After receiving a cancer diagnosis, your first reaction may be to ask your doctor about chemotherapy, also known as chemo.
After all, chemotherapy is one of the most common forms of cancer treatment. But chemotherapy does a lot more than get rid of cancer.
While chemotherapy drugs are powerful enough to kill rapidly growing cancer cells, they can also harm healthy cells. This may cause a variety of side effects. The severity of these side effects depends on:
- your overall health
- the stage of your cancer
- the type and amount of chemotherapy you receive
Many side effects clear up shortly after treatment ends, but some may continue for months, years, or may never go away.
It is important to discuss any side effects you’re experiencing with your doctor. In some cases, depending on the reactions your body is having, your doctor may need to adjust the type or dose of chemotherapy.
Chemotherapy drugs can affect any body system, but may especially impact the following:
- digestive tract
- hair follicles
- bone marrow
- reproductive system
It’s worth understanding how these cancer drugs can affect your major body systems:
Routine blood count monitoring is a crucial part of chemotherapy. The drugs can cause a loss of healthy red blood cells, resulting in anemia.
Symptoms of anemia may include:
- pale skin
- shortness of breath
- chest pain
- rapid heart rate
Chemo can also cause neutropenia, a condition where you have a low white blood cell count. White blood cells play an important role in the immune system and help fight infections. It’s important to take precautions to avoid exposure to viruses and bacteria if you’re receiving chemo.
A low platelet count, called thrombocytopenia, can also occur with chemotherapy. Cells called platelets help blood clot. Low numbers of them mean you’re likely to bruise and bleed easily. Symptoms may include:
- small red dots on your skin called petechiae
- minor cuts that keep bleeding
- heavier than normal menstruation
Some chemo drugs may also damage the heart, potentially leading to cardiomyopathy, or heart muscle disease. It can also disturb your heart rhythm, a condition called arrhythmia. These conditions can affect your heart’s ability to pump blood effectively.
These problems are less likely to occur if your heart is strong and healthy when you start chemotherapy.
The central nervous system controls emotions, thought patterns, and coordination. Chemotherapy drugs may cause problems with memory or make it difficult to concentrate or think clearly. This is sometimes called “chemo brain.”
Chemo brain is usually temporary, but for some people,
Chemo drugs can also cause a variety of other issues with your nervous system based on which nerves are damaged. Symptoms can include:
- lack of balance
- numbness or tingling in the hands and feet, known as peripheral neuropathy
- erectile dysfunction
- slower reflexes
Unsteadiness and difficulty balancing also increase your risk of falling. Working with an occupational or physical therapist may help you improve your motor skills and coordination.
Consuming frequent or larger doses of chemotherapy drugs increases the likelihood of pain and discomfort in your mouth or throat. Certain types of chemo also impact your mucosa more than others. You may experience:
- dry mouth, or xerostomia
- mouth sores that form on the tongue or gums, making you more susceptible to infection
- a metallic or chemical taste
- difficulty chewing and swallowing
If you have trouble eating or if the treatment causes food to taste unusual or unpleasant, it may lead to unintentional weight loss.
Chemotherapy drugs can also harm cells along the gastrointestinal tract. This can cause:
- pressure, bloating, and gas around the abdomen
You can lessen these symptoms by drinking plenty of water during the day.
Nausea is another common chemotherapy symptom that may result in vomiting, leading to dehydration and decreased appetite. Talk with your doctor about anti-nausea medications to reduce vomiting during treatment.
Even if you don’t feel hungry, it’s important to continue eating healthy foods. It may help to try foods that are soft and easy to swallow.
Eating small, frequent, high-calorie snacks instead of large meals is a good way to increase caloric intake. It may also offset weight loss.
Hair loss is perhaps the most well-known side effect of chemo treatments. Many chemotherapy drugs affect hair follicles and can cause hair loss, known as alopecia, within a few days or weeks of the first treatment.
