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 harmed. This can cause side effects.

Ask your cancer care team what side effects you may expect from the chemo you will get.

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

For most people, side effects go away over time after 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 cancer care team 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 cancer care team if your chemo might cause this and what you can do about it.

If your doctor gives you a drug to help nausea and vomiting, be sure to take it. Tell your team right away if the drug isn’t working. Call your doctor if you have been vomiting for more than 1 day or if you can’t keep liquids down.

Hair loss

Some chemo can make your hair fall out. 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. Some only cause the hair to thin out. Your cancer care team can tell you what to expect from the chemo drugs you’re getting. In most cases, hair grows back after chemo. But it may not be the same color or may be different in other ways.

Ask your team for tips on taking care of your hair and scalp during chemo. Some people 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 cancer care team may suggest ways to stay safer from 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 make your gums bleed. So, you might need to use a soft-bristle toothbrush or one made from foam. Check with your team about flossing.

These effects on the bone marrow will not last long. Blood tests will be done 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 not bad, but some need to be treated. Some people are allergic 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 a nurse can watch you for this type of problem. These problems must be treated right away.

Ask your cancer care team for tips on taking care of your mouth and skin while you’re getting chemo. If you have any side effects, tell your 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.

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 gets a woman pregnant while he is in 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 ends. If you think you may want to have children someday, tell your doctor before you start treatment.

To find out more about this, 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 memory and thinking. This may be called “chemo brain” or “chemo fog.” In rare cases, it can last for a long time after treatment. This happens more often in treatments that use large doses of chemo drugs.

If you notice this, talk to your doctor. There are health care workers who can help you with thinking exercises and other types of treatment to help these effects.

Emotional changes

Chemo and cancer can affect a patient’s emotions. Chemo changes your normal life and can make it harder to get things done. You may feel sad or scared. There may be some strain on how you get along with others. But there are ways to cope with these things. Talk to your cancer care team about counseling, support groups, and things you can do to help be less stressed and more relaxed.

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?

There are ways to stop most chemo side effects or make them better. Be sure to talk to your cancer care team if you have side effects.

Remember that not everyone gets the same chemo drugs. Some chemo drugs cause more side effects than others. Your overall health and fitness will also affect how your body reacts to chemo.

Some people are able to go on with everyday life while getting chemo. But others need to be in the hospital during treatment. Most people have to change their work hours to get chemo. Ask your cancer care team what you’ll be able to do during treatment – on chemo days and in between treatments.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: March 15, 2016 Last Revised: March 15, 2016

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