Possible side effects of chemotherapy for head and neck cancer

Chemotherapy for head and neck cancer can cause different side effects, depending on the drugs you are given.

Most side effects can be reduced or managed. Your doctor or nurse will talk to you about this and tell you the most likely side effects. Side effects usually improve gradually when treatment is over. The most common ones include:

  • increased risk of infection
  • anaemia (reduced number of red blood cells)
  • tiredness
  • feeling sick
  • sore mouth
  • hair loss or hair thinning
  • tingling in your hands or feet
  • changes to your hearing.

If you have a temperature or you suddenly feel unwell, contact the hospital immediately. For example, if you have any symptoms of an infection, such as a cold, sore throat, cough, passing urine often, diarrhoea or feeling shivery and shaky.

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. 

If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. 

Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine often.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. 

You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.

A photo of Stuart talking about neutropenic sepsis

Neutropenic sepsis

Stuart talks about he how coped with neutropenic sepsis, an infection which can be a side effect of chemotherapy.

About our cancer information videos

Neutropenic sepsis

Stuart talks about he how coped with neutropenic sepsis, an infection which can be a side effect of chemotherapy.

About our cancer information videos


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 (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.


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.


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.


Numbness or tingling in the hands or feet

If you have treatment with cisplatin, paclitaxel or docetaxel, you may have changes in sensation in your hands and feet. This is caused by the effect these drugs can have on nerves. It is called peripheral neuropathy. You may also notice you have difficulty doing up buttons or similar fiddly tasks.

Tell your doctor if you notice these symptoms. They may need to lower your chemotherapy dose slightly or change the drugs.

Changes in sensation can continue to get worse for 2 to 3 months after stopping chemotherapy, before slowly improving. It can take up to 2 years for symptoms to improve. Sometimes changes are permanent.

We have more information about peripheral neuropathy.


Changes in hearing

If you have treatment with cisplatin, you may have changes in your hearing. You may have ringing in the ears (tinnitus). Or you may lose the ability to hear some high-pitched sounds. Hearing loss can be more severe with higher doses and longer courses of treatment. Very rarely, treatment may affect your sense of balance.

Any hearing loss may be permanent. However, tinnitus usually improves when treatment finishes. 

Tell your doctor if you notice any loss of hearing or tinnitus. They may suggest changing the dose of your chemotherapy.


Tiredness (fatigue)

Chemotherapy affects people in different ways. Tiredness can build up over a course of treatment. And if you have 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. Ask your family or friends to help with jobs such as shopping and housework. Gentle exercise can sometimes help with the symptoms of fatigue.


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.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.


Changes in the way the kidneys work

Cisplatin can affect how your kidneys work. You will have blood tests to check how well your kidneys are working before and during treatment. 

Your nurse will ask you to drink plenty of fluid. This is to protect your kidneys. Tell them if you are not peeing (passing urine) much.

Back to Side effects of chemotherapy

Late effects of chemotherapy

Late effects are side effects you still have six months after chemotherapy, or side effects that begin years later.