DOCEtaxel

Hair thinning or loss 

• Use a gentle soft brush and avoid hair sprays, bleaches, dyes and perms.
• In most cases, your hair will grow back after treatment, but the texture or colour may change. 
• Hair loss may be permanent in rare cases

Low platelets in the blood

• Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
• Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often to prevent infection.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room.
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Fatigue (tiredness)

• Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
• Pace yourself, do not rush. Put off less important activities. Rest when you need to.
• Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
• Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Tingling, numb fingers and toes (may be severe)

• May slowly get better after your treatment ends.
• Contact your health care team if you have trouble doing up buttons, writing, picking up small objects, have pain or trouble moving.

Rash; dry, itchy skin (may be severe)

Rash may be severe in some rare cases and cause your skin to blister or peel. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

• Use skin moisturizer.
• Protect your skin from the sun and the cold.
• Use sunscreen with UVA and UVB protection and a SPF of at least 30.

Mild swelling in arms and legs; puffiness (may be severe)

To help prevent swelling :

• Eat a low-salt diet.
• Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

May be severe if fluid collects in your chest or belly; this may lead to breathing difficulties. Contact your health care team if this happens.

Mouth sores (may be severe)

You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks.

To help prevent mouth sores: 

• Take care of your mouth by gently brushing and flossing regularly.
• Rinse your mouth often. Do not use mouthwashes with alcohol.
• Instead, try a homemade mouthwash:
• Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.

If you have mouth sores:

• Check with your health care team as soon as you notice mouth or lip sores or if it hurts to swallow.
• Avoid hot, spicy, acidic, hard or crunchy foods.. Your doctor may prescribe a mouthwash to relieve mouth sores and prevent infection.

See the Mouth Care pamphlet for more information.

Diarrhea (may be severe)

May happen days to weeks after you get your treatment.

If you have diarrhea :

• Take anti-diarrhea medication if your health care team prescribed it.
• Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
• Eat many small meals and snacks instead of 2 or 3 large meals.
  
   
• Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Nausea and vomiting

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens. 

To help prevent nausea:

• Take anti-nausea medication(s) as prescribed to you by your doctor.
• Drink clear liquids and have small meals. Get fresh air and rest.
• Do not eat spicy, fried foods or foods with a strong smell.
• Limit caffeine (e.g. coffee, tea) and alcohol.

If you have nausea or vomiting:

• Take anti-nausea medication(s) as prescribed to you by your doctor. 
• Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Nail changes 

You may have changes in nail colour, pain or tenderness in the nailbed, swelling of cuticles, or loosening of nails.

• Will slowly return to normal after treatment ends.
• Use a moisturizer for nails and cuticles.
• Avoid nail polish and artificial fingernails until your nails have returned to normal.
• Wear gloves when doing house chores or gardening.

Allergic reaction 

• The most common symptoms include fever, flushing, itchiness, rash, swollen lips, face or tongue, wheezing, chest and throat tightness.
• It may occur during or shortly after the medication is given to you. Let your health care team know right away if this happens to you.
• You may be given medicines to prevent or treat this reaction

Mild joint, muscle pain or cramps 

• Take your pain medication as prescribed by your doctor.
• You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
• Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
• Rest often and try light exercise as it may help.