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Symptom Management:

Symptom Management

Side Effects of Treatment
Side Effects of Chemotherapy
Appetite Loss
Bladder Disturbances
Incontinence - Urinary
Dryness of the Mouth
Fluid and Electrolyte Imbalances
Flu-like Syndrome
Hair Loss
Menopausal Symptoms
Nausea & Vomiting
Neurological Disturbances
Spinal Cord Compression
Peritoneal Effusions
Shortness of Breath
Skin Conditions
Sleep Problems (Insomnia/Oversleeping)
Sore Mouth
Bone Metastases
Sexuality Issues
Sexual Dysfunction
Flulike Syndrome

Symptom and Description Except for the cause, flulike syndrome (FLS) is much like the flu. Your symptoms of fever, chills, headaches, body aches, and nasal stuffiness are expected side-effects of your treatment. Any or all bones, joints, and muscles may hurt. Fever may be mild or severe. Chills may occur—especially when the fever begins—that may range from feeling cold to your teeth chattering or body shaking. These shakes usually don’t last more than a few minutes, but your temperature will almost always increase afterward. You may feel washed out or sweaty afterward. Muscle soreness is also a problem after severe shaking. Usually, the worst symptoms happen in the first few days after treatment has been started. As your body adjusts, your symptoms will probably be less severe. You are at risk of having FLS because of your cancer therapy, specifically the drug.

Learning Needs You need to learn how to manage these side-effects at home. You also need to know when to call your doctor or nurse.

Prevention It is difficult to prevent this syndrome. Some helpful hints to reduce the symptoms include:

  • Getting your drug in the evening, which allows you to be active before treatment.
  • Getting your drug late, which can help you sleep through some symptoms.
  • Taking medications before or after treatment to help prevent these side-effects.
  • Making sure that you wear comfortable clothing to bed.
  • Wearing layers of clothing, so that if you feel warm you can remove some.
  • Having plenty of blankets and a heating pad nearby, in case you feel cold at night.

Management For side-effects that cannot be prevented, here are some ideas on how to manage them at home.

General guidelines:

  • Some people find that relaxation techniques, mental imaging, biofeedback, or massage help them to relax and better tolerate the symptoms of FLS.
  • Plan your activities before you receive your medicine, so there is less to do when you have side-effects.
  • Keep your nutrition up by eating regular, healthy meals.
  • Get plenty of rest.
  • Ask your doctor or nurse for more information if you are interested in trying relaxation exercises.


  • Have an easy-to-read thermometer.
  • Take and record your temperature in the morning, at bedtime, after a chill, and any time you feel warm.
  • Acetaminophen, 650 mg, can be taken every 4 hours until your temperature returns to below 38.3 C (101 F).
  • Notify your doctor or nurse if your temperature stays at 40.0 C (104 F) or greater and does not come down with acetaminophen.
  • Avoid chilling yourself.
  • You may apply cool compresses or ice packs or take tepid baths to feel refreshed and lower your temperature.


  • Keep yourself as warm as possible during these episodes.
  • A heating pad or hot water bottle may help.
  • Notify your doctor or nurse if these episodes last longer than usual, or if you feel any shortness of breath during a shaking period or afterward.

Aches (headaches, joint aches, muscle aches):

  • Taking medication for pain as prescribed by your doctor or acetaminophen—650 mg every 4 to 6 hours—should give some relief.
  • A dark and quiet environment is often helpful.
  • Applying cool compresses to your forehead or warm compresses to the back of your neck may also help, depending on where the pain is located.
  • Notify your doctor or nurse if you notice any visual changes or dizziness with your headaches.
  • Also call the doctor if the pain is in the neck and you can’t touch your chin to your chest.
  • Get plenty of rest—don’t overdo when you are having these aches.
  • Sometimes fun activities will help get your mind off the pain. Reading, sewing, listening to music, and watching TV are a few ideas you may try.
  • Notify your doctor or nurse if you notice increased stiffness or difficulty in walking or in getting up or sitting or lying down.

Cough/nasal congestion:

  • Antihistamines and cough preparations are usually helpful. Ask your doctor to suggest medicines you can take if needed.
  • Drink plenty of fluids—try to drink at least eight glasses of fluid per day.
  • Avoid excess dryness in the home, but be certain that humidifiers are cleaned every few days.
  • If you are coughing up yellow or green phlegm, notify doctor or nurse.

Follow-up Be sure you understand what to expect, what to do about it, and when to call your doctor or nurse. Have emergency phone numbers available. Be able to discuss these plans with your nurse before you go home. If you are unsure of any of the instructions, be sure to clarify them with your doctor and nurse. Keep a log or diary of your symptoms, how long they last, what you did about them, and how well the methods worked to get rid of the symptoms.

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