Chemo - What It Is, How It Helps

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What about chemo side effects?

Chemo drugs are very strong. They kill any cell that’s growing fast, even if it’s not a cancer cell. So, some normal, healthy cells that grow quickly can be damaged. This can cause side effects. Still, some people have no side effects at all.

Ask your doctor and nurse what side effects you might expect from the type of chemo you will get.

If you have bad side effects, your doctor may do blood tests to find out if you need a lower dose of chemo drugs, or if you need longer breaks between doses. Keep in mind that even if chemo causes a few problems, the “good” for you will likely outweigh the “bad” of the side effects.

For most people, side effects will go away in time after their treatments end. How long it will take is different for each person. Some side effects can take longer to go away than others. Some might not go away at all. If you start to feel upset or sad about how long treatment is taking or the side effects you have, be sure to talk to your doctor. Your doctor or nurse can help you with side effects.

Common chemo side effects

Nausea and vomiting

Some chemo drugs can cause nausea (feeling sick to your stomach) and vomiting (throwing up). These symptoms often start a few hours after treatment and last a short time. In some cases, they may last for a few days. Be sure to ask your doctor if your chemo might cause this and what you can do about it. If your doctor gives you medicine for nausea and vomiting, be sure to take it. Tell your doctor or nurse right away if the medicine isn’t working. Call your doctor if you have been vomiting for more than one day or if you can’t keep liquids down.

Hair loss

Some chemo can cause you to lose your hair. You may lose the hair on your head, face, arms, armpits, and groin. You may lose hair slowly or almost overnight. Not all chemo drugs have this effect, and some only cause the hair to thin out. Your doctor can tell you what to expect from the chemo drugs you’re getting. In most cases, hair grows back after chemo. But the texture and color may be different.

Ask your doctor or nurse for tips on taking care of your hair and scalp during chemo. Some people who lose their hair choose to wear head covers, such as caps, scarves, turbans, or wigs and hairpieces. Many health plans cover at least part of the cost of a wig or hairpiece. Also, you can deduct these costs from your income taxes.

Bone marrow changes

The bone marrow is the liquid inner part of some bones. It’s where all your blood cells are made (red blood cells, white blood cells, and platelets). It’s often affected by chemo, which can cause your blood cell counts to drop.

  • Red blood cells (RBCs) carry oxygen from the lungs to all parts of the body. During chemo, the bone marrow may not be able to make enough red blood cells. Not having enough red blood cells is called anemia (uh-nee-me-uh). This can make you feel short of breath, weak, and tired. It can also make your skin, mouth, or gums look pale.
  • White blood cells (WBCs) fight infection. Chemo lowers the number of your white blood cells, which makes you less able to fight infections. Your doctor or nurse may suggest ways to avoid infection, such as staying away from people with colds or fevers, staying away from crowds of people, and washing your hands often.
  • Platelets (plate-lets) form blood clots that stop bleeding from cuts or bruises. If your bone marrow can’t make enough platelets, you may bleed too much, even from small cuts. If your platelet count is very low, you will need to be very careful. Even brushing your teeth too hard could cause your gums to bleed. So, you might need to use a soft-bristle toothbrush or one made from foam. Check with your doctor or nurse about flossing.

These effects on the bone marrow will not last long. Your doctor will do blood tests to see when your bone marrow is making new blood cells again. And there are treatments that can be used if your blood cell counts get too low.

Mouth and skin changes

Some chemo drugs can cause sores in the mouth and throat. Good mouth care is a key part of treatment. Be sure to brush your teeth and gums after each meal. Try to see a dentist before starting chemo. A dentist can show you the best ways to take care of your teeth and gums during treatment.

Some people have skin problems – such as redness, itching, peeling, dryness, and acne. Most skin problems are minor, but some need to be treated at once. Some people have allergic reactions to chemo. This can cause hives (or skin welts), itching, or trouble breathing. Chemo is usually given in the doctor’s office or clinic where the nurse or doctor can watch you for this type of reaction. These problems must be treated right away.

Ask your doctor or nurse for tips on taking care of your mouth and skin while you’re getting chemo. If you have any side effects, tell your cancer care team about them right away. There are often things they can do to help you and keep the problems from getting worse.

Changes in your sex life

Sometimes sexual desire is low or even gone for some time, but it comes back when treatment ends. Some drugs given during chemo may affect a woman’s hormones, causing hot flashes and dryness of the vagina.

Most patients can have sex during treatment, but some don’t feel like it. This does not mean that something is wrong. To learn more about the sexual effects of cancer treatments and how to deal with them, please call us at 1-800-227-2345 to get our free booklets called Sex and Men With Cancer or Sex and Women With Cancer.

Most chemo can cause birth defects if a woman gets pregnant during treatment. Some chemo can affect a man’s sperm, which may cause problems if he fathers a child during treatment. Ask your doctor about what kind of birth control you should use and how long you need to use it.

Fertility problems

Some chemo drugs can leave you unable to have children. This effect does not always go away after treatment is over. If you think you may want to have children some day, tell your doctor before you start treatment. To find out more about having children, call us for a copy of Fertility and Women With Cancer or Fertility and Men With Cancer.

Memory changes

Cancer and its treatment can affect your thinking. In rare cases, this can last for a long time after treatment. Memory and being able to concentrate or think can change. This happens more often in treatments that use large doses of chemo drugs. Many patients who have this call it “chemo brain” or “chemo fog.”

Doctors are not sure why this happens to some people who get chemo but not to others. Other cancer treatments can also affect the brain. If you notice this, talk to your doctor. There are health care workers who can help you with mental exercise programs and other types of treatment to lessen these effects.

Emotional changes

Chemo and cancer can also affect a patient’s emotions. Chemo changes your normal routine and can make it harder to get things done. You may notice a weaker sense of well-being and some strain on how you get along with others. But there are ways to cope with these things. Talk to your doctor or nurse about counseling, support groups, and things you can do as part of your daily routine to help relieve stress and relax.

Your friends and family can give you emotional support, too. But your loved ones may not be sure how to talk to you about cancer and chemo. It’s good to let them know it’s OK to talk about these things.

Can chemo side effects be prevented and treated?

The good news is that there are things you can do to prevent or reduce most chemo side effects. Be sure to talk with your doctor or nurse if you have side effects.

Remember that not everyone gets the same chemo drugs. Chemo given for some cancers may cause more side effects than chemo for other cancers. Your general state of health and fitness will also affect how your body reacts to chemo. Some people are able to go on with what they always do while getting chemo.

On the other hand, some people need to be in the hospital so that doctors can watch them closely and treat certain side effects. And most people have to change their work schedules to get chemo. Ask your doctor and nurse what you’ll be able to do while you’re being treated – on chemo days and in between treatments.


Last Medical Review: 03/25/2013
Last Revised: 03/25/2013