Side effects of chemotherapy into a limb

The side effects of chemotherapy directly into a limb usually only affect the treated limb. They usually improve in the weeks after treatment finishes. Your healthcare team will discuss possible side effects with you. Tell them if you have any side effects as there are ways to help.

Common side effects are:

  • pain and stiffness
  • swelling and redness
  • blisters and peeling skin
  • risk of infection
  • hair loss
  • nail changes
  • numbness or tingling
  • permanent swelling of the treated limb (lymphoedema).

About six weeks after your procedure, you will see your specialist. It can take time for regional chemotherapy to shrink the tumours, so you may notice them getting smaller months after the procedure.

Possible side effects

The side effects usually only affect the treated limb. Your specialist will explain them to you and tell you what you can expect. Side effects usually get better after 6 to 8 weeks, but in some people they may last longer. Let your doctor or nurse know about any side effects or problems you’re having. There’s usually something they can do to make things easier.


Pain and stiffness

After the procedure you’re likely to have some pain in the limb, and your muscles and joints might be inflamed. This means you’ll feel stiff and uncomfortable when you’re moving about. You will be given painkillers to take regularly to control the pain. You’ll probably need to take them for several weeks.

Let your doctor or nurse know if you’re still in pain so that they can prescribe a stronger painkiller.


Swelling and redness

Your limb may become red and swollen. This usually starts about 48 hours after your treatment and is most noticeable after a week. The swelling gradually reduces over 4 to 6 weeks. The redness will gradually fade to brown and become lighter over the next few months. The skin colour of your limb should go back to normal after about six months. But some people are permanently left with a slight darkening of the skin.


Blisters and peeling skin

Rarely you can get blisters or peeling skin after treatment. This can be on the sole of your foot if you have treatment on your leg, or on the palm of your hand if you have treatment on your arm. This usually happens in the first two weeks after treatment but it will gradually heal.


Risk of infection

Very rarely small amounts of the chemotherapy drug may get into the rest of your body. This can temporarily reduce the number of white blood cells made by the bone marrow. White blood cells help to fight infection. If the number of white cells is low you’re more likely to get an infection.

Your white blood cells will gradually recover, but you may have to stay in hospital for a bit longer until they do. You’ll have regular blood tests to check this.


Hair loss

You’ll lose the hair on the leg or arm that’s been treated, but this will grow back again. Very occasionally, people also have a little thinning of the hair on their head but this is not usually noticeable.


Nail changes

A few weeks after treatment, you may notice changes to your nails on the treated limb. They may develop lines or sometimes a nail may come off. If this happens, a new nail will grow in its place.


Numbness or tingling

You may get numbness or tingling after treatment. This will be in your foot if you have treatment on your leg, or in your hand if you have treatment on your arm. It is due to the effect of the chemotherapy drugs on your nerves and is called peripheral neuropathy.

Tell your doctor if this happens. It usually improves slowly over a few months but is sometimes permanent.


Lymphoedema

A possible long-term side effect of regional chemotherapy is a permanent swelling of the treated limb, known as lymphoedema.


Follow-up

You’ll usually be seen about six weeks after the procedure. After this you’ll be seen every few months, unless you live far from the hospital where you had treatment. In this situation you’ll be seen by your own cancer specialist, so that you don’t have to travel far.

It can take time for regional chemotherapy to shrink the tumours, and you may still notice them getting smaller months after the procedure.


Your feelings

When cancer has come back, it’s usual to have times when you find your emotions difficult to cope with. Coping with any physical changes caused by the cancer or its treatment can also be hard. Everyone copes differently with their emotions, and there’s no right or wrong way. It’s important to get the support you need. Talking to family and friends about how you’re feeling often helps. You can also talk to your doctor or nurse for support. Some people may prefer to talk to a counsellor. Your doctor or nurse can give you more advice about this.

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