Abnormal levels of pancreas tests (lipase, amylase)

Your doctor may monitor these regularly.

Rarely may be severe with pain in your belly extending to your back.

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.

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.

Get emergency medical help right away

Get emergency medical help right away

Pains or cramps in the belly

• If you have constipation or diarrhea it may be causing the pain in your belly.
• If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.

Mild swelling in arms and legs; puffiness (may be severe, including rare buildup of fluid around the heart or lungs)

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.

Headache; 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.

Constipation

To help prevent constipation :

• Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
• Be Active. Exercise can help to keep you regular.
• Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

• If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Blockage of an artery (blood vessel)

It can happen in your heart, chest, brain, belly or limb. It may be more severe and block a big artery and cause :

• Stroke: you may feel confused and have a sudden loss of vision or trouble speaking or using your arms or legs.
• Heart attack: you can have chest pain, shortness of breath, pain in your belly or arm.

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. 

Abnormal liver lab tests

• You may have yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. Talk to your health care team if this happens.
• May be severe, especially in patients whose hepatitis B virus becomes active again
• Your doctor may monitor your liver regularly with a blood test.

High blood pressure

• Check your blood pressure regularly. Your doctor may prescribe medication to treat high blood pressure.
• If you have a severe headache, severe dizziness, or if you faint, get emergency help right away as it may be a sign your blood pressure is too high.
• May rarely be severe and lead to kidney problems

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

• 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.
• 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.

Eye problems 

• You may have dry eyes, redness, irritation, pain, tearing, sensitivity to light or blurred vision.
• Avoid wearing contact lenses.
• You may try artificial tears or ointment. 

Tingling, numb fingers and toes

• 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.