Side effects

Side effects of chemotherapy can be daunting. Before commencing treatment, it’s normal to feel anxious about how your health and daily life will be affected.

Not everybody experiences the same side effects. Even though the list of side effects seems never-ending, that doesn’t mean you’ll experience them all. You might get two, six or more from the list you’re given, but we only know for sure once we start the treatment.

Chemotherapy affects people in different ways because every patient is unique and your body’s reaction depends on your current state of health or comorbidities. Therefore, consultations with your doctor are a great time to share your experiences and struggles and gives your oncologist, navigator and oncology nurses the information they need to support you with the necessary tools and medications to relieve your side effects.

You may be receiving different types of therapies, or combination of therapies, such as radiation or targeted therapies. In this case, side effects may vary or be unique.

A common misconception is that all chemotherapy causes hair loss (alopecia). This isn’t true. Hair loss is dependent on the type of chemo you’ve been given.

Hair loss from chemo can cause a sensitive scalp, so it’s important to use gentle soaps or shampoos. Hair loss can be traumatic to some patients and it helps to sometimes cut your hair short before starting treatment.

Other side effects include pain in the form of headaches, body aches and nerve pain. Nerve pain (peripheral neuropathy) can feel like burning or numbness in the hands and feet. Loss of balance, dizziness or dropping objects can result from this if it’s severe.

It’s normal to feel fatigued, especially the first few days after treatment. It’s important to rest and hydrate well during this time. Nausea, vomiting, diarrhoea or constipation are common gastrointestinal side effects. It’s important to know that pre-medications are administered to help prevent some side effects, especially nausea. Always ask your oncologist for a prescription to keep meds at home just in case you have additional side effects.

It’s crucial for your doctor to monitor your blood counts during chemotherapy to monitor for side effects, such as anaemia which can cause shortness of breath and fatigue. Sometimes you may require a blood transfusion during chemotherapy. Low white blood cells (neutropenia) can predispose you to infections and a high fever is important to let your oncologist know about. Another side effect of the blood cells is low platelets (thrombocytopenia). This can cause you to bruise or bleed easily. This can be serious, so it’s important to alert your oncologist.

Nail and skin changes can occur in the form of discolouration or darkening which eventually normalises after you have completed chemotherapy. Sometimes, either during or after chemotherapy, you may develop a rash that may be indicative of an allergy to the treatment or to other medications given to manage side effects.

Your appetite may vary, and you also may experience taste changes. Ask your oncologist to speak to a dietitian to help you manage these changes. It’s imperative for all patients on chemotherapy, regardless of the type, to maintain good oral hygiene to prevent inflammation or sores in the mouth or throat (mucositis). We advise that an alcohol-free mouthwash or salt water is used from the start and throughout to prevent this. It’s always a good idea to visit your dentist before starting chemotherapy as it can affect your dental health as well.

Cardiac abnormalities may ensue depending on the type of chemotherapy that you are receiving. In some cases, a patient is referred to a cardiologist for screening prior to commencing and even during treatment.

Chemotherapy can affect fertility and you may be referred to another specialist to address sexual and reproductive concerns.Cognitively speaking, a patient may experience confusion, forgetfulness, concentration difficulties or brain fog. This is a recognised side effect known as chemo brain. We generally recommend that patients be accompanied by a loved one during chemotherapy, and never be fearful of asking for support if necessary.

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