Chemotherapy (continued)

To protect the head from sun exposure, have your child wear a hat and sunscreen while outside. If your child doesn't experience hair loss, mild shampoos and hair products are still recommended to avoid scalp irritation.

Mouth, Gum, and Throat Sores

Chemotherapy may cause sores in the mouth, gums, and throat or cause gum tissues to become irritated and bleed. The doctor may prescribe a mouth rinse or other products to reduce pain, dryness, and irritation. Be sure to take your child for regular dental checkups and follow the dentist's advice on how to brush your child's teeth during chemotherapy. Kids with mouth or throat pain may find soft, cool foods easier to chew and swallow, and acidic foods and juices should be avoided.

Gastrointestinal Problems

Gastrointestinal problems (including loss of appetite, constipation, diarrhea, nausea, and vomiting) can occur, although medications can help prevent or reduce nausea and vomiting. Talk to your doctor about medicines or dietary changes that may alleviate your child's upset stomach, prevent weight loss, or combat constipation.

If your child who doesn't feel like eating, try serving several small meals rather than fewer larger ones. And be sure to offer foods high in nutrients to prevent weight loss. Avoid serving fatty, sweet, spicy, or fried foods. And even though your child may not feel like drinking, clear broth, juices, and sports drinks can replace fluids lost through vomiting and diarrhea. Room-temperature beverages may be easier to drink than hot or cold liquids. The doctor or a registered dietitian may have suggestions for ensuring adequate nutrition and hydration.

Urinary System Problems

Some chemotherapy drugs can irritate or damage the bladder or kidneys and can cause the urine to change color or take on a strong odor for a day or two. The doctor may ask for a blood or urine sample before beginning chemotherapy to evaluate kidney function.

Giving your child plenty of fluids to drink will ensure good urine flow and help prevent problems in the urinary tract. Be sure to let the doctor know if your child experiences symptoms that may indicate a problem with the urinary system, such as painful or frequent urination, reddish or bloody urine, or an inability to urinate.

Central Nervous System Problems

Chemotherapy may cause temporary confusion and depression, which should go away once treatment is completed.

Other central nervous system side effects can include:

• Anemia
  The doctor will monitor your child's blood counts to check for anemia (low levels of red blood cells, which are made in the bone marrow and carry oxygen throughout the body). Red blood cell transfusions may be necessary.
• Chemotherapy drugs may inhibit the body's ability to produce platelets, which help blood to clot. Your child may bleed or bruise easily because of a reduction in platelets (called thrombocytopenia). Platelet transfusions can be given to treat low counts.
• Increased Risk of Infection
  Chemo may cause a reduction in white blood cells, which are part of the immune system and help the body to fight infection. Therefore, your child is more vulnerable to developing infections during and after chemo.
  
  Infection precautions: Remind kids to wash their hands before eating, after using the bathroom, and after touching animals. Friends or family members with contagious illnesses (such as a cold, the flu, or chickenpox) should refrain from visiting. Try to avoid crowds and children who have received certain vaccines, such as chickenpox or oral polio — these are live-virus vaccines and can spread disease to kids with low blood cell counts. Your child also shouldn't receive immunizations without your doctor's OK. And to prevent food-borne infection, your child shouldn't eat raw fish, seafood, meat, or uncooked eggs.
• Long-Term Side Effects
  Chemotherapy can cause long-term side effects (sometimes called late effects), depending on the type and dose of chemotherapy and whether it was combined with radiation. These effects may involve any organ, including the heart, lungs, brain, kidneys, liver, thyroid gland, and reproductive organs. Some types of chemotherapy drugs may also increase the risk of cancer later in life. Receiving chemo during childhood also may place some kids at risk for delayed growth and cognitive development, depending on the child's age, the type of drug used, the dosage, and whether chemotherapy was used in addition to radiation therapy.

Report any side effects to your doctor so that they can be treated and your child made as comfortable as possible.