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Chemotherapy and Diarrhea

Summary & Participants

Diarrhea is a well known side effect of certain chemotherapies, and while for some patients it's a minor nuisance, for others it may become a life-threatening problem. Fortunately, diarrhea can be controlled with conventional treatments as well as newer hormonal drugs, so it's important for patients to let their doctors know about the problem right away.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ANNOUNCER: For many cancer patients, diarrhea is one of the most serious risks of certain chemotherapy regimens. For some people it's a daily nuisance. For others a life-threatening problem. Fortunately, diarrhea can be controlled with conventional treatments as well as newer hormonal agents, so it's important for patients to let their doctors know about the problem right away.

AL B. BENSON III, MD, FACP: When a person experiences diarrhea, what's critically important is that the individual notify the nurse or physician immediately to discuss the significance of the diarrhea. And what we need to know is if the patient is having very significant diarrhea with a lot of fluid loss, if the individual is drinking fluids, if the person can eat, if there's any fever or chills. We have to make sure that there aren't contributing causes, such as use of certain food substances. For example, if a person has diarrhea, it can be aggravated by dairy products, high fat foods or foods that are high roughage foods. This assessment needs to occur fairly quickly.

ANNOUNCER: Diarrhea can have many causes in cancer patients, including the cancer itself. But chemotherapy is especially threatening, since it works by destroying rapidly dividing cells, which include cancer but also normal cells found in the intestinal walls.

AL B. BENSON III, MD, FACP: When this happens, the normal mechanism of the intestinal tract is severely affected. Normally the intestinal tract is helping us to absorb water, other liquids and foods, but if the lining of the intestine is affected, that process cannot occur, and so what happens is that there is excessive water in the intestinal tract, and that leaves the body as very loose stool or diarrhea.

ANNOUNCER: Many types of chemotherapy can cause diarrhea, but some regimens are worse than others, particularly those used to treat gastrointestinal cancers.

AL B. BENSON III, MD, FACP: These chemotherapy drugs are widely used for a variety of cancers. The interest in chemotherapy-related diarrhea stemmed from experience with a combination of 5-fluorouracil and leucovorin, which was developed initially for the treatment of colon cancer, but it is also used for other GI tract malignancies. Also, with the development of the drug irinotecan, also used for colon cancer, it was clear that diarrhea was a significant problem and needed early and prompt intervention.

ROBERT CATALANO, PHARM.D: The agents such as 5-fluorouracil and irinotecan are the ones that are most effective for these type of cancers, but unfortunately have the highest incidence of toxicity to these organs.

ANNOUNCER: The main health risk associated with severe diarrhea is dehydration, which can be life-threatening if left untreated.

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