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Managing Heartburn

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Hand-foot reaction (sometimes referred to as hand-foot syndrome) describes a common side effect of certain oral anticancer therapies (e.g., capecitabine, sunitinib, cabozantinib) affecting the palms of the hand and/or bottoms of the feet.

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HEARTBURN ORAL CHEMOTHERAPY EDUCATION Heartburn is often described as a burning sensation in the stomach or lower chest that rises toward the neck and occasionally to the back. If you are currently taking heartburn medications (prescription or over the counter), please check with your healthcare team about whether these can be continued, as they may interact with your anticancer medications. Common heartburn medications include the following: Proton pump inhibitors (PPI): omeprazole (Prilosec®), esomeprazole (Nexium®), lansoprazole (Prevacid®) H2 blockers: famotidine (Pepcid®), ranitidine (Zantac®) Antacids: calcium carbonate (Tums®), sodium bicarbonate (Alka Seltzer®) Heartburn may be managed without medications by doing the following: Avoiding certain foods, such as chocolate, spicy foods, high fat foods, carbonated beverages, and peppermint Avoiding tobacco, alcohol, and caffeine Losing weight if you have had recent weight gain or are overweight Elevating your head and upper body in bed if symptoms are at night or while lying down Avoiding wearing tight fitting clothes Your care team may recommend certain medications to help relieve or lessen your heartburn. Take these medications as directed by your care team. Your care team may also ask that you take your heartburn medication and your anticancer medication at separate times. If you are not able to stop taking your heartburn medications and you are taking an interacting medication, your care team may recommend that you take your anticancer medication with 8–12 oz of seltzer water/club soda, or some other acidic beverage, which may help with absorption of your anticancer medication. Call your care team if you experience any of the following symptoms: Severe or new heartburn symptoms Bloody or black tarry stools Persistent vomiting Unexplained weight loss Difficulty swallowing Additional instructions

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