Lymphoma treatment can damage or impair various glandular secretions throughout your body. These can result in reduced saliva production, reduced thyroid function, changes to your skin and nails, and other hormonal issues.
Reduced Saliva Production
If you have had radiation therapy or surgery to your head and neck, you may have experienced damage to your salivary glands which could result in a reduction of saliva produced by your mouth. This can lead to symptoms such as:
- Dry mouth
- Painful mouth and gums
- Mouth infections
- Changes or difficulties with eating
Here are some tips to help alleviate your symptoms:
- Maintain a moist mouth: try drinking water, sucking on ice chips or sugar-free hard candy, chewing sugarless gum, or using a saliva substitute
- Clean your mouth regularly to ensure good mouth and oral hygiene: try brushing your teeth, gums, and tongue with a soft toothbrush after each meal and at bedtime; use a mild fluoride toothpaste and alcohol-free mouthwash; floss gently every day while avoiding areas that are bleeding or sore; rinse your mouth a few times a day with a baking soda and/or salt solution; and if applicable, clean, brush and rinse dentures after each meal
- Avoid certain foods or putting certain objects in your mouth: do not eat foods that will scrape or cut your mouth such as crunchy chips or granola bars; avoid hot, spicy, or acidic foods or juices; stay away from sugary foods that may cause cavities like candy or pop; do not use toothpicks; stop smoking or chewing tobacco; and avoid alcoholic drinks
If your symptoms continue for a long time, discuss ways to control your reduced saliva production with your doctor or dentist and ask them how often checkups are needed.
Reduced Thyroid Function
Your thyroid gland is part of your body’s endocrine system and is responsible for making a hormone that controls the metabolism of your body. It is located in the neck and radiation therapy in the neck area may damage the gland resulting in reduced thyroid function, also known as hypothyroidism. Your risk of developing hypothyroidism is higher in the first five years but can continue beyond that.
Symptoms of hypothyroidism include:
- Cold intolerance
- Dry skin
- Dry hair
- Hair loss
- Weight gain
- Difficulty losing weight
- Menstrual problems
Hypothyroidism is difficult to diagnose as the symptoms are variable and can often be associated with other health issues or lifestyle choices such as aging, menopause, or poor diet. Even if your lymphoma follow up has ended, you can always consult your family doctor if you suspect that you may be experiencing hypothyroidism. It is diagnosed with a simple blood test and can easily be treated with thyroid hormone supplements.
Reduced Sebum Production Affecting Skin and Nails
Skin and nail issues that occur during chemotherapy and/or radiation therapy may also continue sometime after treatment is completed. This is caused by damage to your sebaceous glands in your skin that normally produces sebum, the oily material that lubricates your skin and hair. General skin symptoms include: redness, rash, itching, dryness, acne, peeling, blistering, and discolouration. Nail issues can include: darkening, yellowing, brittleness, cracking, lines, and separation of nails from nail bed. Here are some tips to help alleviate your symptoms:
- Use warm instead of hot water: to bathe or wash your hands to avoid excessively drying your skin
- Keep your skin and nails clean: wash or bathe frequently to avoid infections and skin irritations
- Pat to dry skin after washing or bathing: avoid rubbing and irritating the skin
- Do not exacerbate skin irritations: avoid squeezing, scratching, or picking at acne or other skin irritations
- Moisturize frequently: to prevent your skin from becoming dry or cracked; use products that contains high lanolin content and no alcohol content; ask your healthcare team for suggestions
- Use cuticle cream: avoid cutting or tearing cuticles and hang nails
- Wear gloves: especially when gardening, washing the dishes, or cleaning the house
- Avoid razor cuts: use an electric shaver whenever possible
- Clean all minor skin wounds: wash all minor skin cuts or irritations with soap and warm water to avoid infections and apply an antibiotic ointment to prevent infection
- Avoid skin products that contain alcohol: these products usually include perfumes and aftershave lotion and are especially drying to the skin
- Wear sun protection: use sunscreen with a sun protection factor (SPF) of 30 or more and wear long-sleeved clothing and wide-brimmed hats
Other Hormonal Issues
Your body is composed of other endocrine glands (those that secrete various hormones into your bloodstream), that may be affected by lymphoma treatment. Notably, the more common glands to be affected are the adrenal gland (secretes hormones related to stress) and the pituitary glands (secretes hormones related to growth, sexual health, reproductive health, thyroid function, water retention, and the day-night sleep patterns). If you notice anything abnormal in these areas of your physical function, discuss with your doctor.
The lacrimal glands secrete tears and lymphoma treatment has been known to contribute to eye issues.
Canadian Cancer Society. Skin changes with chemotherapy
Cancer.Net. Long-Term Side Effects of Cancer Treatment
Cancer.Net. Side Effects of Radiation Therapy
Canadian Cancer Society. Late and long-term effects of treatment
Lymphoma Association. Late effects of lymphoma treatment
National Cancer Institute. Facing Forward: Life After Cancer Treatment. Ways to Manage Physical Changes