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Allergies


Allergic reactions, also known as hypersensitivity reactions, happen when the body develops a set of symptoms in an exaggerated response to a foreign substance (e.g. drug, food, pollen, etc). One of the most common hypersensitivity reactions during the cancer treatment phase happens during infusions of anticancer drugs, when the body reacts to the drug. This write up focuses on allergic reactions related to infusions of anticancer drugs.

  

Causes of Allergic Reactions

Allergic reactions have been reported with most anticancer drugs, but occur more commonly with the following:

  • Paclitaxel, Docetaxel
  • Cisplatin, Carboplatin, Oxaliplatin
  • Etoposide, Teniposide
  • Pegylated Liposomal Doxorubicin
  • L-asparaginase
  • Rituximab

  

What you need to look out for

Some allergic reactions may occur immediately upon infusion, while others may take hours to develop. They range from mild to severe. A severe allergic reaction can occur rapidly to affect the whole body, and can be life-threatening if not taken care of immediately.

Mild allergic reactions can present as:

  • Skin rashes
  • Chills
  • Itchy / runny nose
  • Mild shortness of breath
  • Watery / itchy / red eyes
  • Flushing or temporary redness of the face and neck
  • Chest tightness

Moderate to severe reactions can present as:

  • Nausea / vomiting
  • Abdominal cramps
  • Swelling of face / eyes / tongue / throat
  • Difficulty swallowing
  • Wheezing / severe difficulty in breathing

  

How it can be treated

For anticancer drugs that are known to commonly cause allergic reactions, pre-medications (medications given prior to your anticancer drug infusion) will usually be prescribed to prevent or lessen reactions where needed. However, allergic reactions may still occur, and if they do, a doctor will assess you, determine the severity of the reaction and may do the following:

  • Stop the drug infusion. If the reaction settles, the drug infusion may be restarted at a slower rate, but if the reaction is severe, the drug infusion will likely be discontinued permanently.
  • Prescribe medications to reduce the effects of the reaction. These can include antihistamines (e.g. benedryl), corticosteroids (e.g. hydrocortisone), and/ or bronchodilators (e.g. salbutamol) to ease any symptoms that you may experience.
  • Inform your treating oncologist of the reaction so that future measures can be taken to prevent the allergic reaction from occurring again.

  

What you can do

The following are some steps you can take to help reduce your risk of allergic reactions from anticancer drug infusions:

Before your treatment

  • Inform your doctor of any past history of allergies you have, including food and drugs
  • Take pre-medications as prescribed. If you forget, let your doctor or nurse know

During treatment

  • Inform your nurse immediately if you experience physical discomfort, or any symptom as listed in the previous section

  • Do not try to tolerate or keep any discomfort to yourself. Allergic reactions may start off with mild symptoms and eventually worsen

​After treatment

  • Inform your doctor of any signs of allergies that you experience
  • If you are unsure of whether the symptom(s) you are experiencing is an allergic reaction or a side effect, do consult your doctor for further discussion
  • Even if symptoms are not causing you any discomfort, it is important for you to inform your doctor about it

  • Avoid self-medications
  • Avoid delaying seeing your doctor. Allergic reactions may progress and eventually worsen


When to call your cancer care team

Because it can be life-threatening, you are advised to seek emergency help if you experience the following symptoms:

  • Difficulty in breathing
  • Wheezing
  • Swelling of face / eye / tongue / throat

If you are receiving treatment at NCCS Ambulatory Treatment Unit, please contact your nurse chemotherapy educator, or refer to “Your Guide to Chemotherapy Booklet” if you have any questions regarding allergic reactions from your treatment regimen. For all other general enquiries, please call Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.


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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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