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Leading Kidney Cancer Treatment Options

Managing Symptoms & Side Effects

Throughout your kidney care journey, you may experience symptoms from the cancer itself, or side effects from your treatment. Managing symptoms and side effects can help you better tolerate treatment. It’s also important to your physical health, emotional well-being and your overall quality of life. Discuss with your doctor who on your care team will help you manage symptoms. Your point person may be that doctor, or an oncology nurse, nurse practitioner or physician’s assistant. Your care team also will help you manage symptoms or bring other specialists to your care team.

Side Effects of Treatment

A side effect is your body’s reaction to treatment. Everyone reacts differently to treatment. Some people have no reaction.

Side effects can range from a nuisance to your daily life to life-threatening. Knowing what to expect can help reduce fear and anxiety. It also prepares you to better manage any side effects. Before starting treatment, ask your treating doctor or nurse about possible side effects.

Possible Symptoms and Side Effects

Constipation

Constipation is when your bowel movements occur less often, are small or incomplete, or your stool becomes hard and more difficult to pass. You also may have:

Leakage of liquid stool
Belly discomfort, stomach ache or cramps
Swollen belly

Causes

Medications, especially pain and anti-nausea drugs
Tumor in the belly or digestive tract
Surgery
Lack of activity
Eating or drinking less

What You Can Do at Home

Do:

Keep a written log of your bowel movements so you can answer questions from your care team.
Go to the bathroom as soon as you feel the urge.
Drink more fluids. Warm fluids in the morning may help get your system going.
Keep active, as directed by your care team.
Stay on a daily routine for eating meals and going to the bathroom.
If approved by your care team, eat foods high in fiber, such as whole-grain breads and cereals, raw fruits and vegetables, dry fruits such as prunes, and nuts.

Avoid:

Stool softeners or laxatives, unless approved by your care team
Suppositories or enemas, unless approved by your care team
Carbonated drinks
Foods that cause gas, such as beans, broccoli and cabbage
Dairy, such as milk, cheese and eggs

When to Contact Your Care Team

You should contact your cancer care provider if you have:

No bowel movement for 2 days (or a period of time discussed with your care team)
Blood in your stool or anal bleeding
Severe belly pain and/or vomiting
Diarrhea
Not had anything to eat or drink for 24 hours

If constipation is an ongoing problem, ask your cancer care team about a bowel care plan that includes diet, bowel schedule and supplements/over-the-counter products.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Diarrhea

Diarrhea is loose or watery stools, usually passed more frequently than your usual bowel movements. You also may feel cramping or belly discomfort.

Causes

Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Radiation therapy
Surgery
Tumor in the digestive tract
Infection
Nutrition supplements or liquid food replacement
Eating spicy, fatty or fried foods that upset your digestive system

Risks

If you have diarrhea, your body is not getting the water and essential nutrients you need. Diarrhea can lead to dehydration and malnutrition.

What You Can Do at Home

Do:

Keep a log of times of your bowel movements so you can answer questions from your care team.
Take diarrhea medicine only if approved by your care provider.
Drink eight to ten glasses of clear fluids a day, including adult Pedialyte®
Start with a clear liquid diet of broth, popsicles and gelatin (Jello®).
As you improve, transition to a BRAT diet (bananas, rice, applesauce and dry toast) and high-sodium foods such as plain crackers and pretzels.

Avoid:

Carbonated drinks
Caffeinated drinks
Alcohol drinks
Milk and milk products
Spicy foods
Greasy foods
High-fiber foods such as fresh or dried fruits and vegetables
High-sugar foods such as cookies and rich baked goods

When to Contact Your Care Team

You should contact your cancer care provider if you experience:

Change in bowel habits such as diarrhea or loose stools
Belly pain or a swollen belly
Blood in your stool or anal bleeding
Temperature greater than 100.5
No urination in 12 hours
Nothing to eat or drink in 24 hours
Dizziness

If diarrhea is an ongoing problem, ask your cancer care team for support with diet/nutrition, supplements and over-the-counter products.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Fatigue and Weakness

Feeling physically weak or fatigued is common during cancer treatment and can linger even after treatment ends.

Fatigue can mean different things to different people. You may feel:

Tired, weary or worn out
Decreased physical strength
No drive or interest to do anything

Causes

You may experience cancer-related fatigue and weakness for myriad reasons throughout your cancer care journey. Pain and other side effects can burden your body and drain your energy. Your body also requires energy to heal and regenerate healthy tissue. Causes of your fatigue and weakness may include:

Surgery
Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Radiation therapy
Weight loss and/or malnutrition
Anemia (low red blood cell count)
Loss of muscle strength
Lack of physical activity
Changes in hormones
Infection
Depression

Risks

Fatigue and physical weakness can lead to frustration when not being able to do daily activities. They also can foster feelings of hopelessness and depression.

