As with any serious disease, complications can often arrise during treatment. With this disease it is critical to remain healthy not only to fight the disease but to withstand the treatment.
A. Neutropenia - Occurs during treatment with chemotherapy and/or radiation. Neutropenia is the result of a patients body not producing enough white blood cells (WBC). The patients immune system is than compromised and a patient is at risk for serious infections that can lead to treatment delays. Neutropenia can happen at any time, but the patient is most at risk about 8-10 days after starting chemotherapy. Most patients monitor their WBC or neutrophil counts twice a week. When their WBC count is below 500 ANC a patient should take appropriate precautions. Patients may also use granulocyte (gran-ew-low-site) colony stimulating factor to give their WBC a boost. Check with your physician.
B. Central Line Infection - It is essential to keep the Broviac or Hickman catheter central line or portacath as clean as possible. Use alchol pads and gloves to swab lines and change dressing. Be careful of water. A low grade fever can indicate a low grade infection harbored in one of the lines. A hide grade fever can be life threatening. And, since there are hundreds of different bacteria and infections a patient will remain hospitalized while doctors try to establish the type of germ causing the problem. (note -high grade fevers may be accompanied by vomiting, acheness, and uncontrollable shaking called 'rigors' - in a central line infection - the severity of illness will come and go as the line is flushed.) Central line complications can be life threatening as well as mean a delay in scheduled treatment. If the doctors cannot get rid of the source of infection through antibiotics they may elect to remove the central line and than replace it a few days later.
- There are hundreds of different types of bacterial infections, some are more dangerous than others. In the case of the majority of cancer patients, the immune system is already compromised so a central line infection is considered serious. In most cases the patient will be hospitalized and blood cultures taken daily to try and identify the bug. It takes about 24-48 hours for the blood culture bacteria to be identified. In the meantime the patient will be placed on a number of antibiotics to try and stop the infection.Vancomycin is usually one of the drugs used.
- Some of the bacterial infections reported by DSRCT patients: Staphylococcus epidermidis ;MSRA ; and Klebsiella
C. Ascites - Desmoplastic small round cell tumor can present with abdominal ascites or fluid within the abdomen. This can also cause bloating in the extremities. The symptoms for ascites is a swollen and distended abdomen which can be uncomfortable and painful. It can cause the patient to feel tired, breathless, nauseous, and sick. Ascites can be caused by cancer cells spredding to the lining of the abdomen, or it may be due to liver damage, or cancer blocking the lymphatic system. Ascites is an uncomfortable complication. It is possible to treat ascites with a diuretic or a shunt. However, in advanced disease a doctor may need to insert a drainage tube to relieve the patient. This may become a chronic condition. There is a Phase IIClinical Trial being held to determine if hyperthermic peritoneal perfusion can be used in the treatment of malignant ascites.
D. Oral Mucositis (Mouth sores) -Caused by chemotherapy. Recommend keeping mouth and teeth as clean as possible.
E. Neuropathy - A nerve damage that causes tingling, numbness, "pins and needles" feeling in feet and hands.
G. Diarrhea or Constipation -Can be triggered by several of the chemotherapy medications or other drugs
H. Pulmonary Embolism Blockage of an artery in the lungs caused by a blood clot.
- Adhesions - Bands of scar-like tissue that form between two surfaces inside the body generally after a major surgery. Surgical adhesions can later cause bowel obstruction, abdominal pain, nausea, fever, unexplained vomiting, infertility, and other problems. Surgery may be needed to separate adhesions.
- Colostomy - Because this disease predominately affects the abdominal cavity, surgery often involves removing parts of diseased large or small intestine. The patient may need to have a temporary or permanent colostomy as a result.
- Splenectomy - Surgery to remove the entire spleen. Complete recovery expected. Patients should be vaccinated against pneumococcal pneumonia, H. influenza and meningococcus.
Secondary Health Issues
- Myelodysplastic Syndromes - A pre-cancerous condition that can develop after high dose chemotheapy and radiation treatments.
- Acute Myeloid Leukemia - A secondary cancer of the blood that can develop after high dose chemotherapy and radiation treatments.
- Hyperplasia - An increase in the number of the cells of an organ or tissue causing it to increase in size. Caused by high dose chemotherapy and radiation treatments.
- Biliary Hyperplasia - Indicates damaged, poorly healed tissue in the biliary tract and is the result of high dose chemotherapy and radiation treatments.
Disclaimer: This page is for informative purposes only. If a patient has any concerns, please consult with your physician immediatly. Depending on individual health and other factors patients may never develop any of these symptoms, conditions, or complications.