Side Effects of Chemotherapy

The side effects of chemotherapy happen because chemo drugs are made to kill fast growing cells and can have some effects on all cells. The cancer drugs travel throughout the body so they can contact all cells, even normal, healthy cells. The normal cells most likely to be damaged are those that divide rapidly, such as:

Likely damaged cells

• bone marrow/blood cells
• hair follicle cells
• digestive tract cells
• reproductive tract cells

Many of the side effects of chemotherapy happen when these normal, healthy cells get damaged by the cancer treatments.

You are probably concerned about what side effects of chemotherapy will occur during your treatment. The side effects are different for:

• different people
• different drugs
• different drug doses

You might not be able to tolerate one particular drug, but do quite well on another. A lot depends on finding the right dose that will be effective against the cancer but still be tolerable for you.

Fortunately, doctors now have many ways to reduce and even prevent the side effects of chemotherapy. Also encouraging is that newer chemo drugs cause fewer and milder side effects.

Rules to Remember About Side Effects

• Every person doesn't get every side effect, and some people get few, if any
• The severity of side effects varies greatly from person to person - be sure to talk to your doctor and nurse about it
• Which side effects are most likely to occur with your chemotherapy
• How long they might last
• How serious they might be
• When you should seek medical attention for them
• Your doctor may prescribe medications to prevent some side effects before they appear
• Many people have no long-term problems from chemotherapy, and although side effects can be unpleasant, they are a sign that the cancer cells are being attacked by the chemo treatment

What are the side effects?

Some of the more common side effects include:

Feeling tired and lacking energy

This is the most common side effect of chemotherapy. Fatigue can include feeling exhausted, tired, sleepy, drowsy, confused or impatient. You may also have trouble concentrating and lose your appetite.

What can you do?

• You may have to make some adjustment in work and family responsibilities
• Try to balance activity and rest
• Try to maintain your everyday activities as much as possible - it can be very beneficial to both your physical and emotional recovery

If you aren't sleeping well, tell your doctor or nurse. They may be able to help. But don't take any pills or medications unless they say you can. Some pills and medications may react badly with your chemotherapy.

Feeling sick or vomiting

Many people used to have nausea and vomiting with chemotherapy. However, new medications can minimize or prevent these side effects in most people. Some patients have delayed vomiting (vomiting up to 24 hours after treatment) or anticipatory vomiting (vomiting before the next treatment after a bad episode with the first treatment). Talk to your doctor if you have either of these side effects.

Constipation or diarrhea

Some chemotherapy drugs, pain relief medicines and anti-nausea drugs can affect the lining of your digestive system and cause constipation or diarrhea. Let your doctor or nurse know if you experience constipation-your medication may be changed or other medication given to relieve the constipation. Diarrhea is often treated first with medication at home. If the diarrhea is severe, it may cause dehydration and you may need to be admitted to hospital.

Mouth sores

Some chemotherapy drugs can cause mouth sores such as ulcers or infections. If you notice any change in your mouth or throat, such as sores, ulcers or thickened saliva, or find it difficult to swallow, contact your doctor. Discuss any dental problems with your doctor. If you need any dental work, tell your dentist you are having chemotherapy.

Loss of Hair

In most cases, drugs used for treating colorectal cancer do not result in complete hair loss. There may be some hair thinning. Currently, there is no known prevention for hair loss due to chemotherapy, but sometimes the hair grows back naturally over time.

Itchy skin and other skin problems

Your skin may darken, peel or become dry and itchy when you are having chemotherapy. It may also be more sensitive to the sun. Protect your skin from the sun - especially between 10am and 3pm--by wearing a high-protection sunscreen (SPF 30+), hat and protective clothing. This applies to everyone, but it is even more important when you are having chemotherapy.

Nerve and muscle effects

Some drugs can cause tingling and loss of sensation in the fingers and/or toes, and muscle weakness in the legs. If this happens, tell your doctor or nurse before your next treatment. Your treatment may need to be changed or the problem carefully monitored.

Change in hearing

Some chemotherapy drugs can cause loss of the ability to hear high-pitched sound. They can also cause a continuous noise in the ears known as tinnitus. Let you doctor know if you notice any change in your hearing.

Getting Infections More Easily

The amount of white blood cells may be reduced during chemotherapy. This can make colds and flu harder to shake off. Also scratches and cuts may get infected easily or take longer to heal. See your doctor if you are unwell: don't wait out a cold when you're having chemotherapy. Sometimes doctors recommend taking antibiotics as a precaution against infection. If you are having chemotherapy in winter, check with your doctor about getting a flu shot.

We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. All information in this website is meant to be helpful and educational, but it is not a substitute for medical advice about your personal condition.

Written by Deborah Theres - 3/12/09

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