Changes to your hormone levels

Your treatment causes changes in the levels of estrogen in your body. This can affect your mood, energy levels or physical appearance, among other things.

You may have many of these symptoms or none at all. Your symptoms may also change at different times in your treatment.

What to look for?

Hot flashes:

• A hot flash feels like a sudden warmth in your upper body and face. It can happen quickly and with no warning.
• Your face may get flushed (turn red) and you may sweat more.
• Hot flashes can cause you to have trouble sleeping.

Other symptoms of having low estrogen levels:

• Vaginal dryness (possibly with discharge or bleeding)
• Memory loss
• Mood changes, depression
• Thinning of the bones and increased risk of fracture

What to do?

To help prevent hot flashes:

• Avoid triggers such as spicy food, alcohol and caffeine (tea, coffee, and soft drinks).
• Exercise regularly. Ask your health care team what exercises are appropriate for you before you start any new exercise.
• Quitting smoking may also help.

If you have hot flashes:

• To keep cool, dress in light, cotton clothing or in layers that you can easily remove. Use a fan.
• Drink plenty of water or other liquids (at least 6 to 8 cups) unless your health care team has told you to drink more or less. 
• Lay a towel on top of your bed sheet before you sleep so you can change it easily if you sweat at night.

Hot flashes may improve over time. Talk to your health care team if this or any symptoms of low estrogen are bothersome for you.

Headache; Mild joint, muscle pain or cramps 

What to look for?

• A mild headache
• New pain in your muscles or joints, muscle cramps, or feeling achy.
   

What to do?

• Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
• Rest often and try light exercise (such as walking) as it may help.

Ask your health care team for the Pain pamphlet for more information.

Fatigue 

What to look for?

• Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
   

What to do?

• Be active. 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.
• Ask family or friends to help you with things like housework, shopping, and child or pet care.
• Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
• Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Mood changes

What to look for?

• You may feel hopeless or sad most of the day.
• You may feel anxious, nervious, restless, agitated or stressed.
• You may feel like you have less energy or have little or no interest in activities that you usually enjoy.
• You may have changes in your personality.

What to do?

• Eating well and exercising may give you more energy and help you feel better. Always check with your health care team before starting a new exercise program to make sure it is safe for you.
• Try to keep a regular bedtime routine. Go to bed and get up at the same time every day. 
• Get support from your family, friends, community and your health care team.

Talk to your health care team if your mood changes do not improve or if they are severe.

High blood pressure

What to look for?

• There are usually no signs of high blood pressure.
• Rarely, you may have headaches, shortness of breath or nosebleeds.
   

What to do?

• Check your blood pressure regularly.
• Your doctor may prescribe medication to treat high blood pressure.

If you have a severe headache get emergency help right away as it may be a sign your blood pressure is too high.

Nausea and vomiting (generally mild)

What to look for?

• Nausea is feeling like you need to throw up. You may also feel light-headed.
• You may feel nausea within hours to days after your treatment.

What to do?

To help prevent nausea:

• It is easier to prevent nausea than to treat it once it happens.
• 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 (like coffee, tea) and avoid alcohol.

If you have nausea or vomiting:

• Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
• Ask your health care team for the Nausea & Vomiting pamphlet for more information.
• Talk to your health care team if:
  • nausea lasts more than 48 hours
  • vomiting lasts more than 24 hours or if it is severe

Rash; dry, itchy skin

What to look for?

• You may have cracked, rough, flaking or peeling areas of the skin.
• Your skin may look red and feel warm, like a sunburn.
• Your skin may itch, burn, sting or feel very tender when touched.

What to do?

To prevent and treat dry skin:

• Use fragrance-free 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.
• Avoid perfumed products and lotions that contain alcohol.
• Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

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.

Bone pain; Bone loss or Bone fractures

Your treatment may cause your bones to thin earlier than normal. Thin bones are weak and fragile. They may break easily from simple falls or movements. Your health care team may check your bone density (measure of how strong your bones are) with a bone scan.

What to look for?

• You may have severe or unusual bone pain especially in your back, hips and wrist.

What to do?

To help prevent bone loss and fractures

• Your health care team may ask you to change your diet, or may ask you to take calcium and vitamin D supplements, or other prescription medications. Talk to your health care team before taking any supplements.

Get emergency medical help if you experience severe bone pain or are unable to move as these may be signs of a bone fracture.

See our Bone Health During Cancer Treatment pamphlet for more information.

Trouble Sleeping

Your medications may cause trouble sleeping. It may get better once your body gets used to the medication or when your treatment ends.

What to look for?

• You may find it hard to fall asleep or stay asleep.
• How well you sleep may change over your treatment. For example, you may have several nights of poor sleep followed by a night of better sleep.
• You may wake up too early or not feel well-rested after a night’s sleep.
• You may feel tired or sleepy during the day.

What to do?

Talk to your health care team if no improvement or if severe.