Risks and side effects of chemotherapy

Your healthcare team will monitor you closely for an allergic reaction to chemotherapy. Signs of an allergic reaction include: 

• a sudden itchy rash (hives)
• swelling of your hands, feet, ankles, face, lips, mouth or throat 
• feeling faint or that you might faint 
• severe chest pains.  

You must tell your healthcare team about any of these symptoms, because they will treat an allergic reaction straight away. If you are not in the hospital and get symptoms, you should call your CNS, hospital, or out-of-hours chemotherapy number.

Chemotherapy can make you feel very tired and physically weak. This is called fatigue. It is not like usual tiredness – you may feel exhausted after doing nothing. This is simply your body responding to the treatment, as it tries to repair any healthy cells the chemotherapy has damaged. 

You may also feel weak because chemotherapy lowers the amount of red blood cells you have. These are the cells that carry oxygen around your body. If you have too few red blood cells, you may develop anaemia. 

Fatigue may only last for a few days or weeks after treatment, but it can last for months. Speak with your healthcare team if you feel fatigued, as they may be able suggest things to help. Tips from our community include:

• getting moving – gentle exercise like a walk or yoga can help
• getting some fresh air – even if it’s sitting by an open window.

Chemotherapy drugs will be new to your body, so it might try to get rid of the drugs by making you want to be sick. This feeling usually happens between within a few hours and 24 hours of starting chemotherapy. It usually lasts for about a week and may come back whenever you have a cycle. You may actually be sick (vomit) too.   

Tell your healthcare team if you feel or are sick with chemotherapy. They can prescribe you anti-sickness medicine and suggest other ways to help. Tips from our community include:

• drinking water or ginger tea
• eating whatever helps the sickness – but check with your healthcare team first
• practicing mindfulness to focus your thoughts somewhere else.

Chemotherapy can make you feel like you don’t want to eat or have no taste for food. This may be because you feel sick, your taste has changed, or the effects of treatment have simply made you lose your appetite. 

It is important to keep eating and drinking while you are having chemotherapy. Try to figure out which foods you can eat or want to eat. It’s a good idea to let your healthcare team know too, so they can make suggestions and make sure you are getting enough nutrients.

Chemotherapy can cause:

• loose or runny poo (diarrhoea) 
• problems doing a poo (constipation).

These bowel changes can start to happen about a week after having chemotherapy. If you are having chemoradiation, you may also have bowel changes from the radiotherapy. 

It is important to let your healthcare team know about any bowel changes, as they may be able to prescribe medicines and suggest things to help. You may find it helpful to eat smaller meals more often and take sips of water throughout the day.

It’s important to look out for signs of an infection while you are having chemotherapy. As your immune system is weak, even mild infections can be become very serious if you don’t get treatment as soon as possible. 

Your healthcare team will give you more information about symptoms of an infection but you should let them know if:

• you feel generally unwell
• your temperature is 37.5ºC or above or below 36 ºC.

The different drugs used for chemotherapy make it more or less likely that you may lose your hair:

• Cisplatin – You don’t usually lose much of your hair, but it may thin. 
• Paclitaxel (taxol) – You will usually lose your hair.  

If your hair falls out, it usually grows back within a few months of finishing treatment. 

Read more about hair loss on the Macmillan Cancer Support website >

Chemotherapy can also more serious side effects. You must contact your healthcare team or go to the Accident and Emergency (A&E) department if this happens. They can give you treatment. You should have been given the telephone number for the hospital and out-of-hours chemotherapy support. 

Serious side effects include: 

• severe leg pain or swelling
• chest pain
• difficulty breathing
• problems with your heartbeat – for example, beating too fast or slow
• blood poisoning (sepsis).

Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.

References

• British Gynaecological Cancer Society (2020). BGCS framework for care of patients with gynaecological cancer during the COVID-19 Pandemic. Web: www.rcog.org.uk/globalassets/documents/guidelines/2020-05-05-bgcs-covid-19-framework-v3.pdf. Accessed October 2020.
• Li, M. et al (2019). Adjuvant chemoradiotherapy versus radiotherapy in cervical cancer patients with intermediate-risk factors: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology & Reproductive Biology. 238. pp.1-6. 
• Falcetta, FS. et al (2016). Adjuvant platinum‐based chemotherapy for early stage cervical cancer. Cochrane Database of Systematic Reviews. 11. pp.1-3.
• Electronic Medicine Compendium. Cisplatin 1mg/ml Concentrate for Solution for Infusion. Patient Information Leaflet. Web: https://www.medicines.org.uk/emc/files/pil.6111.pdf

We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected]

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