What You Can do at Home

The best thing you can do is understand that fatigue is a normal part of having cancer. Everyone responds differently to treatment and recovers on their own timeline.

Keep a log of your symptoms. Your care provider may be able to identify and treat the cause of your fatigue.
Eat a healthy, balanced diet
Take vitamin, mineral or electrolyte supplements if approved by your care provider
Drink 8 to 10 glasses of liquid a day
Practice simple activities that you enjoy
Walk, stretch, or exercise daily, as allowed by your care provider
Consider meditation, yoga, or a restorative nap
Allow yourself to have a bad day

When to Contact Your Cancer Care Provider

You are unable to do your everyday activities
Your fatigue leads to depressive thoughts

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Insomnia

Insomnia is when you have trouble falling or staying asleep through the night. It’s recommended that the average adult sleep at least seven hours a night. Symptoms of cancer and side effects of treatment can affect your ability to get a full night’s sleep. If you previously experienced insomnia, you may find it worsens following your cancer diagnosis.

Causes

Cancer treatments including chemotherapy targeted therapy, immunotherapy
Hormone therapy
Radiation therapy
Surgery
Medications for cancer side effects
Uncontrolled pain
Nausea
Fever
Reduced physical activity during the day
Anxiety
Depression
Muscle cramps
Changes in hormones, night sweats and/or hot flashes

Risks

Cancer treatment can leave you fatigued. If you are not getting enough sleep, this can add to your fatigue. Lack of sleep can leave you too tired to do daily tasks or things you enjoy.

What You Can Do at Home

Do:

Practice relaxation techniques.
Exercise regularly, with approval from your care provider.
Only take short naps of 30 minutes or less during the day.
Take medications on a schedule.
Keep a sleep diary or use a sleep app to track the times you sleep and wake up, and any conditions that bothered you.

Avoid:

Drinking beverages with caffeine in the late afternoon or evening.
Drinking alcoholic beverages.
Exercising in the evening.
Spending waking hours in your bed.
Using your electronic devices right before bedtime.

When to Contact Your Cancer Care Provider

You are sleeping very little or not at all
You experience confusion or disorientation

Talk to your care provider. They may be able to address the cause of your insomnia or prescribe medication to help.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Loss of Appetite

Your appetite and desire to eat can be impacted by the cancer itself, or from surgery or treatment. Fueling your body with fluids, calories and nutrients is essential so you can maintain a healthy weight throughout treatment.

Causes

Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Radiation therapy
Cancer in the digestive tract
Pain
Stress
Depression
Nausea and vomiting
Constipation and diarrhea

Risks

Loss of appetite can cause you to eat and drink less. This can lead to dehydration, malnutrition, fatigue and weight loss.

Severe weight loss can impact whether you can continue to undergo treatment.

What You Can Do at Home

Do:

Stick to a regular meal schedule
Eat small snacks every 2-3 hours throughout the day
Sip liquids with calories throughout the day
Remain physically active (as approved by your care team)

Try:

High-calorie, high-protein foods such as supplement shakes, pudding, nuts, protein/granola bars, canned chicken or tuna
Bland foods, such as crackers, cereal and dry toast
Hard candy to get rid of any bad taste in your mouth

Avoid:

Sugar-free or diet foods and drinks
Greasy or fried foods
Foods that do not appeal to you
Only eating if you’re hungry
Drinking during meals (which can fill you up)

When to Contact Your Care Team

You should contact your cancer care provider if you:

Have not eaten solid food in more than 1 day
Have less than 4 cups of liquid or ice chips in a day
Vomit for more than 1 day
Have difficulty swallowing
Have not taken your medicines or can’t keep them down
Have not urinated for 1 day
Have no bowel movement for 2 days
Feel dizzy or confused
Lose more than 3 pounds in a week

Be sure to talk to your cancer care team about any loss of appetite. You may benefit from meeting with an oncology nutritionist or registered dietitian who can personalize a meal plan for you. There also are medications that can help stimulate your appetite or changes to your treatment plan that can help.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Nausea and Vomiting

Nausea is having an upset stomach and feeling like you may vomit (throw up). Both nausea and vomiting are common during cancer treatment, and can come with lack of appetite, acidic mouth juices and increased saliva, and feeling clammy or sweaty.

Causes

Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Surgery
Radiation therapy
Cancer in the digestive tract
Medication

Risks

Feeling nauseous or vomiting reduces the amount you eat and drink. This can lead to dehydration and weight loss and impact your cancer treatment plan.

What You Can Do at Home

Do:

Keep a record of times you feel nausea or vomit so you can answer questions from your care team.
Eat small snacks to keep something in your stomach throughout the day.
Sip liquids throughout the day.
Sit upright for the first hour after each meal.
Distract yourself by reading, watching a show or listening to music when you feel nauseous.
Eat a small meal or snack before treatment, if allowed by your care team.

