic management;
- We recommend that you take some self-care measures to relieve discomfort rather than discontinuing the medication, as this may affect the progress of treatment.
The following is a summary of common adverse reactions to targeted drugs for kidney cancer and how to deal with them, which we hope will help you:
Hand-foot syndrome
Dry, peeling skin on the hands and feet. You can try the following methods to relieve it:
- Urea ointment is applied topically, and if there is a co-infection, an antibiotic-containing ointment such as mupirocin or chlortetracycline can be used.
- Vitamin B6 tablets crushed into a powder and mixed with urea cream and applied to the affected areas of the hands and feet.
- When the pain is severe and you cannot walk on the ground, suspend or reduce the dose of the medication under the guidance of your doctor and visit a dermatologist at the same time.
Stomatitis
Most occur about two weeks after starting the medication and manifest as ulcers and redness and painful discomfort in the mouth or tongue. Take care to maintain good personal dietary hygiene, seek medical attention if necessary, and control can usually be obtained with medication.
High blood pressure
Some patients may develop hypertension while taking targeted drugs, and it is recommended to increase the frequency of blood pressure monitoring and to visit a cardiovascular specialist.
Loss of body weight
Tumor patients themselves are prone to weight loss. In addition, targeted drugs may cause diarrhea in some patients, affecting nutrient absorption. Some patients also follow the propaganda of friends, relatives, or other patients to restrict their diet and “avoid” many foods. In fact, there is no need to avoid food, because there is no evidence that “hairy items” such as chicken, eggs, beef and lamb, and seafood can cause tumor recurrence.
So, here’s what we recommend:
- If you have diarrhea, you should actively treat it and try to eat as much nutritious food as possible without diarrhea, including chicken, eggs, fish, shrimp, beef, etc. Any nutritious food should be eaten, and if you have poor kidney function, you can control your protein intake under the guidance of your doctor, but not completely.
- Also, moderate exercise is very beneficial to improve one’s overall metabolism, promote digestion, and improve sleep quality.
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Diarrhea
When diarrhea occurs, the first step should be to determine if it is related to the targeted drug. If it is indeed caused by the targeted drug, you can suspend the drug, or reduce the dose of the drug under the guidance of your doctor.
In addition, you need to make appropriate dietary changes, such as not eating fatty foods, not eating cold foods (including fruits), eating 1 to 2 hot, cooked apples a day, and using Emmenthal (loperamide hydrochloride capsules) for severe diarrhea.
Declining white blood cells
If your white blood cells are below 2.0, you are prone to respiratory infections. Be careful not to go to crowded places and wear a mask when you go out.
Patients with declining white blood cells should prefer a urology visit rather than a visit to the hematology department for white-raising medication. They can take oral licoquinone tablets (Lixin), but the white-raising effect is slower; they can also have injections of recombinant human granulocyte-stimulating factor (e.g., Wheal Blood, Rebel), which can rapidly raise white blood cells.
Declining platelets
If platelets fall below 30, you are prone to spontaneous bleeding and should be especially alert for gastrointestinal or visceral bleeding.
Patients are advised to prefer a urologic consultation over a visit to the hematology department for platelet-raising medication, either subcutaneous macro- and granulocyte ( recombinant human interleukin-11 for injection) or terbinol (recombinant human thrombopoietin injection), with platelet transfusions required for severe platelet decline.
Patients can also try eating loach, eels, and turtle, which help raise platelets.
Hypothyroidism
Thyroxine replacement therapy is not usually needed, but blood should be drawn closely to monitor changes in thyroid function. If there is a severe decline in thyroid function, such as symptoms of facial swelling, the medication needs to be discontinued and replacement therapy with oral thyroxine tablets is required.
Rash
A skin rash on the head, neck, and perineum, which may or may not be accompanied by itching, may occur during drug use.
Small rashes can be treated with oral Keratan (loratadine tablets) 1 tablet per day; large rashes require suspension of the drug and a visit to the hospital, where anti-allergy treatment such as dexamethasone can be administered.
Abnormal liver function
When liver function abnormalities occur, it is recommended to review liver function every 2 weeks and take liver-protective medications if necessary.
Depigmentation of skin and hair
For example, blanching of the face and hair may occur after taking Sotan (sunitinib) for a long time, which is a normal side effect and does not have much impact on health.
If there is also facial and eyelid swelling, urine tests and thyroid function are needed to determine if there is proteinuria and hypothyroidism and to take treatment.