Possible side effects

Your cancer doctor or nurse will talk to you about the side effects you may get. They’ll explain how they can be controlled and give you advice. Tell them about any side effects you have.

You may get some of the following:

  • Increased risk of infection, becoming anaemic (low red blood cells) or unexplained bleeding if your platelet cells are low.
  • Tiredness.
  • Feeling sick – you’ll be given drugs to control this.
  • Hair loss is common with BEP chemotherapy.
  • Sore mouth – your nurse will explain how to take care of your mouth.
  • Changes to the lungs or to your hearing – certain drugs may cause this.
  • Numbness or tingling in the hands or feet.
  • Changes in the way your kidneys work – you’ll have regular blood tests to check this.

Chemotherapy may make you infertile but this is usually temporary. Your doctor will advise you to store sperm before treatment starts. You’ll also be advised to use effective contraception during chemotherapy and for a few months after. This is because the drugs may harm a developing baby.

Side effects

Chemotherapy drugs may cause unpleasant side effects, but these can usually be well controlled with medicines and will usually go away once treatment has finished. Not all drugs cause the same side effects and some people may have very few. You can talk to your doctor or nurse about what to expect from the treatment that’s planned for you.


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.

We have information about avoiding infections.


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.

The week after chemotherapy wasn’t the nicest week of my life, but I was over the worst of it after 3-4 days. Think of it as a bad hangover with a touch of cold thrown in.

Rob, after chemotherapy treatment


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.


Sore mouth

Chemotherapy can cause mouth problems such as a sore mouth, mouth ulcers or infection. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Your chemotherapy nurse will explain how to look after your mouth to reduce the risk of problems. They can give you mouthwashes, medicines and gels to help.

We have some useful tips on coping with a sore mouth during chemotherapy.


Loss of appetite

Some people lose their appetite while they’re having chemotherapy. This can be mild and may only last a few days. If you don’t feel like eating during treatment, you could try replacing some meals with nutritious drinks or a soft diet. If it doesn’t improve, you can ask to see a dietitian.


Losing your hair

Some chemotherapy drugs cause all or most of your hair to fall out, which can be very upsetting. There are lots of ways you can cover up, if you choose to, such as using wigs, hats, turbans, scarves or bandanas.

Hair loss usually starts within a few weeks of starting chemotherapy or, very occasionally, within a few days. You usually notice your hair coming out more when you brush, comb or wash it, and you may find hair on your pillow in the mornings.

You may lose underarm, body and pubic hair as well. Some chemotherapy drugs also make the eyelashes and eyebrows fall out.

Your hair will usually grow back over a few months once you’ve finished treatment. It will be very fine at first and may be a slightly different colour or texture than before. You’ll probably have a full head of hair after 3–6 months. To begin with, you should try to look after the condition of your hair.

Helpful hints – coping with hair loss

  • Cutting hair short before chemotherapy can stop the weight of long hair pulling on the scalp, which can make hair fall out earlier.
  • Wearing a hairnet, soft cap or turban at night stops your hair becoming tangled and helps to collect loose hair.
  • You can ask your own hairdresser to cut and style your wig for you.

In terms of hair loss, the speed at which it came out was certainly a surprise. I expected a gradual loss over a few weeks, but once it started, it fell out in clumps.

PJ, affected by hair loss


Changes to the lungs

Bleomycin can cause some changes to the lungs. This can happen during treatment or afterwards. Your doctor can tell you more about this side effect.

Tell your doctor if you smoke, or if you notice any wheezing, coughing or breathlessness. You’ll probably have a chest x-ray before starting bleomycin treatment, and you may have regular chest x-rays during your treatment.

If you need an operation after having bleomycin, always tell the anaesthetist that you’ve had bleomycin treatment.

If sub-aqua diving is an activity you’re involved in, you may need to be careful doing it for a while after treatment with bleomycin, so talk to your doctor about this.


Changes to your hearing

Cisplatin may affect your hearing. You may have ringing in the ears (tinnitus) and 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. Tinnitus usually improves when treatment ends.

Tell your cancer doctor or nurse if you notice any hearing loss or tinnitus. They will monitor this closely and arrange hearing tests if necessary.


Numbness or tingling in the hands or feet

Cisplatin can affect the nerves in your hands or feet. This can cause tingling, numbness, or muscle weakness called peripheral neuropathy. You may notice that you have difficulty fastening buttons or doing similar fiddly tasks. Your hands and feet may also become more sensitive to the cold. It’s important to report your symptoms as they may be controlled by slightly lowering the dose of the drug.

This side effect usually improves slowly, a few months after the treatment has finished. Sometimes symptoms can continue – talk to your doctor if this happens.

We have more information about managing peripheral neuropathy.


Changes in how your kidneys work

Some chemotherapy drugs can affect how well your kidneys work (kidney function).

Before each treatment your kidneys will be checked with a blood test. You’ll be given fluid through a drip (infusion) before and after the treatment to keep your kidneys working normally. The nurses may ask you to drink plenty of fluid and to record what you drink and the amount of urine you pass.


Increased risk of blood clots

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 be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information about blood clots.


Contraception

It’s not advisable to father a child while having any of the chemotherapy drugs used to treat testicular cancer, as the drugs may harm the developing baby. It’s important to use an effective barrier method of contraception. Condoms are usually recommended during your treatment and for at least a few months afterwards. You can discuss this with your doctor or nurse.

It’s also safest to either avoid sex or use a condom for about 48 hours after chemotherapy treatment, to protect your partner. This is because it’s not known whether chemotherapy drugs are present in the semen.


Fertility

Chemotherapy for men with testicular cancer often causes infertility during treatment and for a time after. This is usually temporary, but your doctor will advise that you consider storing sperm before having treatment. The rate at which the sperm count recovers varies from person to person but it generally returns to normal from around 18 months after treatment. Some men with testicular cancer have a low sperm count before they start treatment. Treatment with chemotherapy can sometimes improve sperm production, once the sperm count has recovered after treatment. In men having high-dose chemotherapy, the risk of infertility is much higher and infertility is often permanent.

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.