The side effects of chemotherapy will vary depending on the specific medications used. Different individuals may respond differently to the same treatment.
Some people may experience all of the known side effects of a particular chemotherapy treatment, while others may only experience a few. Side effects may also vary in severity in different individuals.
Whether mild or severe, most side effects can be treated with medication. Your doctor or nurse will be the best resource for information on the specific side effects related to your treatment.
Keep in mind that chemotherapy works systemically. Chemotherapy is intended to damage dividing cells, but the medication can’t tell the difference between normal cells and cancer cells. That’s why the unintended consequence of chemotherapy is damage to healthy cells — and the side effects that go along with it.
Most chemotherapy side effects are reversible and short-term. Normal tissues can repair themselves and correct most of the damage. The table below provides a general summary of the most common side effects from chemotherapy.
|Side effect type or location||Symptom(s)|
|hair, skin, and nails||– head and body hair loss|
– skin sensitivity and dryness
– brittle nails
|low red blood cell count, or anemia||– breathless and looking pale|
– tiredness and weakness
– low energy
|abdominal, gastrointestinal system, whole body||– nausea|
|brain/mind||– changes in memory, concentration, and the way you think|
– also called “chemo brain” or “chemo fog”
|drop in blood cells, or low platelet count||– bruising easily|
– nosebleeds or bleeding gums when brushing teeth
|nerves||– numbness or tingling in hands and feet|
|low white blood cell count in bone marrow||– increased risk of infections|
|ulcers and sores in the mouth||– loss of appetite|
– changes in taste
It depends on your specific chemotherapy regimen. For example, side effects can vary based on the type of medications and dose of your treatment.
For some people, nausea is the first side effect they experience. Nausea may be noticed as early as a few days after the first dose of chemotherapy.
It takes time for chemotherapy to make its way through your body. Healthy, normal cells divide and grow on a schedule. That means more obvious side effects, such as hair loss, may only be noticed after several cycles of chemotherapy.
Although side effects from chemotherapy are usually expected, not everyone will feel sick. Whether you notice side effects depends on how your body reacts to the medication. Your doctor or nurse is the best person to ask questions about how soon and how long side effects from your treatment may be likely to last.
Nausea from chemotherapy, in general, is a feeling of sickness. This can typically be controlled with anti-sickness medication, also known as anti-emetics.
Anti-emetics are designed to be taken during a course of chemotherapy and continued regularly, even when your symptoms are gone. The medication is much better at preventing sickness than stopping it once it starts.
In some cases, a medication intended to treat a side effect can actually cause side effects of its own. These are often mild and temporary.
If you’re interested in alternative ways to manage nausea, outside of prescription medications, there are some options:
- Try to eat a small meal a few hours before chemotherapy, but not immediately before.
- Talk to your doctor or nurse about high-calorie drink options to help cope with nausea.
- Avoid high-fat foods or foods with a strong smell.
- Drink enough fluids to stave off dehydration.
- For some people, drinking fizzy liquids helps with nausea.
Don’t try any herbal or other alternative products to manage nausea without letting your doctor know first. It’s also a good idea to avoid your favorite foods during your chemotherapy treatment, so that you don’t develop bad associations. This is especially important for kids.
Depending on the specific chemotherapy regimen, your immune system may be affected by the treatment. One possible side effect of chemotherapy is an increased risk of infection.
White blood cells are a part of your immune system that can be impacted by chemotherapy. The white blood cells that fight infections are called neutrophils. When the number of neutrophils in your blood is low, your body is more vulnerable to infections. This is called neutropenia.
Your healthcare team will use lab tests to monitor your immune system before, during, and after chemotherapy treatment. Your doctor or nurse will check your “absolute neutrophil count (ANC)” to see if it’s within a normal range.
Neutrophil counts less than 1,000 per microliter, and in severe cases, less than 500 per microliter of blood, indicate neutropenia. At these counts, the risk of infection is high.
If you’re diagnosed with neutropenia, your body is at risk of frequent infections. However, there are ways to reduce your risk:
- Practice strict hygiene, such as washing your hands regularly.
- Avoid crowded areas, or wear a face mask if you need to go to busy places.
- Be vigilant about food safety because of the risk of food-borne pathogens.
Food safety is especially important during chemotherapy. Be aware that bacteria tend to grow in foods that are at room temperature, carbohydrate-rich, and moist.
There’s no cure-all drug to treat all side effects. The following general treatment options are commonly used to manage some of the side effects of chemotherapy:
- Prescription medication may be used to target specific side effects. For example, in order to help your body regenerate neutrophils and reduce infection risk, your doctor may prescribe growth factors, such as pegfilgrastim (Neulasta) or filgrastim (Neupogen).
- Complementary treatments such as massage therapy may be recommended, but talk to your doctor first.
- Diet-based treatments may focus on avoiding inflammation-inducing foods, such as high-sugar treats and processed meats.
- Choosing foods to reduce nausea based on your personal preferences may help.
- Lifestyle changes, such as light to moderate exercise, may help to manage some symptoms.
There are alternative and complementary therapies available that some people believe may help with chemotherapy side effects. However, evidence on the effectiveness of these options is limited. Your healthcare team may be reluctant to recommend any specific alternative therapy if there isn’t good evidence to support it.
Lifestyle habits can have positive or negative consequences, depending on the habit. A positive lifestyle change to improve your quality of life might involve quitting smoking or sleeping better. These changes can have a wide-ranging impact and affect individuals differently.
In terms of managing chemotherapy side effects, some lifestyle habits may have a lasting and positive impact when practiced in combination with your cancer treatment. For example, you may find it beneficial to eat nourishing foods, stay as physically active as you can, and get a good night’s sleep.
Lifestyle habits are akin to complementary therapy. They’re intended to relieve symptoms or side effects, to ease pain, and to help you enjoy life more. However, some lifestyle habits — such as a very specific diet or an intense exercise regime — might actually be harmful in some cases, especially if these habits interfere with your cancer treatment.
Talk to your doctor first. They can also talk to you about whether there’s any evidence of a benefit or harm related to the habit.
Yes. The American Cancer Society has a website dedicated to linking you to regional support programs and services for cancer patients and even their loved ones. Most are free or low-cost.
If you’re looking for online communities, the American Cancer Society has additional resources to help you find what’s right for you.
Reaching out to your nurse or oncologist can also be helpful. They may be aware of hospital-sponsored support groups as well as additional local resources. Social media platforms also have online community support groups. If you post a question, you may be surprised by the hidden cancer support group experts in your community.
Christina Chun, MPH, is a clinical trials research professional in the fields of oncology and cellular therapy. She graduated from John Hopkins Bloomberg School of Public Health in Baltimore, Maryland, with a master’s in public health in epidemiology and biostatistics.