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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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Below you'll find information about the side effects that you may experience after chemotherapy treatment|.
Chemotherapy can reduce the number of blood cells made by the bone marrow. Bone marrow is a spongy material that fills the bones and produces the cells (called stem cells), which develop into three different types of blood cells:
If the number of white cells in your blood is low you’re more likely to get infections as there are fewer white cells to fight off bacteria. The main white cells which fight bacteria are called neutrophils. When they are low, you are neutropenic.
If your temperature goes up or you suddenly feel unwell, even with a normal temperature, contact your doctor or the hospital straight away. Most hospitals consider a temperature above 38°C (100.4°F) to be high, although some hospitals use a lower or higher temperature. The doctors and nurses will let you know when you need to contact the hospital.
Regular blood tests will show the number of white cells in your blood. If you get an infection when your white blood cell level is low, you’ll need to have antibiotics. These may be given as an injection at hospital or you may be given antibiotic capsules or tablets to take at home. You may need to be admitted to hospital for the antibiotic treatment.
Blood cells are usually at their lowest level (known as the ‘nadir’) 7-14 days after the chemotherapy treatment, although this will vary depending on the type of chemotherapy you are having.
A drug called G-CSF| is sometimes used after chemotherapy to help your bone marrow make white blood cells more quickly and so reduce the risk of infection. G-CSF is a protein made naturally in the body that can now be produced in the laboratory.
Red blood cells contain haemoglobin, which carries oxygen around the body. If there are fewer red blood cells in your bloodstream because of the chemotherapy, the level of haemoglobin in your blood will be low (anaemia). This means you may feel very tired| and lethargic. You may also feel breathless|, as there is less oxygen being carried around your body. People with anaemia can also feel dizzy and light-headed, and have aching muscles and joints.
Blood tests will measure your haemoglobin. If it's low you may be offered a blood transfusion|. The extra red cells in the transfusion will pick up oxygen from your lungs and take it around the body. You will feel more energetic and any breathlessness will be eased.
Platelets are cells which are important in blood clotting. If you have a low number of platelets in your blood you may bruise very easily, have nosebleeds or bleed more heavily than usual from minor cuts or grazes.
If you develop any unexplained bruising or bleeding, such as nosebleeds, blood spots, rashes on the skin (petechiae) or bleeding gums, you should contact your doctor or the hospital straight away. You may have to be admitted to hospital for a platelet transfusion|. This is given by drip (infusion). The platelets will start working immediately to prevent bruising and bleeding.
Your regular blood tests will count the number of platelets in your blood. If your platelets are low, take care to avoid injury. If you're gardening, for example, wear thick gloves. You can use a soft toothbrush to clean your teeth to reduce the risk of scratching your gums and making them bleed.
Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain.
Blood clots can be very serious so it’s important to tell your doctor straight away if you have any of these symptoms. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information about blood clots.
Some drugs don't make your hair fall out|. With others, hair loss is so slight it's hardly noticeable. Some chemotherapy can damage the hair and make it brittle. If this happens, the hair may break off near the scalp a week or two after the chemotherapy has started. Some chemotherapy drugs can make all of your hair fall out, which can be very upsetting.
The amount of hair that falls out, if any, depends on the type of drug or combination of drugs used, the dose given and how the drug affects you personally.
If your hair falls out, it usually starts within a few weeks of beginning treatment, although very occasionally it can start within a few days. Underarm, body and pubic hair may be lost as well. Some drugs also make the eyelashes and eyebrows fall out. If your hair does fall out due to the chemotherapy, it usuall grows back over a few months once you've finished your treatment.
You’re entitled to a free wig| if you are an inpatient when your wig is fitted, or if you or your partner is claiming the Guarantee Credit part of Pension Credit, income-based Jobseeker’s Allowance, Disability Working Allowance or Income related Employment and Support Allowance. Children and young adults up to the age of 19 in full-time education are also entitled to free wigs following cancer treatment. If you’re not entitled to a free wig you can get one from the NHS at a subsidised price.
Some people having certain types of chemotherapy may be able to prevent hair loss by using a 'cold cap'. This works by temporarily reducing the blood flow and the amount of the drug reaching the scalp. Unfortunately, the cold cap only works with certain drugs and does not always prevent hair loss. You can ask your doctor or chemotherapy nurse whether one would be useful for you. See our section on scalp cooling| .
Your digestive system can be affected in a number of ways by chemotherapy.
Some chemotherapy drugs can make you feel sick (nausea), or actually be sick (vomit). |Not all chemotherapy drugs cause sickness and many people have no sickness at all. There are very effective treatments to prevent and control it. If you do feel sick, it may start from a few minutes to several hours after the chemotherapy is given, depending on the drugs you’re having. How long the sickness lasts varies.
