The information below describes side effects that might be caused by traditional or standard chemotherapy. There are also other drugs that are used to treat cancer in different ways, including targeted therapy, hormone therapy, and immunotherapy.
Why does chemo cause side effects?
Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body, they can affect normal, healthy cells that are fast-growing, too. Damage to healthy cells causes side effects. Side effects are not always as bad as you might expect, but it's normal to worry about this part of cancer treatment.
The normal cells most likely to be damaged by chemo are:
- Blood-forming cells in the bone marrow
- Hair follicles
- Cells in the mouth, digestive tract, and reproductive system
Some chemo drugs can damage cells in the heart, kidneys, bladder, lungs, and nervous system. Sometimes, you can take medicines with the chemo to help protect your body’s normal cells. There are also treatments to help relieve side effects.
Doctors try to give chemo at levels high enough to treat cancer, while keeping side effects at a minimum. They also try to avoid using multiple drugs that have similar side effects.
What do I need to know about side effects?
- Every person doesn’t get every side effect, and some people get few, if any.
- The severity of side effects (how bad they are) varies greatly from person to person. Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them.
- Your doctor may give you medicines to help prevent certain side effects before they happen.
- Some chemo drugs cause long-term side effects, like heart or nerve damage or fertility problems. Still, many people have no long-term problems from chemo. Ask your doctor if the chemo drugs you’re getting have long-term effects.
While side effects can be unpleasant, they must be weighed against the need to kill the cancer cells.
Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them.
How long do side effects last?
Many side effects go away fairly quickly, but some might take months or even years to go away completely. These are called late effects.
Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later.
People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. You may be able to change your medicine or treatment schedule. They also may be able to suggest ways to reduce any pain and discomfort you have.
What are common side effects of chemo?
Most people worry about whether they’ll have side effects from chemo, and, if so, what they’ll be like. Here are some of the more common side effects caused by chemotherapy:
- Hair loss
- Easy bruising and bleeding
- Anemia (low red blood cell counts)
- Nausea and vomiting
- Appetite changes
- Mouth, tongue, and throat problems such as sores and pain with swallowing
- Peripheral neuropathy or other nerve problems, such as numbness, tingling, and pain
- Skin and nail changes such as dry skin and color change
- Urine and bladder changes and kidney problems
- Weight changes
- Chemo brain, which can affect concentration and focus
- Mood changes
- Changes in libido and sexual function
- Fertility problems
Learn more about these and other problems in Managing Cancer-related Side Effects.
Chemotherapy drug interactions and side effects
When looking at how best to combine chemo drugs, doctors must look at interactions between chemo drugs and other medicines the person is taking, including over-the-counter medicines, vitamins, and supplements. These interactions may make side effects worse and affect how well chemo drugs work.
It’s important that you tell your doctor about all medicines, including over-the counter medicines, vitamins, herbal or dietary supplements you are taking– even if you only take them “as needed.”
For instance, platelets help blood clot and prevent bleeding. Many chemo drugs lower the number of platelets for a time. Taking aspirin or other related drugs can also weaken blood platelets. This isn’t a problem for healthy people with normal platelet counts, but if a person has low platelet counts from chemo, this combination might put them at risk of a serious bleeding problem.
Your doctor can talk with you about the safety of using other medicines, vitamins, and supplements while you are being treated for cancer.
How vitaminsaffect chemotherapy drugs
Many people want to take an active role in improving their overall health. They want to help their body’s natural defenses fight the cancer and speed up their recovery from chemo. Most people think of vitamins as a safe way to improve health, so it’s not surprising that many people with cancer take high doses of one or more vitamins. But some vitamins might make chemo less effective.
More research is needed, but until more is known about the effects of vitamins on chemo, keep these points in mind:
- If your doctor has not told you to take vitamins, it’s best not to take any.
- Always check with your doctor first before starting to take a vitamin of any kind, even a simple multivitamin.
- Ask your doctors if and when it might be OK to start taking vitamins after treatment.
- If you’re concerned about nutrition, you can usually get plenty of vitamins by eating a well-balanced diet. See Nutrition for People With Cancer to learn more about nutrition during and after cancer treatment.
When to call your cancer care team about chemo side effects
Because your cancer care team will give you lots of information about side effects, you might be more aware of physical changes. Do not take any physical symptoms you have lightly. Some side effects are short-lived and minor, but others may be a sign of serious problems. Make sure you know how to reach someone on your team any time, including after hours, weekends, and holidays.
Contact your cancer care team right away if you have any of the following symptoms during chemo treatment:
- A fever higher than what your cancer care team has instructed (usually 100.5°F -101°F or greater (taken by mouth)
- Bleeding or unexplained bruising
- A rash
- An allergic reaction, such as swelling of the mouth or throat, severe itching, trouble swallowing
- Intense chills
- Pain or soreness at the chemo injection site or catheter site
- Unusual pain, including intense headaches
- Shortness of breath or trouble breathing (If you’re having trouble breathing call 911 first.)
- Long-lasting diarrhea or vomiting
- Bloody stool or blood in your urine
Ask your cancer care team if there are any other problems they should know about right away.
- Written by
The American Cancer Society medical and editorial content team Our team is made up of doctors andoncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
The American Cancer Society medical and editorial content team
Our team is made up of doctors andoncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Anderson MK, Matey L. Overview of cancer and cancer treatment. In Olsen MM, LeFebvre KB, Brassil KJ, eds.Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society; 2019:25-50. Chu E, DeVita VT.Physician's Cancer Chemotherapy Drug Manual, 2019.Burlington, MA: Jones & Bartlett Learning; 2019. Olsen MM, Naseman RW. Chemotherapy. In Olsen MM, LeFebvre KB, Brassil KJ, eds.Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society; 2019:61-90.
