Hot Topics in Chemotherapy Management

Lidia Schapira, MD, FASCO, associate professor of medicine at Stanford University School of Medicine and director of cancer survivorship at the Stanford Comprehensive Cancer Institute, and Merry Jennifer Markham, MD, FACP, FASCO, acting chief of the division of hematology and oncology and clinical professor at the University of Florida and associate director for medical affairs and chief medical officer for cancer services at the University of Florida Health Cancer, spoke with Healio about managing the side effects most commonly related to chemotherapy.

In the first video in this series, Schapira discussed common side effects associated with chemotherapy treatment and options to help with some of the “old villains” such as hair loss, low blood counts, and neutropenia.

When discussing chemotherapy-induced neuropathy (CIN), Schapira provided three critical takeaways:

1. Currently, there is no way to prevent CIN;
2. There is a high degree of variability between patients; and
3. Management depends mainly on patient-reported symptoms.

“Sometimes, patients can actually lose function very quickly,” she said. “So, they may come in their treatments and report some discomfort, some loss of sensation and so on. But they can very quickly become disabled.”

In the second video in this series, Markham discussed how care has adapted since the beginning of COVID-19.

“COVID has not really changed how we manage side effects, but it has made our patients a bit more anxious about things like fever … or coughs,” Markham said.

She explained that it can be difficult to know if these new symptoms are a side effect of treatment, side effect of the cancer or side effects of a new infection. In her own practice, Markham said she “errs on the side of caution” and tests for COVID if there is any suspicion of infection.