Hair loss can happen anywhere on your body, but is most likely to occur on your scalp. New hair growth usually begins several weeks after the final treatment.
Minor skin irritation is possible, too, including:
Your doctor can recommend topical ointments to soothe irritated skin.
You may also develop sensitivity to the sun and burn more easily. You can help shield your skin when outdoors by wearing sunscreen, long sleeves, and a hat.
Additionally, your fingernails and toenails may turn yellow and become brittle. In severe cases, they may separate from the nail bed. Moisturizing your cuticles and cutting your nails short may help.
Chemotherapy drugs alter hormones in both men and women. In women, chemotherapy can affect the ovaries, potentially causing:
- hot flashes
- irregular periods
- sudden onset of menopause
- dryness of vaginal tissues
In men, some chemo drugs can harm sperm or lower sperm count. Like women, men can have temporary or permanent infertility from chemo.
Doctors advise against getting pregnant during chemotherapy treatment. Chemotherapy drugs can damage sperm and can also harm the fetus if given during pregnancy, possibly leading to birth defects.
If you are already pregnant when you receive a cancer diagnosis, you still have options. You and your doctor will discuss the next best steps. Treatment may involve surgery rather than chemo, or different timing of treatment.
While symptoms like fatigue and anxiety may interfere with sex drive in both men and women, many people on chemotherapy are still able to have active sex lives.
The kidneys work to excrete the chemotherapy drugs as they move through your body. In the process, some kidney and bladder cells can become irritated or damaged.
Symptoms of kidney damage include:
- decreased urination
- swelling of the hands or feet
- high blood pressure
Some chemo medications may cause urine to turn red or orange for a few days. You may also experience bladder irritation, which causes a feeling of burning when urinating and increased urinary frequency.
Your doctor will likely recommend that you drink plenty of fluids to help keep your system functioning properly.
It’s common to lose bone mass with age, but some chemo drugs can increase this loss. In women, chemo may damage the ovaries, so they stop making estrogen. Lower levels of estrogen leads to bone loss.
According to the National Institutes of Health, women treated for breast cancer are at increased risk of osteoporosis and bone fracture. The most common areas of the body to experience breaks are:
You can help keep your bones strong by:
- eating a balanced diet
- getting enough calcium and vitamin D
- exercising regularly
- stopping smoking
There are also medications and alternative treatments to help prevent or ease osteoporosis.
Living with cancer and dealing with chemotherapy can impact your mental health. It’s normal to feel a range of emotions, such as:
Talking with friends and family may help you process your emotions. Your healthcare team may also be able to suggest a local cancer support group where you can speak with others undergoing cancer treatment.
If feelings of depression persist, look for professional counseling or talk with your doctors. While emotional side effects are common, there are ways to reduce them and increase your quality of life.
Chemotherapy may cause additional side effects in rare cases. These include:
- pancreatitis (when the pancreas becomes inflamed)
- neutropenic enterocolitis (inflammation of the intestines that most often occurs in people with neutropenia)
- hemolysis (damage to red blood cells)
- watering eyes, or epiphora
- acneiform eruptions (skin conditions that look like acne)
Some of these uncommon side effects may be minor, while others can be life threatening.
Some side effects of chemotherapy can put you at risk of serious complications. For example,
Chemotherapy may also cause long-term effects, such as:
- heart damage
- lung damage
- kidney problems
- nerve damage
Some chemo drugs may also increase your risk of developing a second cancer. There’s a greater chance of this happening if you receive higher doses of chemo over a longer period.
Side effects are different for each person, so it’s difficult to predict how chemotherapy will affect you. Still, you can ask your doctor:
- which side effects are common with your chemo medication
- when you might experience side effects and for how long
- which symptoms or side effects may need further treatment
- when you should call your doctor if you have certain symptoms
Once you’re familiar with the side effects that you may experience, you can prepare for them by planning to rest, taking time off, or asking for help with energy-consuming commitments such as child care after chemotherapy.