Gastric Cancer Chemotherapy Side Effects and Management

Chemotherapy for gastric cancer can cause a range of side effects, which are generally categorized into hematologic and non-hematologic toxicities. Hematologic toxicity primarily involves bone marrow suppression, which can lead to decreased white blood cell counts, low platelet levels, and anemia. Liver and kidney function may also be affected, and these changes are usually detectable through routine laboratory tests.

On the other hand, non-hematologic side effects commonly include gastrointestinal issues, allergic reactions, skin problems, neuropathy, cardiotoxicity, and hair loss. The specific adverse effects experienced often depend on the type of chemotherapy drug used.

Commonly used chemotherapy agents in gastric cancer treatment include platinum-based drugs, taxanes, fluorouracil derivatives, and irinotecan. For instance, cisplatin is known to cause significant nausea and vomiting, although the use of prophylactic antiemetic drugs has greatly reduced the severity of these symptoms in modern clinical practice.

Oxaliplatin and taxane-based drugs may lead to skin hypersensitivity reactions, while taxanes and irinotecan are more likely to cause alopecia. Irinotecan can also result in delayed-onset diarrhea and acute cholinergic syndrome, which often requires the use of antidiarrheal medications for effective management.

Fluorouracil compounds, especially when taken orally, are associated with cardiotoxic effects and may cause hand-foot syndrome. Each of these side effects arises through different biological mechanisms, meaning that a tailored approach using specific medications or supportive care techniques is often necessary to manage them effectively.