The most common side effects of drugs involve the cells that line the gastrointestinal tract, the skin and scalp (hair follicles), and the marrow. Each of these parts of the body has a common characteristic: as part of their normal functions, they all have rapid cell turnover (growth of new cells to replace old cells).

Side effects can vary considerably from treatment program to treatment program as well as from individual to individual. For example, one patient being treated for Hodgkin lymphoma related that he doesn't remember a day when "I've felt normal," hile another patient undergoing similar treatment for a comparable period said,"I think I've had a pretty easy time of it."

Sources of Information. The best source of information about side effects is your medical team. They are the most knowledgeable about your particular case and, therefore, the most qualified to discuss your treatment program. You should not hesitate to talk with your physician about any questions or fears you may have regarding your treatment and possible reactions to it.

Other healthcare professionals, such as a nurse or technician responsible for administering your treatment, can also supply you with assistance and information. You may also wish to read some literature that describes the side effects associated with your treatment program. Material of this nature is usually available from your doctor's office, treatment center or from one of the sources listed under "Services and Support." Many people also find that support groups provide an excellent forum for the exchange of experiences and information about side effects and how to cope with them.

Some General Reactions to Treatment. The most common side effects of treatment for leukemia, lymphoma or myeloma include nausea and vomiting, hair loss and mood swings. These reactions can be unpleasant, but they are usually temporary. They are more exaggerated during periods of aggressive treatment and subside completely, or come and go, during maintenance therapy. In many instances, the intensity of these side effects can be controlled by modifications in treatment and/or diet, as well as by medications prescribed by your physician.

While there are medications available that help limit hair loss, many patients undergoing aggressive treatment still lose a good portion of their hair. Regrowth normally begins after initial therapy has been completed. Some might be pleased to know that hair often comes back thicker than it was originally.

No one looks forward to the prospect of losing his or her hair. If this possibility is particularly disturbing to you, it might help if you get your hair cut very short and practice wearing scarves, a hairpiece or a wig before your hair actually begins to fall out. Many patients find that this type of preparation makes it a little easier to adjust to this change in appearance.

There is no doubt that treatment affects the central nervous system, and you may experience emotional highs and lows. Mood swings are generally not severe enough to require medication, and most patients report that prior knowledge and understanding of this side effect help them to weather these emotional ups and downs. You may want to tell family members and friends that your moods are "subject to change," to prevent possible conflicts and misunderstandings with other people.

Fatigue, too, is a common complaint among patients. Most people learn to combat fatigue by maintaining a balanced diet, setting priorities and adjusting their daily schedule to ensure they get adequate rest until their normal energy level returns. Medical treatment may help certain causes of fatigue.

Both men and women may experience some sexual difficulties during and after treatment. These difficulties can include impotence, lack of sexual interest or frequency and sterility or infertility. Women may develop menstrual irregularities as well as other symptoms of early menopause, such as hot flashes, insomnia and increased irritability. In time, most patients are able to resume normal sexual activities and functions. Hormone replacement therapy may reverse the process of early menopause or alleviate its symptoms. Replacing hormones lost during treatment also reduces the possibility of osteoporosis, which might otherwise result from premature menopause.

In certain instances, specific drug therapies and/or radiation treatments for leukemia, lymphoma or myeloma may increase the risk of permanent sterility and infertility. When possible, the risks of sterility and/or infertility, and fertility preservation options, should be discussed with your oncologist prior to beginning treatment. There has been some success with preserving pre-treatment sperm samples for artificial insemination at a later time for men; options for women include freezing fertilized eggs retrieved prior to treatment. New fertility preservation techniques are being studied, such as egg (oocyte) freezing and ovarian transposition, a surgery to move the ovaries out of the field of radiation to minimize exposure and damage. For additional information on these options and others, and their success rates and risks, contact Fertile Hope, (888) 994-HOPE or visit www.fertilehope.com. Many of these procedures may not be covered by your health insurance. For more information on insurance coverage for fertility procedures, contact RESOLVE at www.resolve.org or (888) 623-0744. Some couples may want to consider adoption.

Accurate information will help you to evaluate treatment options and make informed decisions. Couples having trouble discussing the impact sterility and infertility will have on their relationship can seek help from their doctor, social worker or such organizations as Cancer Care at www.cancercare.org or (800) 813-4673.

Tips for keeping track of information from your healthcare provider: