Are there any side effects?

Some people only get a few side effects while others will have more. It’s hard to know how it will be for you. Most side effects will disappear after treatment has finished. You can read some ways to help cope with them in our deal with it section.

Common side effects

• Lowered resistance to infection: Your immune system doesn’t work so well when you’re having chemo, so you might pick up more colds and infections. This begins around 7 days after treatment is started and reaches its lowest point around 10–14 days after chemo. Your blood cells then gradually go back to normal.

Keep an eye on your temperature and if it goes above 38°C (or you feel unwell) it’s important to let your doctor know. If necessary, you’ll be given antibiotics to keep any infection under control.

During the course of treatment your doctor may prescribe a growth factor medicine called GCSF which can encourage your body to produce new white cells. This is given as an injection under the skin once a day.

• Bruising and bleeding: The number of platelets in your blood can fall because of the chemo. This can cause bleeding or bruising (for example, of the gums, nose bleeds, heavy periods or pin prick dots on the skin). Let your doctor know if you have any problems with this. If your platelets are really low, they might suggest a platelet transfusion.
• Anaemia: The number of red cells (haemoglobin) in your blood can be low because of the chemotherapy. This can make you feel tired and sometimes breathless. If necessary (to help with the symptoms) your doctor might suggest a blood transfusion to increase the amount of red cells in your blood.
• Hair loss: This usually starts 3–4 weeks after the first course of treatment. Usually all the hair on your head will fall out. You may also notice that some or all of your eyelashes, eyebrows and body hair fall out. This can feel really tough to cope with but remember that it’s temporary and your hair will start to grow again once the treatment is finished. You might want to read our info on wigs and scarves in our deal with it section.
• Feeling sick: Anti sickness drugs are given to help prevent or control this. Let your doctor know if you feel sick and they’ll prescribe extra medicines.
• Sore mouth: You might get a sore, dry mouth or notice some small ulcers. Drinking plenty of fluids and brushing your teeth regularly with a soft toothbrush can help. Doctors can prescribe mouthwashes and medicine to prevent or clear any infection.
• Off your food: You might find that you go off certain foods or don’t have much appetite. If this happens, a dietician at the hospital can give you help and advice on what to eat and how to deal with it.
• Tiredness: You may feel more tired than normal and may not have as much energy. It’s important to try to get as much rest as possible and take it easy.
• Breathing changes: Bleomycin can affect the way your lungs work. Let your doctors know if you have a cough or feel breathless. Smoking may increase the risk of lung problems with bleomycin.
• Constipation: This is also a side effect of the vinblastine. If you find that you are not going to the toilet as often as you used to, let your doctors know and they may give you some medicine to treat the constipation.
• Changes to urine: Doxorubicin can make your urine look pink or red. This will only last for about a day.
• Fertility: Treatment can also affect your fertility. That’s your ability to become pregnant or father a child. It’s important to talk this over with your doctor before you start your treatment. See our information on fertility to find out more. Guys may need to consider sperm banking.
• Periods: For girls, your periods may stop. This is usually a temporary effect of treatment and they’ll come back after treatment has finished.

Less common side effects

• Numbness or tingling in your hands or feet: This is caused by the effect of vinblastine on the nerves and is known as peripheral neuropathy. This usually improves slowly a few months after treatment is finished.
• Changes to your heart : High doses of doxorubicin can affect the way your heart works. This sounds scary but the doctors will keep a close check on things. For example, you'll have tests to see how well your heart is working before you have your chemo.
• Changes in your nails: Your nails may become darker or ridged. They usually return to normal within a few months of finishing treatment
• Allergic reactions: Some people have an allergic reactions to bleomycin. This can cause a rash, fever, wheeze, swelling of the face, throat tightness or difficulty breathing. If you experience any of these symptoms tell your nurse or doctor immediately.
• Sensitive to sunlight: Both dacarbazine and bleomycin can make your skin more sensitive to sunlight. This means you can burn more easily. You can still go out in the sun but always wear a high protection sun cream and a hat. Some people notice that their skin darkens in some places.
• Taste changes: You may find that your food tastes different. Normal taste usually comes back when the treatment has finished.

These are the most common side effects. It can feel really scary reading about all of these. It’s important to remember that most of them can be controlled and they will usually get better after the treatment is finished.

It might help to talk to your doctor or nurse about things if you’re worried or nervous. They are there to help. Also have a look at our share it section where you can talk to others who have been through a similar experience.