Your doctor will prescribe anti-sickness drugs (anti-emetics) to help. If your chemotherapy is known to cause sickness, you’ll be given anti-sickness drugs by injection or tablets before your chemotherapy. You’ll also be given tablets to take at home afterwards. It’s important to take the anti-sickness medicines as advised by your doctor or chemotherapy nurse as it’s easier to prevent sickness than to treat it once it’s started.
Steroids| can be given to reduce nausea and vomiting. They often give a sense of well-being, as well as helping to reduce feelings of sickness and loss of appetite. If the chemotherapy you’re having doesn’t usually cause sickness, you’ll still be given anti-sickness medicine that you can take only if you need to.
Some chemotherapy drugs can affect the lining of the digestive system and this may cause diarrhoea| for a few days.
Some chemotherapy and anti-sickness drugs can cause constipation|. If you have any diarrhoea or constipation, or are worried about the effects of chemotherapy on your digestive system, you can talk to your doctor or chemotherapy nurse. You can also ask to see a dietitian. If you have more than 4-6 episodes of diarrhoea a day, contact your nurse or doctor at the hospital.
Some chemotherapy drugs can affect your appetite. Our section on eating well| has information to help if your appetite is low.
Chemotherapy can affect your sense of taste; food may taste more salty, bitter or metallic. Your normal sense of taste will come back after the chemotherapy treatment finishes.
Some drugs can cause a sore mouth| , which may lead to mouth ulcers. If this happens it's usually about 5-10 days after the drugs are given and will clear up within 3-4 weeks. You can be given mouthwashes to help.
Mouth ulcers can become infected. Your doctor or specialist nurse can give you treatment to help prevent or clear any infection. Cleaning your teeth regularly and gently with a soft toothbrush will help to keep your mouth clean.
It may be helpful to see your dentist before you start your treatment. Dental treatment sometimes needs to be delayed when you're having chemotherapy because of the risk of infection and a sore mouth.
If your mouth is very painful, gels, creams or pastes can be used to reduce the soreness. Your cancer specialist can tell you about these.
Some people feel very tired during chemotherapy. This is normal. Feeling tired all the time can be very frustrating and difficult to cope with, especially for people who normally have a lot of energy. The hardest time may be towards the end of the course of chemotherapy.
Try to cut down on any unnecessary activities and ask your family or friends to help you with jobs such as shopping and housework. Give yourself time to rest and, if you're still working, see if it's possible to reduce your hours while you are having treatment. If you're having problems sleeping, your GP may be able to prescribe sleeping tablets for you.
The tiredness will ease once the chemotherapy has ended, but it can often be three or four months until you feel back to normal. Some people find that they still feel tired a year or so afterwards.
Our section on coping with fatigue| gives helpful tips on dealing with tiredness during chemotherapy treatment.
Some drugs can affect your skin. It may become dry or slightly discoloured, which may be made worse by swimming, especially if there is chlorine in the water. Tell your doctor if you develop any rashes. Your skin may also be more sensitive to sunlight, during and after the treatment.
Chemotherapy may make your nails grow more slowly or become brittle or flaky. You may notice white lines appearing across them. False nails or nail varnish may disguise these. Sometimes the shape or colour of your nails may change.
Some chemotherapy drugs can affect the nerves in your hands or feet. This can cause tingling or numbness, or a sensation of pins and needles. This is called peripheral neuropathy|.
It's important to let your doctor know if this happens. They may need to change the chemotherapy drug if it gets worse. Usually, it gradually gets better when the chemotherapy treatment ends. Sometimes damage to the nerves can be permanent.
Some drugs can make you feel anxious, restless, dizzy, sleepy or have headaches. Some people also find it hard to concentrate. If you have any of these effects let your doctor know, as medicines can often be given to help. Our cancer support specialists| can give you advice on how to cope with these effects.
Some chemotherapy drugs can affect how well your kidneys work (kidney function). In order to prevent this, fluids may be given by drip into your vein for several hours before you have the treatment.
Your kidney function will be carefully checked by blood tests before each treatment. The nurses may ask you to drink plenty of fluid and it's important to do this. They may also ask you to measure the amount of urine you pass.
Some chemotherapy drugs can affect your hearing. You may have ringing in the ears (tinnitus) and you may lose the ability to hear some high-pitched sounds. Very occasionally your sense of balance may be affected. Any hearing loss, and balance changes if they occur, may be permanent. However, tinnitus usually improves when treatment ends. Tell your doctor if you notice any loss of hearing or tinnitus.
Some chemotherapy drugs can increase the risk of developing particular types of cancer| or leukaemia| later in life. This is rare, and your doctors will weigh up the small increase in risk of cancer or leukaemia, against the benefit of the chemotherapy in treating your current cancer. If the chemotherapy you are having could cause a second cancer, your doctors will discuss this with you.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.