side effects

so what about side effects?

Different chemo drugs cause different side effects. Some people just have a few side effects and others have more. It’s hard to predict how it’s going to be for you as everyone is different and reactions can vary from treatment to treatment.
Almost all side effects are short-term and will gradually disappear once treatment stops.

what can happen?

The main areas of your body that might be affected by chemo are those where normal cells rapidly divide and grow. For example; the lining of your mouth, your digestive system, your hair, skin and your bone marrow (the spongy material inside some bones where new blood cells are made).

Your chemo nurse can tell you more about the specific side effects of the drugs you are taking but here is some general info that applies to a lot of chemo.

tiredness

During your treatment, and for a while afterwards, you’ll probably feel pretty wiped out. You won’t have your normal energy levels and will need to rest more than usual. The tiredness will ease off gradually when treatment ends but some people still feel tired up to a year later.

effect on bone marrow

Bone marrow is kind of like the ‘factory’ of the blood. It’s the spongy stuff inside some of our bones and it’s where new blood cells start life. Blood cells start off as stem cells and then go on to become:

White cells which fight infection
Red cells which carry oxygen around the body
Platelets which help the blood to clot and prevent bleeding.

Chemo makes the bone marrow work less well, which can lead to problems….

White cells - if you don’t have enough white cells you can pick up infections more easily and it can be hard to fight them off. You’ll need to keep a check on your temperature and if it goes above 38ºC (or you feel unwell) let your doctor know. Blood cells are usually at their lowest around 10 – 14 days after you have the chemo. After this they should start to pick up and your immune system should work a bit better. Doctors will keep an eye on all this by taking regular blood tests throughout your treatment. If necessary, you’ll be given antibiotics to keep any infection under control.

Red cells – if the level of your red cells (haemoglobin) is low you can become tired and lethargic, maybe even a bit breathless. These are symptoms of anaemia. And it means there’s not enough oxygen getting to your cells. A blood transfusion can be given which will increase the amount of haemoglobin in your body and will sort out the symptoms of anaemia.

Platelets – if the number of platelets in your blood is low you might bruise very easily and may have nosebleeds. You could bleed more heavily from a small cut or graze. If you do have any unexplained bleeding then you must contact your doctor straight away. If your platelets drop to below a certain level, you might need a platelet transfusion (fluid containing platelets is given to you in a drip).

nausea and vomiting

Some chemo drugs can make you feel sick (nausea) or actually be sick (vomit). There are some really good anti-sickness drugs around so it’s unlikely that this will be a major problem for you. If you do feel sick it will usually start from a few minutes to a few hours after you have the chemo (depending on the drugs). The sickness might last for some hours or (very rarely) for some days. Your doctor will prescribe anti-sickness drugs that will be given intravenously with your chemo. You’ll also have tablets to take home just in case.

sore mouth

A sore mouth can occur with some chemotherapy, which can lead to mouth ulcers. If this happens, it’s usually about 5 to 10 days after the drugs are given and will clear up within 3 to 4 weeks. Cleaning your teeth regularly and gently with a soft toothbrush helps. There are also mouthwashes that the doctor can prescribe. If your mouth gets very sore the doctor can prescribe medicines and gels that can really help.

taste changes

Chemo can cause your taste to change; food might taste bitter or metallic. Normal taste comes back when treatment finishes.

hair loss

Hair loss (either complete or partial) can occur with some drugs. This can be really upsetting. If hair loss happens it usually starts within a few weeks of starting treatment. Very rarely it can start to fall out within a few days. You can also lose underarm, pubic and body hair. Some chemo drugs also make you lose your eyelashes and eyebrows too. This is really tough to cope with but your hair will always grow back once you’ve finished treatment.

It can be helpful to have your hair cut short before you start the chemo. This is because the weight of long hair pulls on the scalp and makes it fall out faster. If you colour your hair, use a mild vegetable-based colourant and tell your hairdresser what’s happening. Use gentle hair products and a soft brush.

Talk to your chemo nurse about your options. Wigs can be quite funky or you may prefer hats, baseball caps or a mixture of all of these. You might decide just to go for shaving your head and staying bald until it’s all finished.

your kidneys

Drugs such as cisplatin and ifosfamide can cause damage to your kidneys. In order to prevent this you are given plenty of fluids through your drip before and after the chemo. You’ll also be given blood tests to check that your kidneys are working normally.

effects on the nerves

Certain drugs might affect the nerves in your hands and feet. This causes tingling or numbness and a sensation of pins and needles (called peripheral neuropathy). Usually this gradually fades away after treatment ends but if it is severe it can cause long term problems. Let your doctor know if it’s a problem for you.

skin changes.

You might find with some drugs, that your skin becomes dry or slightly discoloured. This is temporary but it can help to use a moisturiser. Your skin might also be more sensitive to sunlight, during and after treatment so it’s best to protect yourself with sunscreen and lose clothing.

how will chemo affect my everyday life?

Even though chemo can cause some bad side effects, many people still manage to lead an almost normal life during treatment. Even if you feel poorly during your course of chemo, you might find that you recover quickly enough before the next lot to be able to do most of your usual things.

You’ll feel pretty tired during chemo. This is normal. It’s caused by the drugs and your body fighting the disease, plus you’re probably not sleeping too well either. Try to take it a bit easier than usual and rest as much as you can.