Help with Side Effects-Need Advice

Hi Craig 8826 

Thanks for getting in touch with our online community. My name’s Louise and I’m one of the Cancer Information Nurse Specialists here. 

I’m sorry to hear you have been struggling with diarrhoea during treatment for bladder cancer that has spread to the liver (metastatic bladder cancer). It can be very difficult and unpleasant and can really impact daily life. 

Chemotherapy can cause a range of side effects, and many people have bowel issues. Cancer cells divide rapidly and chemotherapy targets rapidly dividing cells. However healthy cells such as those found in the bowel, stomach, mouth, hair and skin also rapidly divide. This is why people get side effects that affect these areas.  

You mention you seem to feel all right whilst you are taking the steroids. Steroids can be given as part of cancer treatment to destroy cancer cells and make the treatment more effective, and help manage with treatment side effects. This means that often people will notice side effects are worse when the steroids stop. 

However, there are many ways to manage side effects to make you more comfortable and make treatment easier. Sometimes it can take a bit of time to find the right medication and regime that works for you. This is especially the case with managing bowels as everyone’s routine is so different. 

Many people notice they develop a pattern of side effects. It’s good you are keeping a diary as this can be a useful way to be able to prepare for the next treatment, so keep doing this. Side effects may not stop, but with a clear plan for managing your bowels, it is possible to lead a much more normal life and be able to carry on with activities. 

While you are struggling it might help to get a toilet card so you can go out and use public facilities without worrying about where the nearest toilet is.  

You ask if you have taken too many laxatives. As we do not have access to medical records and are not directly involved with care, it is not possible for us to give medication advice here on the support line. 

Your healthcare team are there to support you and answer any questions, and we would always encourage anyone to contact their healthcare team straight away with any changes or concerns. For example, diarrhoea can be a sign of infection or cause dehydration, which can make someone seriously unwell. 

You mention an “uncontrollable accident”. We would always just want to rule out spinal cord compression as loss of bowel control can be a sign of this. Although this is a rare complication of cancer, it’s important to get it treated straight away to avoid further problems. 

Many people having treatment are given a 24-hour number to call with any issues. You can call this or 111 at any time. They will be able to assess you and give you the right advice. You can also mention the sore / dry mouth, cough and disturbed night’s sleep (insomnia) you are experiencing, as there is a lot of support for managing these issues too.  

You mention that mentally and physically you are in a good place. This is good to hear, however it’s important to look after yourself. Sometimes it can be helpful to share experiences with others in a similar situation. You can find this type of support from our bladder cancer forum. You can also find support in your area.  

It might also be helpful to call us. One of our nurses would be happy to talk things through. 

Kind regards   

Louise, Cancer Information Nurse Specialist   

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.   

Our Ref:  LR/SH