How to manage chemotherapy side effects

When do chemotherapy side effects start?

There are lots of types of chemotherapy. When side effects start, and what they are, will depend on which drug is being used and how you react.

You might feel or be sick within a couple of hours of starting treatment. Hair loss will usually start within two to three weeks.

Talk to your care team about what to expect and when to expect it.

You can find out more about the side effects of chemotherapy here. We also have more information about coping with hair loss here.

How long do chemotherapy side effects last?

Most chemotherapy side effects should stop once your treatment is over. Even during your treatment, many can be reduced or managed.

Some people do get long-term side effects after treatment has finished. These are called late side effects. Your care team can talk to you about the chances of late side effects.

Managing chemotherapy side effects

Some side effects of chemotherapy can be managed with medication. Take any drugs exactly as you are told to help them work best for you.

There are also changes you can make in your daily life which you might find help you cope with some side effects. Some of these are below.

You should always talk to your care team before making any changes.

Fatigue and breathlessness

Fatigue is when you feel very tired. It can make you feel like you have no energy but also make it hard to sleep. You might also find you get breathless more quickly when exercising or just moving around. Here are some things which can help.

Diet

Eating a healthy, balanced diet can give you more energy and help keep up your strength. You should also drink plenty of fluids. Find out more about what to eat and what to avoid here.

Exercise

Keeping active and doing regular, gentle exercise can give you more energy. It can also help you sleep, which will help with feeling tired.

You should always talk to your care team before starting new exercises. Find out more about some of the types of exercise you might find helpful here.

Rest

It may be hard to stop and rest but try to listen to what your body needs. If you are working, you might want to reduce your hours. You might need friends to help you with things like picking up shopping.

If you feel like you need to sleep during the day, try to keep it to a short nap so it does not make it harder for you to sleep at night.

Managing an increased risk of infection

Chemotherapy affects your immune system. This means you are at a higher risk of getting an infection. Make sure you wash your hands regularly and have a bath or shower every day. Do not share towels and flannels.

Try to stay away from crowded places when you can. You might also need to avoid people who have illnesses like colds, flu, sore throats or infections.

If you have pets or work with animals, wash your hands after stroking them.

Managing additional bruising and bleeding

Some chemotherapy drugs reduce the platelets in your blood. This means you might bruise more easily, have heavy nosebleeds or bleeding gums.

To help lower your risk of injury you can do things like wear gloves when doing jobs in the house or garden. You should use a soft toothbrush to help protect your gums.

Make sure you tell your cancer team about any bleeding and bruises.

Managing nausea and vomiting

Nausea and vomiting are feeling sick or being sick. The best way to control this is with anti-sickness drugs. Other things which might make you feel more comfortable include:

• Relaxation techniques
• Complementary therapies like hypnotherapy and acupuncture
• Eating crystallised stem ginger or adding fresh ground ginger to your food and drinks
• Sucking on peppermint sweets or drinking peppermint tea
• Eating smaller, bland portions

Managing a loss of appetite

You might find you are eating less, or do not want to eat at all, during chemotherapy. Here are some things you can try:

• Eating little and often rather than having big meals
• Adding extra calories and protein to your food using things like butter and cheese
• Eating cold or slightly warm meals if the smell of cooking makes you feel sick
• Having drinks which are dairy-based
• Asking someone else to prepare meals for you
• Making and storing small servings of your favourite foods

You might also want to try new foods and tastes. You might be surprised at what tempts you to eat.

Managing diarrhoea or constipation

Some chemotherapy drugs can cause diarrhoea. This means having to poo more than is usual for you or having very loose or watery poos. Make sure you drink at least two litres of fluids a day. You might also need to avoid alcohol, caffeine, high-fat and high-fibre foods for a while.

Chemotherapy drugs, anti-sickness drugs and painkillers can cause constipation. This means you cannot poo as often as you usually do. It may also be painful. Make sure to drink at least two litres of fluids a day. It can help to eat high-fibre foods like fruit, vegetables and wholemeal breads. Gentle exercise, like walking, can also help.

You should always tell your care team if you have diarrhoea or constipation.

Managing a sore mouth

Chemotherapy can cause a sore mouth or gums. There are some things you can do to prevent this or ease the symptoms:

• Clean your teeth three times a day with a soft toothbrush
• Use an alcohol-free mouthwash
• Drink plenty of fluids
• Avoid dry, spicy foods
• Suck on ice cubes to ease the discomfort

Managing hair loss

Not all chemotherapy drugs cause hair loss and not everyone loses all their hair. But it can be upsetting if it happens to you. Some things you might find helpful include:

• Cutting your hair short to feel more in control
• Wearing a wig
• Wearing a headscarf or other covering
• Trying out a new hairstyle which disguises thinning hair
• Using makeup to draw in facial hair

We have lots more tips on looking after your hair here. If you are thinking of shaving your head, you can find out more here.

Managing changes to your skin

Chemotherapy can make your skin more sensitive. It might feel dry or itchy. Keeping up a good skincare routine can help with this. Some of our top tips include:

• Moisturising regularly
• Avoiding very hot showers or baths
• Swapping to unscented products
• Wearing loose-fitting clothing

Read more about the changes you can expect, and get more tips, here.

Managing behaviour changes

Cancer treatment is stressful. You might notice some changes in your behaviour. You might get angry more quickly, feel anxious or feel more emotional than usual. Chemotherapy can also cause cognitive changes. You might hear these called ‘chemo brain’. Side effects can include:

• Finding it hard to concentrate
• Feeling very disorganised
• Forgetting things
• Feeling low in mood

You should talk to your doctor if you have any of these symptoms. Some things which might help are:

• Talking to someone about how you are feeling
• Breathing exercises
• Using a calendar to help you keep track appointments
• Writing a to-do list
• Eating a healthy diet
• Keeping your mind active with puzzles or crosswords

More advice on coping with anxiety is available here. More advice on coping with feelings of depression is available here.

How we can support you with the effects of chemotherapy

Our Young Lives vs Cancer social workers and community workers are here to support you with the daily challenges cancer brings. This includes dealing with the side effects of treatment.

You can contact our expert social care team using the Live Chat pink button at the bottom right of this page.

As well as all the information on our website, we also have a YouTube channel. This includes videos of young people and their families talking about life with cancer.

We can also help you meet other families and young people who have been affected by cancer. Find out more here.