Each person’s reaction to chemotherapy is different. Some people have very few side effects while others may experience more. The side effects described here will not affect everyone who is having this treatment.
We have outlined the most common side effects but have not included those that are rare and unlikely to affect you. If you do notice any effects that are not listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
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 37.5°C (99.5°F) or over 38°C (100.4°F) 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), or 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.
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.
Anaemia (low 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.
Feeling sick (nausea)
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 take.
Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk. Some people find sucking on ice soothing. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections.
Occasionally during treatment, you may get a strange, metallic or bitter taste in your mouth. Some people find sucking on a strongly flavoured sweet or mint helps to disguise this. You may also notice that food tastes different, but your normal taste will usually come back after treatment finishes.
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.
Chemotherapy affects people in different ways. Tiredness can build up over a course of treatment, and if you’ve had a lot of chemotherapy or a combination of treatments, it can last for several months or more after your treatment has finished.
Try to cut down on any unnecessary activities and ask your friends or family to help with jobs such as shopping and housework. Gentle exercise can sometimes help with the symptoms of fatigue.