Chemotherapy Side Effects

Taste changes


Some people experience a change in their sense of taste or smell.

You may find that food may taste more salty, bitter or metallic. This is only temporary; normal taste and smell usually returns 2 or 3 months after the end of treatment.

Taste changes may also be caused by infection in your mouth. Please inform your medical team of any changes you may have eg. sore mouth.

Hair loss from chemotherapy


Hair loss can be distressing. But not all chemo drugs will make you lose your hair. Some people have mild thinning that only they notice. Your doctor/nurse will be able to tell you if your chemo is likely to cause hair loss. 

If you do lose your hair, it will almost always grow back after the treatments are over. But it might be a different color or texture.

You can lose hair on all parts of your body, not just your scalp. Eyelashes and eyebrows, arm and leg hair, underarm hair, and pubic hair all may be affected. 

Hair loss usually doesn’t happen right away. More often, it starts within a few weeks of treatment.

Things that may help with hair loss:


  • Use mild shampoos. 
  • Use soft-bristle hair brushes. 
  • Use low heat if you use a hair dryer. 
  • Don’t dye your hair or get a perm. 
  • You might like to have your hair cut short. A shorter style will make your hair look thicker and fuller. It also will make hair loss easier to deal with if it does happen. 
  • Use a sunscreen, hat, scarf, or wig to protect your scalp from the sun. 
Sometimes, either during the re-growth of your hair or when you are bald, your scalp may feel extra tender, dry, and itchy. It may help to keep your scalp clean by using a moisturizing shampoo and conditioner. Also, use gentle creams or lotions on your scalp as needed. Even a gentle scalp massage may make your scalp feel better. 

Fatigue


Fatigue can be caused by cancer itself or the side effects of treatments. It is when you feel very tired or exhausted most, or all, of the time. Nine out of ten people with cancer (90%) experience fatigue and it affects everyone differently. 

For some people the effects will be very mild, for others it can be very disruptive. You may get tired very quickly, and not feel better after resting and sleeping. Fatigue can affect all areas of your life. Even reading or watching television can be very tiring. This can be frustrating and overwhelming.

There are things you can do to help manage the symptoms of fatigue

  • Eating well and drinking lots of fluids can help increase your energy levels. Your doctor or nurse can give you advice on your diet.
  • Being physically active may also improve your energy levels and increase your appetite. Start slowly and increase the amount of activity you do over time. Try setting yourself small goals that you can achieve, such as walking to the front door. Some exercise, even a small amount, is better than no exercise at all.
  • You may find that you can’t continue working due to fatigue, or that you have to reduce the amount of time you spend at work.
  • It can help to talk to your employer or personnel/human resources (HR) department and let them know that you may need some time off.
  • Don’t feel that you have to work if you’re too tired. If you do want to carry on working, you may be able to find ways of making your work less tiring for a while.

Diet


Following chemotherapy you may have eating problems such as a dry mouth, changes in taste and a reduced appetite. It may take a few months before your appetite is back to normal.

Try to eat a well balanced diet and to drink at least 6 - 8 glasses of fluid a day. There is no ban on alcohol unless your doctor has told you otherwise.

You need to be careful about preparing food, eg. Make sure your food is fresh and not out of date, wash all salad foods, fruit and vegetables very well and make sure your eggs are well cooked.

Constipation caused by chemo


Some people become constipated (have trouble passing bowel movements) from chemo. Others may become constipated because they are less active, eat less than usual, have diet changes, or because they are taking certain pain medicines. Tell your doctor if you haven’t had a bowel movement in 2 or more days. You may need to take a laxative or stool softener.

Things that may help you deal with constipation:

  • Drink plenty of fluids to help keep your stool soft. Warm and hot fluids often work well. 
  • Eat a lot of high-fiber foods. High-fiber foods include bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh and dried fruit, nuts, and popcorn. 
  • Get some exercise. Just getting out for a walk can help, as can a planned exercise program. Be sure to check with your doctor before increasing your physical activity.

Coloured urine


Some chemotherapy drugs may cause the urine to change to a red or blue-green colour. This occurs because the chemotherapy drug is coloured and is naturally excreted from the body in this way. This is normal and should disappear within 24 hours, but if you are at all worried please speak to one of the chemotherapy team,
eg. your doctor or one of the nurses.

Anaemia (reduced number of red blood cells)


If chemotherapy reduces the number of red blood cells in your blood, you may become very tired and feel you have no energy. You may also become breathless and feel dizzy and light-headed. These symptoms happen because the red blood cells contain haemoglobin, which carries oxygen around the body.
If your haemoglobin is low you may be offered a blood transfusion. You’ll feel more energetic and any breathlessness will be eased.

Increased bleeding and bruising


If the number of platelets in your blood is reduced you may bruise very easily, or bleed more than usual from minor cuts or grazes.

Tell your hospital doctor or nurse about this and contact them straightaway if you notice or have:

  • Nosebleeds
  • Bleeding gums
  • Tiny red or purple spots on the skin (petechiae) that sometimes cluster to make a rash.

Pregnancy


It may be possible to become pregnant during the time you are having chemotherapy, but it is not advisable to do so.

You are very strongly advised to use a very reliable form of contraception during treatment and for at least 6 months afterwards. Patients having curative chemotherapy may be advised to avoid pregnancy for even longer than 6 months.
You need to discuss this with your consultant at your follow up appointment. This applies to men and women.

Each chemotherapy treatment has a different affect on fertility, so you should ask the medical team looking after you for advice about contraception. If you or your partner suspects that you might have conceived a child during treatment you must tell us immediately.

Fertility


Fertility and chemotherapy is a very complex subject, and cannot be covered here in depth. You should discuss any fertility issues with your doctors and specialist nurses before you start treatment.

Some chemotherapy drugs can damage the ovary or testis, leading to an increased risk of infertility (inability to have a child). Although chemotherapy may make you infertile during your treatment there is still a chance of getting pregnant or fathering a child.

During treatment women may experience irregular periods, or periods which are lighter or heavier than normal. Some chemotherapy drugs will stop periods completely during treatment. 
These effects may last for many months after treatment has finished.

Usually after treatment is over, if your periods return and are regular, you will be ovulating normally and will have normal fertility. If your periods are absent or are irregular a year after treatment you should ask your doctor to refer you to a gynaecologist for fertility studies.

Sexual Activity


There is no medical reason why you should not have a normal sex life during treatment with chemotherapy. Resuming sexual activity usually depends on how you feel, rather than any medical considerations. However, patients who have very low blood counts should ask their chemotherapy nurses for advice on resuming sexual activity.
If you have any questions/issues related to this please speak to either your clinical nurse specialist or chemotherapy nurse.

Patient Information

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