Chemotherapy – often abbreviated to chemo or CTX – is a cancer treatment that uses anti-cancer drugs to fight the disease. Chemo is very common and is used to treat most types of cancer, both as a cure and as a method of improving the prognosis.

Chemotherapy can result in a wide range of side effects. Cancer cells are characterized by their tendency to divide rapidly; chemo therefore fights the disease by attacking fast-dividing cells. Unfortunately, healthy cells that divide quickly are also targeted, resulting in adverse side effects.

Although there is no way to prevent chemotherapy side effects altogether, there are methods of managing them that can lessen their worst symptoms.

Some of the more common side effects of chemotherapy may include:

Fatigue
Vomiting and nausea
Hair loss
Anemia
Loss of appetite and feeling full after eating only a small amount
Sleeping issues
Sex and fertility issues
Emotional stress
Bruising and bleeding
Diarrhea and constipation
Mouth and throat problems
Skin and nail problems
Memory loss

There is a higher risk of chemotherapy side effects in the elderly. With increasing age, the total body water decreases, leading to a reduced volume of distribution for drugs that dissolve in water. The total body fat increases, changing the body’s distribution of drugs that dissolve in fat.

In addition, kidney function may decrease with age, leading to a decreased clearance of drugs that are excreted by the kidneys. Furthermore, the presence of other conditions, as well as other drugs being taken may, among other factors, all impact on the tolerability of chemotherapy.^[1]

Common side effects

Side effects of chemotherapy differ from person to person, ranging from mild to severe, depending on the type of cancer that is being treated, the chemotherapy drug that is being administered, the length of the course and the general health of the person.^[2]

It is difficult to predict what side effects will be experienced. Of those listed below, it is unlikely a person will experience them all.^[3]

Fatigue

Fatigue – lack of energy – is the most common side effect of chemotherapy. Those undergoing chemotherapy often feel a whole-body tiredness that is not relieved by sleep, and which may make them unable to carry out everyday tasks or work. Fatigue may continue once the treatment is over; intensive chemotherapy weakens the body, meaning full recovery can take a long time.

There are many possible underlying causes of fatigue, some of which have medical treatment options. Where possible, the best way to combat fatigue is to find out and treat the underlying cause. For instance, there are medications available for fatigue caused by anemia.

Vomiting and nausea

Vomiting and/or nausea is common to those undergoing chemotherapy. It can be managed with anti-sickness drugs which can be prescribed by a doctor. It should be noted, however, that these drugs can also have their own side effects.

Hair loss

Many people find that hair loss is one of the most distressing side effects of chemo treatment. This side effect is common but won’t affect all people. The head is the most common location for hair loss, though other regions of the body can also be affected. In almost all cases, the hair will grow back once chemotherapy has been completed.

Depending on the type of cancer and type of chemotherapy used, it is sometimes possible to reduce the chances of hair loss by wearing a cold cap during a treatment, designed to cool the scalp, reducing blood flow to the scalp and therefore reducing the amount of medicine that reaches it.

Anemia

By lowering the amount of red blood cells in the body, chemotherapy can also result in anemia. Symptoms of anemia can include:

Fatigue
Heart palpitations
Shortness of breath
Pale complexion.

Treatments for anemia differ according to its severity; a doctor will be able to explain the best options.

Loss of appetite and early satiety

People going through chemotherapy often experience a loss of appetite, i.e. the feeling of not being hungry, and/or early satiety, i.e. the feeling of being full after eating only a small amount. These changes may last the entire drug regimen or may only be experienced immediately after a treatment. Causes of loss of appetite include:

Taste changes
Dry mouth
Mouth sores

It is recommended that the affected person try to eat what they can and, if their doctor says it is ok, ensure they drink plenty of fluids. Some medications may be prescribed by a doctor for long-term lack of appetite.

Sleeping issues

Problems with sleep, or insomnia, are common during chemotherapy. It may be helpful to think about possible causes, such as certain medications, pain or anxiety. A healthcare provider will be able to offer advice on how to manage sleep issues.

