Chapter Six: Side Effects and Symptom Management

Monday, June 6, 2022


I am in the process of preparing for my upcoming radiation treatment, which will happen this week. While the concept of taking a pill to eliminate any remaining cancerous thyroid tissue sounds like a simple course of treatment, there are plenty of complicated logistics that need to be worked out ahead of time as the treatment will make me temporarily radioactive. Since this treatment happens outside the hospital and typically at home, I will have to isolate from everyone for a few days. Unfortunately, this includes my three dogs which makes this impossible. My solution has been to book a hotel apartment for the duration of my isolation. I know I am fortunate that I am able to afford this; I do not know what other people do in this situation. Even with the location settled, there are more logistics to coordinate, which range from bringing my own sheets and towels to the hotel because they will need to be washed separately afterwards to ensuring I have enough food to last me for the duration of my stay.

In addition to all of the logistical preparations, it is nerve-wracking to think about taking something into your body that is actually radioactive. It is my best chance at disease-free survival, but it is unnerving just the same. Not to mention that it increases my risk for other cancers, like leukemia. There is a lot of additional stress that comes from suddenly caring for yourself under such extraordinary circumstances: all of the additional appointments, the anxiety of being separated from my daughter, and the general wondering about what will happen next. We focus on the physical elements so much that we tend to devalue what we face mentally and how that manifests itself. Stress can cause or increase your risk of serious health conditions, like ulcers, heart issues, and even cancer. All this is happening as I am still working with my doctor to find the right dosage of synthetic thyroid hormone, which is still causing a significant amount of fatigue. Throughout my isolation I plan to continue to work, so long as the side effects – most commonly nausea – are tolerable.

Managing symptoms and side effects can be a real challenge. As Céleste* continued her chemotherapy treatments, she started experiencing neuropathy – a numbness and often pins-and-needles feeling – in her hands and feet. She let her doctor know right away and began seeing a physical therapist regularly after learning that the nerve damage some patients experience during chemo can be permanent.  The medications she has been prescribed to help with some of the side effects from chemo have been effective but also come with side effects of their own, so she must carefully weigh the benefits of each new drug.

Céleste is also doing her best to get some level of exercise each day if she can, even if it’s just walking around in her back yard with her husband, as she knows that studies have linked light exercise to better symptom management and overall recovery. Some days this can be difficult though – there are times when she does not get far without needing to take a break. This is the level of exhaustion chemotherapy can bring. One thing that has worked well for her is IV hydration when she needs it which, together with the suggestions from her nutritionist, have helped her with managing her diet and feeling well enough to eat small meals throughout the day. Still isolating and terrified of catching Covid in her immunocompromised state, Céleste knows that she and her loved ones are doing everything they can to keep her safe.

There are many resources and services that we offer to help patients and caregivers manage the significant challenges of symptom management and mental health.

  • For more information on ways diet and nutrition can help with symptom management visit our webpage.
  • If you are between doctor appointments and have questions about pancreatic cancer treatment or symptom management, reach out to our free Ask An Expert service.
  • Access our free Peer Support service if you or a loved one need someone to talk to who understands the impact of pancreatic cancer.


*Pancreatic cancer can be an intensely personal experience, particularly when a patient is still undergoing treatment. With this in mind, we have gathered the experiences of several patients navigating a stage II pancreatic cancer diagnosis, and present them here as the story of Céleste.