Many people continue with their usual activities while having chemotherapy, for example working between injections or cycles of tablets. However, most people do find that they are more tired than normal for the first few days after treatment. You may need to take life more slowly, working part-time or cutting down on social activities. Take care not to overtire yourself, get enough rest and accept offers of help with everyday tasks. The drugs, among other things, may cause you to feel a little ‘down’. It’s quite normal for this to happen at various times during your treatment. If you’d like to chat about this, contact your nurse or doctor or talk it over at your next appointment. Generally most chemotherapy protocols can be adapted to fit in with holidays or other special occasions. It will usually be all right for you to have a small amount of alcohol, if you feel like it. There are one or two anti-cancer drugs which may interact with alcohol but you will be told about these. Please tell your doctor in advance so your treatment can be planned around your arrangements.
Are there any side effects or complications?
Yes, but these will depend on the type of chemotherapy you are given. Side effects are the secondary effects of treatment and can be acute or late. Acute (immediate) side effects occur during and immediately after treatment and late (delayed) side effects develop after treatment has been going on for some time and may continue, at least for a while, after treatment is finished.
Chemotherapy drugs damage fast growing cells. As well as destroying cancer cells, they also cause damage to normal cells. It is this damage to normal cells that may cause side effects. Everyone reacts differently to chemotherapy and some people may have no side effects at all. The side effects you may experience with your chemotherapy protocol will be discussed with you. For example, not all chemotherapy drugs cause sickness or hair loss, so do check what is relevant for you. We can offer help for most side effects, so please tell your doctor or nurse if you feel any different from normal.
You must contact your hospital team or GP immediately if you
develop any of the following symptoms:
- A temperature of 38C /100F or higher
- Shivering episodes
- Signs of infection
- Flu-like symptoms
- Gum/nose bleeds or unusual bleeding (if bleeding doesn’t stop after 10 minutes of pressure)
- Mouth ulcers that stop you eating or drinking
- Vomiting (that continues in spite of taking anti-sickness medication)
- Diarrhoea (four or more bowel movements than usual or diarrhoea at night)
- Difficulty with breathing.
Some more common effects which occur with several drugs are:
- Infection
- Anaemia
- Bruising or bleeding
- Sore mouth
- Taste changes
- Nausea and vomiting
- Changes in appetite
- Diarrhoea or constipation.
Hair loss (alopecia) is a common side effect of chemotherapy. Not all drugs cause hair loss and some drugs only cause thinning of the hair or cause it to become brittle. Hair loss can be very distressing. However, it is always temporary and your hair will grow again when treatment finishes. Occasionally, hair will start to grow back before the end of chemotherapy. Hair loss does not always happen straight away and usually starts within a few weeks of beginning treatment. Sometimes it starts within a few days. It can occur on all parts of the body, including the head, face, arms and legs, underarms, and pubic area. For some types of chemotherapy, cooling the scalp with a ‘cold cap’ as the drug is given can prevent hair loss. This works by reducing the blood flow to the scalp so that less of the drug reaches the hair follicles on your head. However, the cold cap doesn’t work for everyone and isn’t suitable to use with all types of cancer. Your doctor or nurse will be able to tell you if this is appropriate in your case. Wigs, available on the NHS and privately, can be obtained in advance if you are likely to lose your hair.
Your fertility
Some chemotherapy drugs can damage the ovary or testis, leading to an increased risk of infertility (inability to have a child) and also, in women, early menopause. If this is an important issue for you, make sure you discuss it fully with your doctor before treatment starts. Chemotherapy may affect sexual organs or functions in various ways. You may experience changes in your desires or desired level of sexual activity or you may notice no difference. Loss of libido (sex drive) is not uncommon in both women and men. However, chemotherapy in itself doesn’t usually affect sexual performance or cause impotence. The stress of your illness or the treatment schedule may make you feel more tired than usual. If fatigue is a problem you may want to set aside time for physical intimacy after a period of rest.
How will I feel during my chemotherapy?
The fact that you need to have chemotherapy and the effect it has on your life, can prompt a range of feelings. Fear, anxiety and depression are common to many people with cancer and are entirely normal. This may be in addition to how you feel physically. Some people find it helps to gather information about their disease and treatment because this lessens the fear of the unknown. Find out as much as you want to know and don’t be afraid to ask questions. Your emotional wellbeing is as important as your physical health. Many people don’t understand about cancer or its treatment and may avoid you because they’re not sure what to say or how to help. Try to be open in talking with others about your illness, treatment, needs and feelings.
Loss of concentration may be a side effect of chemotherapy. This can affect your ability to listen and remember things which are explained at your treatment visits. Don’t feel embarrassed to ask for information to be repeated as often as you need it. You may find it helpful to bring a friend, partner or relative to hospital visits and to make a note of any questions you have beforehand. The doctors and nurses caring for you will be happy for you to do this.
During your chemotherapy you may start to feel tired and listless. This may be general fatigue or it may be that you become tired more easily after normal activities. This is quite normal and usually occurs with all types of chemotherapy. Once you know what makes you more tired and when this happens, you can plan ahead. Try to plan your day so that light activities are spaced between more energetic activities. Do get enough rest and only do what you feel you can cope with. People will often be willing to lend their support. If you get tired easily, limit your activities and do only the things that mean the most to you. Ask your family and friends to help with household chores, cooking and so on. Work part-time or see if you can work more flexible hours. Conserve your energy for the important events in your life.
Tiredness can also be a sign of anaemia, so tell the nurse or doctor if you are worried about how you feel.
What happens when chemotherapy treatment has finished?
Once your chemotherapy treatment has finished, most side effects gradually disappear. Everyone is an individual and will recover in their own time. You may find that it takes a while for your energy levels to recover. You may also find that it will take some time for your emotions to settle down. As well as feeling relieved that your chemotherapy has finished, you may miss the close support of the hospital you had during treatment. You will be given an appointment for a follow-up check. Ask who you should contact if you have any problems or concerns before your appointment.