Try:

Clear liquids, such as apple juice, broth, ginger ale
Foods that are easy to eat, such as popsicles, gelatin (Jello®), pudding, yogurt, milkshakes
Bland foods, such as crackers, cereal or dry toast
Cold or room-temperature drinks and food
Hard candy to get rid of bad taste in your mouth

Avoid:

Greasy or fried foods
Low-fat foods because you need the calories
Foods that do not appeal to you

When to Contact Your Care Team

You should contact your cancer care provider if you:

Inhale or choke on your vomit
Vomit 4-5 times in 1 day
Vomit for more than 1 day
Vomit with blood (can look like coffee grounds)
Have not eaten in more than 1 day
Have less than 4 cups of liquid or ice chips in a day
Have not taken your medicines or can’t keep them down
Feel dizzy or confused
Are losing weight

Be sure to talk to your cancer care team about your nausea and vomiting. There are medications or changes to your treatment plan that can help.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Pain

Managing your pain is important when you have cancer. Pain can range from overall discomfort to feeling something severe and debilitating.

Be sure to talk to your care provider about pain. There are medications and combinations of medications that can lessen the pain. It’s likely that the type and amount of medication will be adjusted as needed throughout treatment.

Causes

Pain from the tumor or tumors
Pain from cancer that has spread
Chronic pain or pain prior to cancer diagnosis
Surgery
Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Radiation therapy

Risks

Pain that is not controlled can leave you exhausted and unable to do normal, daily activities. Uncontrolled pain also can cause insomnia (loss of sleep), anxiety and depression – especially for people who already have these conditions.

What You Can Do at Home

Do:

Keep a symptom diary. Log in a journal or an app:

Where you feel pain
Time that it started
How long it lasted
How often it occurred
How it rates on a scale of 0 (no pain) to 10 (highest)
Were you able to find any relief and if so, what worked
Remain physically active, as approved by your care provider. This will help keep your mind off pain and help prevent constipation.
Stay ahead of the pain. Take your pain medicine exactly as prescribed. Don’t wait until you feel severe pain to take your medication.
Follow the warnings on your pain medication bottle.

Avoid:

Breaking or crushing pills, unless approved by your care provider.
Driving or other activities prohibited when taking your pain medication.
Waiting until you are out of medication to ask for more.
Stopping your medication without talking to your care provider.
Avoid taking more pain medication than prescribed.
Living with unbearable pain. Always ask your care provider for help.

When to Contact Your Care Team

You should contact your cancer care provider if you:

Have new pain
Have pain that is getting worse
Have pain in a new location
Find pain medication isn’t helping
Are nauseous or vomiting
Become constipated
Are disoriented or confused

Be sure to talk to your cancer care team about pain. Your supportive care specialist can refer you to a pain management expert, if needed.

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

Shortness of Breath

Sometimes people with cancer or undergoing cancer treatment may become short of breath or feel like breathing is difficult. This shortness of breath (called dyspnea) can make it difficult to do your usual activities. Depending on the cause, it also may be accompanied by a cough.

Causes

Cancer treatments including chemotherapy, targeted therapy, immunotherapy
Surgery
Radiation therapy
Muscle weakness
Fatigue due to weight loss, anemia or lack of physical activity
Uncontrolled pain
Anxiety
Pneumonitis (inflammation of the lungs)
Pneumonia
Fluid in the lungs, chest or other locations
Tumor in the lung or chest/blocked airway

Risks If you are short of breath, you may not be getting enough oxygen into your lungs and bloodstream.

Don’t wait until your next appointment to tell your care provider about shortness of breath. If you keep having trouble breathing, there are medicines that can help. It also may be a sign of a serious problem or lead to losing consciousness or cardiac arrest.

What You Can Do at Home

Try to stay calm. Anxiety can make breathing worse.
Do not lie flat. Sit propped up in bed, couch or chair at a 45° angle or greater.
Try pursed lip breathing. Inhale deeply through your nose and exhale through pursed lips for twice as long as your inhale.

When to Call 911

If you have any of the following symptoms:

Shortness of breath that starts suddenly and doesn’t get better
Bluish-colored skin or lips
Trouble talking
Chest pressure or pain
Dizziness

When to Contact Your Cancer Care Provider

Shortness of breath when resting, eating, talking or being active
Faster breathing
Racing heart (track your wrist or neck pulse rate/beats per minute)
Wheezing
New cough or cough that is getting worse
Coughing up yellowish-green or bloody phlegm
Fever
Confusion or mental disorientation

*Always talk to your care provider about your cancer symptoms and side effects. This information does not replace their medical advice.

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Symptoms and Side Effects Log

You may get questions from your care provider about any side effects you experience during and after treatment. Keeping track of this information will help your care team treat your side effects and make adjustments to your treatment plan, if necessary. Keep a written log or use an app to track:

Symptom you experience
Time that it started
How long it lasted
How often it occurred
Were you able to find any relief and if so, what worked