Life During Treatment

During your treatment, you will likely experience treatment-related side effects. 

The following side effects can worsen during the course of treatment and can negatively impact your quality of life: 

  • Fatigue
  • Changes in your speech (e.g., hoarseness, loss of voice) 
  • Pain 
  • Changes in hearing; over 85 percent of patients with head and neck cancer who had chemoradiation therapy experienced hearing loss
  • Decreased salivation, which often increases dental caries and other dental problems 
  • Problems swallowing (e.g., delayed swallowing or other complications) 
  • Decreased ability to eat


Let’s look more closely at a few of the side effects that have the most profound impact on quality of life and strategies that can be implemented to manage them. In addition, we will briefly review policies to obtain time off from work for medical treatment if you need time off to receive treatment and/or manage side effects. 

Changes in your level of fatigue 

When patients were asked which cancer-related symptoms had the most impact on their quality of life, 60 percent of patients ranked fatigue as having the strongest impact.

You may experience fatigue as you are undergoing treatment; this is one of the most prevalent symptoms among patients who have cancer. Approximately 70 to 80 percent of patients who underwent radiation therapy, chemotherapy or a combination of these therapies (chemoradiation therapy), experienced fatigue. Moreover, cancer-related fatigue can be so severe that 32 percent of patients could not do their daily routines. It may be harder for you to plan and commit to other activities. 

There are strategies that you can do to try to decrease your cancer-related fatigue. Be aware that fatigue can have many different underlying causes, so you may need to consult with a health care professional to evaluate, identify and treat the underlying causes. 

  • Assess and report the level of fatigue daily. You may want to consider using a diary or worksheet to monitor fatigue. Report the severity of fatigue (none, minor, moderate, advanced) that you are experiencing and other related observations that you may have, such as the times of the day when you may have more or less fatigue. 
  • Plan and schedule routines or activities during the time of day when you are likely to have the least fatigue. 
  • You may consider entrusting a caregiver to perform some daily tasks for you. 
  • Initiate and maintain a daily exercise program. In a study evaluating exercise among patients with head and neck cancer, over 80 percent of patients reported that they did not participate in moderate or vigorous exercise.Even low impact exercise, such as walking daily, has been found to reduce fatigue, improve quality of life and enable patients to perform activities of daily living.
  • Evaluate your psychosocial needs with a counselor or psychologist and consider initiating treatments, such as regular counseling or therapy. 
  • Consider using medications. Your health care professional will evaluate underlying causes of fatigue. Some patients who experience cancer-related fatigue, however, develop anemia as a side effect to chemotherapy treatment. Your health care professional will then decide if a medication would be helpful. Erythropoietin, for example, is used to treat anemia and also reduces cancer-related fatigue. If anemia is not contributing to your fatigue, your health care professional may consider using other stimulants to improve your level of energy. 
I think once it started, I felt better because I felt like not only was he seeing doctors every day, but we were doing something. There was a light at the end of the tunnel. Bonnie S. (wife of a tonsil cancer survivor)