Sex and fertility issues

Chemotherapy may lower a person’s libido or sex drive. Chemotherapy can also result in reduced fertility in both men and women. If there are concerns about lasting infertility, options such as IVF and egg/sperm banking can be explored with a doctor.

Emotional stress

Chemotherapy can result in a large amount of emotional stress. This stress can take the form of anxiety and may develop into depression. Talking therapies such as counseling and psychotherapy, as well as support groups to share with others in similar circumstances may help with the emotional stress of chemotherapy.

Bruising and bleeding

Chemotherapy can often reduce the number of platelet cells in the blood. This can result in:

Severe bleeding when cut
Skin that bruises easily
Nosebleeds
Bleeding gums

Treatments to improve platelet cell count are available. These include corticosteroid drugs and, in severe cases, blood transfusions.

Diarrhea or constipation

Diarrhea and/or constipation can be a common side effect in the early stages of chemotherapy.
An affected person can consult a doctor for dietary recommendations to minimize diarrhea or constipation. If the problem persists and a doctor says it is ok, over-the-counter medications may be taken to help minimize this side effect.

Mouth and throat problems

Chemotherapy can result in mouth and throat ulcers or sores, also known as mucositis. These ulcers can be painful and result in difficulty eating and drinking. They can also become easily infected. If necessary, doctors can prescribe painkillers or other appropriate treatments.

Skin and nail problems

Dry, itchy, discolored or sore skin can result from chemotherapy. The nails can also become brittle or flaky. Ointments and creams can be prescribed to help.

Memory loss

For reasons that aren’t completely clear, chemotherapy can also result in short-term memory loss and an inability to concentrate properly. This side effect usually dissipates once the treatment is complete. Many people manage this by setting reminders, keeping written records and asking for help where necessary.

Nerve damage

Nerve damage can occur with chemotherapy. It often occurs during chemotherapy but can last longer or even be irreversible. It may also worsen with each dose. Symptoms of nerve damage may include some of the following sensations in the hands and feet:^[4]

Tingling
Burning
Warmth
Numbness
Weakness
Discomfort or pain
Being less sensitive to hot and cold
Cramps in the feet

Treatment may be given to relieve the pain of nerve damage, and occupational therapy may be recommended in cases of permanent nerve damage. Sometimes, chemotherapy treatment has to be stopped because of nerve damage.

More serious side effects

Some side effects of chemotherapy are less common but can become serious.

Osteoporosis

People undergoing chemotherapy are more at risk of developing osteoporosis, a condition that thins and weakens the bones. Women, particularly those over the age of 50, as well as people with breast cancer, are most at risk of osteoporosis.^[5] Getting enough calcium and vitamin D (see vitamin D Deficiency) lessens the risk of developing the condition. If osteoporosis does develop after chemotherapy, treatment options are available.

Heart problems

In rare cases, heart problems can occur with chemotherapy. The symptoms of this may include:^[6]

A rapid or irregular heartbeat
Fatigue
Chest pain
Coughing
Dizziness
Breathing problems

In extreme cases, these heart problems may lead to a heart attack. If a person experiences any of these symptoms, it is important they contact their doctor immediately.

Eye problems

Anti-cancer drugs used in chemotherapy can, in rare cases, lead to eye problems, including:^[7]

Cataracts
Conjunctivitis
Dry Eye Syndrome
Glaucoma
Light sensitivity

Thorough washing of the hands and the avoidance of unnecessary touching of the eyes can reduce the risk of eye problems.

Long-term side effects

The duration of chemotherapy side effects varies. A majority of chemotherapy side effects will continue in duration for the length of the chemotherapy and disappear soon after the treatment has finished. However, some can be more long lasting, and others can develop after the chemotherapy has finished.

Chemo side effects after treatment may include:

Organ problems

The anti-cancer drugs used in chemotherapy can lead to long-term problems in organs such as the heart, lungs, kidneys and bladder.^[8] To lessen the chances of developing these problems, doctors will check the person’s medical history before administering the drugs and avoid uncomplimentary drugs accordingly.

