Possible side effects of chemotherapy

Chemotherapy treatment can cause different side effects. These vary depending on the drugs you have. If you’re having a single drug, you may not have as many side effects as someone having a combination of drugs. People having high doses of chemotherapy may have more complex side effects.

Some side effects are more common than others but you won’t have them all. The main areas of your body that may be affected by chemotherapy are areas where new cells are being quickly made and replaced. This includes the:

  • bone marrow (where blood cells are made)
  • hair follicles (where hair grows from)
  • digestive system
  • lining of your mouth.

Your cancer doctor and nurse specialist will explain the side effects that your chemotherapy is likely to cause. Most side effects can be reduced and controlled with drugs. Your doctor or nurse can tell you how to manage them.

Most side effects stop or gradually go away when chemotherapy is over. Although the side effects can be unpleasant, the benefits of chemotherapy usually outweigh this.

Possible side effects

The side effects you get will depend on the chemotherapy drugs you’re having. Different drugs cause different side effects. You may get some of the side effects mentioned, but you are very unlikely to get all of them.

Some side effects are mild and easily treated. Your doctor, nurse or pharmacist may prescribe drugs to help control them. It is very important to take the drugs exactly as instructed. This means they will be more likely to work for you. Other side effects can be harder to manage but can often be reduced or helped in some way. Your nurse will give you advice about this.

Most side effects stop or gradually go away when chemotherapy is over. Although the side effects can be unpleasant, the benefits of chemotherapy usually outweigh this.

If you’re having a single drug, you may not have as many side effects as someone having a combination of drugs. People having high doses of chemotherapy may have more complex side effects.

Your cancer doctor and nurse specialist will explain the side effects that your chemotherapy is likely to cause. The main areas of your body that may be affected by chemotherapy are areas where new cells are being quickly made and replaced. This includes the:

  • bone marrow (where blood cells are made)
  • hair follicles (where hair grows from)
  • digestive system
  • lining of your mouth.


Your bone marrow and blood

Chemotherapy can reduce the number of blood cells made by the bone marrow. Bone marrow is a spongy material that’s found in the middle of your bones. It makes special cells called stem cells which develop into the different types of blood cells:

  • white blood cells, which fight and prevent infection
  • red blood cells, which carry oxygen to all parts of the body
  • platelets, which help the blood to clot and prevent bleeding and bruising.

You’ll have regular blood samples taken to check the number of these cells in your blood (called a full blood count).


Risk of infection

Chemotherapy can reduce the number of white blood cells, which help fight infection. If the number of your white blood cells is low you'll be more prone to infections. A low white blood cell count is called neutropenia.

Always contact the hospital immediately on the 24-hour contact number you've been given and speak to a nurse or doctor if:

  • you develop a high temperature – this may be over 37.5ºC (99.5ºF) or over 38ºC (100.4ºF) depending on the hospital's policy. Follow the advice that you have been given by your chemotherapy team
  • you suddenly feel unwell, even with a normal temperature
  • you feel shivery and shaky
  • you have any symptoms of an infection such as a cold, sore throat, cough, passing urine frequently (urine infection), diarrhoea.

If necessary, you'll be given antibiotics to treat any infection. You'll have a blood test before each cycle of chemotherapy to make sure your white blood cells have recovered. Occasionally, your treatment may need to be delayed if the number of your white blood cells is still low.


Anaemia (reduced number of red blood cells)

If chemotherapy reduces the number of red blood cells in your blood, you may become very tired and feel you have no energy. You may also become breathless and feel dizzy and light-headed. These symptoms happen because the red blood cells contain haemoglobin, which carries oxygen around the body.

If your haemoglobin is low you may be offered a blood transfusion. You’ll feel more energetic and any breathlessness will be eased.


Bruising and bleeding

Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you develop any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin, contact your doctor or the hospital straight away.


Feeling sick or being sick

Some chemotherapy drugs can make you feel sick (nauseated) or possibly be sick (vomit). Your cancer specialist will prescribe anti-sickness (anti-emetic) drugs to prevent this. Let your doctor or nurse know if your anti-sickness drugs are not helping, as there are several different types you can try. We have more information about controlling nausea and vomiting.


Tiredness (fatigue)

You’re likely to become tired and have to take things slowly. Try to pace yourself and save your energy for things that you want to do or that need doing. Balance rest with some physical activity – even going for short walks will help increase your energy levels. We have helpful tips on coping with tiredness.


Hair loss

Some chemotherapy drugs may cause hair loss. Some people may have complete hair loss including eyelashes and eyebrows. Others may only experience partial hair loss or thinning. It depends on what chemotherapy drugs you are having (your doctor or nurse can tell you more about what to expect). If you do experience hair loss your hair should start to grow back within about 3–6 months of the end of treatment. It may grow back straighter, curlier, finer, or a slightly different colour than it was before. Your nurse can give you advice about coping with hair loss and how to look after your scalp.

Some chemotherapy departments may offer scalp cooling to reduce hair loss during chemotherapy. We have more information about coping with hair loss.


Numbness or tingling in hands or feet

These symptoms are caused by the effect of carboplatin and paclitaxel on nerves. It’s called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks.

Tell your doctor if you notice any changes in sensation in your hands or feet. They may need to slightly lower the dose of the drug to control the symptoms.

The symptoms usually improve slowly after treatment finishes but in some people they may never go away. Talk to your doctor if the symptoms don’t improve.


Muscle and/or joint pain

Paclitaxel may cause pain in your muscles or joints for a few days after you have the treatment. Tell your doctor if this happens so they can prescribe painkillers. Let them know if the pain does not get better.


Sore mouth and loss of appetite

Some chemotherapy drugs can make your mouth sore and cause small mouth ulcers. Regular mouthwashes are important, and your nurse will show you how to do these properly. If you don’t feel like eating, you could try replacing some meals with nutritious drinks or eating foods that are soft and moist.

We have more information to help you if you’re coping with mouth problems and eating problems.


Early menopause

Chemotherapy can also bring on the menopause. This can be difficult, particularly if you are already coping with cancer. We have information about menopause to help support you.

Back to Side effects of chemotherapy

Chemo brain

Chemo brain describes changes in memory, concentration and the ability to think clearly. These changes can sometimes happen during or after cancer treatment.