Managing chemotherapy side effects

Learn how chemotherapy for cancer can affect your body and what you can do to manage side effects. This guide is brought to you by TMC Health Cancer Center, where your care is our top priority.

Why does chemotherapy cause side effects?

Chemotherapy (chemo) works by killing fast-growing cells. Cancer cells grow quickly, so chemo targets them. But some healthy cells also grow fast, like those in your hair, mouth and stomach. Chemo can harm those too, which causes side effects.

Healthy cells most affected by chemo include:

• Blood-making cells in bone marrow
• Hair roots (follicles)
• Cells in the mouth, stomach and private areas

Some chemo drugs may also harm the heart, kidneys, lungs, bladder or nerves. Your doctor might give you extra medicine to protect your healthy cells. They also try to use the right amount of chemo to treat the cancer while keeping side effects low.

What should I know about side effects?

• Not everyone gets the same side effects
• Some people get only a few or none at all
• Your doctor may give you medicine to help prevent certain side effects
• Some chemo may cause long-term problems, like nerve or heart damage or trouble having children

Ask your TMC Health Cancer Center care team about what to expect. They can explain how long side effects may last, how bad they might get and when to call the doctor.

How long do side effects last?

Many side effects go away soon after treatment ends. Others might take months or even years to go away completely. These are called late effects.

Sometimes, side effects last a lifetime. Chemo can cause long-term damage to the heart, lungs, kidneys or reproductive organs. In rare cases, some chemo may lead to a second type of cancer many years later.

If you’re feeling upset about how long treatment takes or how you feel, talk to your care team. They may be able to adjust your treatment or help you feel better with other options.

What are common side effects of chemo?

Most people wonder if they’ll have side effects from chemo. Here are some of the most common ones:

• Feeling very tired (fatigue)
• Hair loss
• Bruising or bleeding easily
• Infections
• Low red blood cells (anemia)
• Feeling sick or throwing up (nausea and vomiting)
• Appetite changes
• Constipation or diarrhea
• Mouth and throat sores or pain when swallowing
• Numbness, tingling or pain in hands and feet (nerve problems)
• Dry or discolored skin and nails
• Bladder or kidney problems
• Weight gain or loss
• Trouble thinking or focusing ("chemo brain")
• Mood changes
• Changes in sex drive or sexual function
• Problems with fertility (having children later)

Doctors need to know about any other medicine you take while you're getting chemo. This includes vitamins, supplements and over-the-counter medicine. Some of these can cause side effects to get worse or stop the chemo from working well.

• Always tell your doctor about any pills, vitamins or supplements you take—even if you only take them once in a while

For example, chemo can lower platelets, which help your blood clot. Taking aspirin at the same time might make you more likely to have bleeding problems. This might not be a big deal for healthy people, but for someone on chemo, it can be serious.

Your doctor can help you understand what is safe to take and what’s not.

How vitamins affect chemotherapy drugs

A lot of people want to help their body stay strong during cancer treatment. They often turn to vitamins. But some vitamins might actually stop chemo from working as well.

We still need more research, but until we know more:

• Don’t take any vitamins unless your doctor says it’s okay
• Always check before starting any kind of vitamin, even a multivitamin
• Ask when it’s safe to start vitamins again after treatment
• You can often get the vitamins you need from a healthy, balanced diet

Talk to your care team if you’re worried about nutrition during or after treatment.

You’ll get a lot of information about chemo side effects, so you’ll be more aware of changes in your body. Don’t ignore any new symptoms. Some are small, but others can be a sign of a serious problem.

Call your TMC Health Cancer Center team right away if you have:

• A fever of 100.5°F (38°C) or higher
• Bleeding or unexplained bruising
• A rash
• Swelling of the mouth or throat, bad itching or trouble swallowing
• Strong chills
• Pain or soreness where you got the chemo or near your catheter
• Bad headaches or new pain
• Trouble breathing or shortness of breath (call 911 if it's an emergency)
• Diarrhea or vomiting that doesn’t stop
• Blood in your stool or urine

Ask your care team if there are any other signs you should report right away.

The National Cancer Institute provides medical advice and practical tips to help you navigate chemotherapy. Their resources cover self-care strategies, when to call your doctor and important questions to ask about various side effects, including:

• Anemia: How to manage fatigue and when to seek medical help.

• Appetite loss: Tips for maintaining nutrition and strength during treatment.

• Bleeding and bruising: Ways to prevent complications and signs to call your doctor.

• Constipation: Foods that help and questions to ask your doctor.

• Diarrhea: Dietary adjustments and when to seek medical care.

• Fatigue: Strategies to reduce tiredness and improve energy.

• Hair loss (alopecia): Coping with hair loss during treatment.

• Infection and neutropenia: How to lower infection risks and recognize warning signs.

• Lymphedema: Managing fluid buildup and when to seek medical help.

• Memory changes (“chemo brain”): Understanding cognitive effects and ways to cope.

• Mouth and throat changes: Managing pain, avoiding irritants and helpful mouth rinses.

• Nausea and vomiting: Foods that ease nausea and medications that can help.

• Nerve changes (neuropathy): Recognizing symptoms and treatments that may help.

• Pain: Managing pain, tracking symptoms and knowing when to call your doctor.

• Sexual and fertility changes in men: Addressing common concerns and questions to ask before treatment.

• Sexual and fertility changes in women: Understanding how chemotherapy affects reproductive health.

• Skin and nail changes: Caring for skin and nails during treatment.

• Sleep problems: Tips for improving rest and how your doctor can help.

• Swelling (fluid retention): Preventing and managing swelling.

• Urination changes: Recognizing bladder issues and when to seek medical advice.

Your cancer care team at TMC Health Cancer Center is here to help. If you experience any side effects, talk to your doctor for personalized care and symptom management.