Risk of second cancer

Some chemotherapy drugs have been linked to causing a second cancer of a different type. It is important to realize that this is very rare, and that doctors will avoid the use of these drugs if at all possible. They will also advise about the risks before going forward with the treatment.^[9]

FAQs

“Breast Cancer in the Elderly.” Medscape. Date Accessed: 3 August 2018. ↩
“Managing Chemotherapy Side Effects.” Breast Cancer. February 14 2017. Date Accessed: June 26 2017. ↩
“Side-effects of chemotherapy.” NHS Choices. February 22 2017. Date Accessed: June 26 2017. ↩
““What Is Peripheral Neuropathy?” American Cancer Society. 8 January 2019. Date Accessed: 27 February 2019. ↩
“Bone Health.” NCCN. Date Accessed: June 26 2017. ↩
“Can chemotherapy side-effects increase the risk of heart disease?.” Mayo Clinic. October 13 2015. Date Accessed: June 26 2017. ↩
“Eye Problems.” Chemocare. Date Accessed: June 26 2017. ↩
“Chemotherapy’s Effects on Organs/Body Systems.” URMC. Date Accessed: June 26 2017. ↩
“Late side effects of chemotherapy.” Cancer Research UK. January 15 2015. Date Accessed: June 26 2017. ↩
“Can Natural Remedies Help Ease Cancer Drug Side Effects?” WebMD. Date Accessed: 3 August 2018. ↩
“Chemotherapy: effects and side effects.” The Royal Marsden NHS. Date Accessed: 3 August 2018. ↩
“Side Effects of Chemotherapy.” Cancer.Net. Date Accessed: 5 August 2018. ↩
“What is the Timeline for Chemotherapy Side Effects?” Livestrong.com. 14 August 2017. Date Accessed: 3 August 2018. ↩

**Question: What‌ are⁣ Chemotherapy Side Effects?**

**Answer:**

Chemotherapy, ⁢as an integral part of cancer treatment, often⁤ comes with a range of side‍ effects. These side effects‌ can vary based on the specific chemotherapy drugs used, ‌the patient’s overall ⁤health, ‍and the duration of treatment.

**Common Chemotherapy Side ‍Effects:**

* **Nausea and vomiting:** The cytotoxic properties of chemotherapy drugs can affect the‍ stomach lining, causing nausea and vomiting.

* **Hair loss:** Some chemotherapy drugs target rapidly ⁣dividing⁤ cells, including‍ hair follicles, leading to ‍temporary or permanent hair ⁣loss.

* **Bone marrow suppression:** Chemotherapy ‍can reduce ‍the production of blood ‌cells ⁣in the bone marrow, resulting‍ in anemia, neutropenia, or impaired clotting.

* **Immune system weakness:** Chemotherapy⁤ can weaken⁢ the⁣ immune system, increasing the risk ⁢of infections and reducing the body’s ability to⁤ fight ⁢off viruses and bacteria.

* **Diarrhea:** Certain chemotherapy⁢ drugs can‌ damage the intestinal lining, causing dehydration⁣ and electrolyte imbalance.

* **Constipation:** Some chemotherapy drugs can slow down bowel movements, leading to constipation in patients.

**Managing Side Effects:**

Managing chemotherapy side effects is an important aspect‌ of cancer care. Strategies⁤ include:

* **Anti-nausea ⁣medications:** Drugs‍ like ondansetron (Zofran) and granisetron (Kytril) can help reduce nausea and vomiting.

* **Appetite stimulants:** Drugs seperti megestrol acetate and dronabinol can increase appetite and reduce food aversion.

* **Supportive care for hair loss:** Wigs, hats, or scarves can provide emotional comfort and support ‌during hair ⁣loss.

* **Blood transfusions ⁤and growth factors:** Anemia or neutropenia may require blood transfusions⁤ or growth factor medications.

* **Anti-infectives:** Patients may need antibiotics or ⁤antifungal medications to prevent or treat infections.

**Importance of Reporting Side Effects:**

It is crucial ‍for patients undergoing chemotherapy to report any side effects promptly. By ‍doing so, healthcare providers can adjust treatment plans,⁢ provide supportive care,⁣ and monitor for potential complications. Open communication and close monitoring are essential ⁣for ensuring the well-being of cancer ‍patients during and after chemotherapy treatment.

What are Chemotherapy Side-Effects?