Anderson MK, Matey L. Overview of cancer and cancer treatment. In Olsen MM, LeFebvre KB, Brassil KJ, eds.Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society; 2019:25-50.
Chu E, DeVita VT.Physician's Cancer Chemotherapy Drug Manual, 2019.Burlington, MA: Jones & Bartlett Learning; 2019.
Olsen MM, Naseman RW. Chemotherapy. In Olsen MM, LeFebvre KB, Brassil KJ, eds.Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society; 2019:61-90.
Last Revised: May 1, 2020
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For most people the side effects were worst in the first few days after treatment, then they gradually felt better until the next treatment. Some said the effects were worse with each successive treatment. Most side effects don't persist and disappear within a few weeks after the end of treatment.Do chemo side effects get worse with each treatment? ›
Most types of pain related to chemotherapy get better or go away between individual treatments. However, nerve damage often gets worse with each dose. Sometimes the drug causing the nerve damage has to be stopped. It can take months or years for nerve damage from chemotherapy to improve or go away.What are 5 side effects of chemotherapy? ›
- Tiredness. Tiredness (fatigue) is one of the most common side effects of chemotherapy. ...
- Feeling and being sick. ...
- Hair loss. ...
- Infections. ...
- Anaemia. ...
- Bruising and bleeding. ...
- Sore mouth. ...
- Loss of appetite.
Nausea and vomiting can start within the first few hours after chemotherapy drugs are given and usually last about 24 hours. However, nausea and vomiting may start more than 24 hours after treatment and last several days (called delayed nausea and vomiting).Does chemo get worse each week? ›
The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.What should you not do after chemo? ›
A person undergoing chemotherapy should avoid eating undercooked or raw food, interacting with actively infectious people, overexerting themselves, and consuming too much alcohol. There are also things that a person can do to minimize risks during chemotherapy.When do chemo side effects peak? ›
If you have side effects, they will usually start during the first few weeks of treatment and may become more intense with each treatment cycle.How many rounds of chemo is normal? ›
During a course of treatment, you usually have around 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break, to allow your body to recover.Does all chemo make you really sick? ›
Sickness caused by some chemotherapy drugs is for many people the most difficult side effect to cope with. Uncontrolled sickness can affect your quality of life on many levels. But not all chemotherapy drugs make you sick. If they do, it generally starts from a few minutes to several hours after having the drug.Is it normal to sleep a lot after chemo? ›
Nearly everyone who has chemotherapy has some tiredness. It can be due to the direct effect of chemotherapy on the body. But anaemia may also cause tiredness. This is because chemotherapy can stop your bone marrow from making red blood cells for a while.
- Get some rest. ...
- Stay hydrated. ...
- Eat when you can. ...
- Create a sense of normalcy in your routine. ...
- Look to your support and care teams to have your back through treatment. ...
- Keep things around that bring you comfort. ...
- Stay ahead of your nausea. ...
- Stay positive.
You might notice an improvement in cancer symptoms, such as less pain, reduced lymph node swelling, and improved energy levels. If you use topical chemotherapy on skin lesions, the area might feel irritated and look red and swollen for the first few weeks. These are all signs that chemotherapy is working.What is the hardest chemo? ›
Doxorubicin is considered one of the strongest chemotherapy drugs for breast cancer ever invented. It can kill cancer cells at every point in their life cycle, and it's used to treat a wide variety of cancers, not just breast cancer. Doxorubicin is also known as “The Red Devil” because it is a clear bright red color.How do you feel after first week of chemo? ›
There Will Be First Chemo Treatment Side Effects
Fatigue: You may feel tired or very fatigued the day after your first treatment. This differs from tiredness that can be cured with sleep. It may feel like profound lack of energy you can't seem to shake.
You may be feeling tired, relieved, anxious, and happy all at the same time after your first treatment. Once you are home, follow all instructions given to you. Take your medications on time, rest, hydrate, and eat. Keep track of any side effects or new feelings you have, and report these to your care team.How many weeks of chemo is normal? ›
Most chemotherapy treatments are given in repeating cycles. The length of a cycle depends on the drug(s) you receive. Most cycles range from 2 to 6 weeks.Do you have good days on chemo? ›
Most people have ups and downs during treatment, but support is available. Some people find they can lead an almost normal life during chemotherapy. But others find everyday life more difficult. You may feel unwell during and shortly after each treatment but recover quickly between treatments.Does chemo make you lose weight? ›
Whether it's due to pain from a growing tumor, swallowing difficulties caused by radiation therapy, or the nausea, loss of appetite or mouth sores that are sometimes caused by chemotherapy, involuntary weight loss is a serious side effect of cancer and its treatment for many patients.What is the 7 day rule in chemotherapy? ›
Short, planned delays in chemotherapy for good-risk GCT patients (less than or equal to 7 days per cycle) appear to be acceptable since they may prevent serious toxicity in this curable patient population. Delays of longer than 7 days are strongly discouraged except in extraordinary life-threatening circumstances.Can you sleep next to someone with chemo? ›
You may worry about the safety of family and friends while you are having chemotherapy. There is little risk to visitors (including children, babies and pregnant women) because they aren't likely to come into contact with any chemotherapy drugs or body fluids.
Yes. It will take some extra planning and working out who can support you but it's possible to continue living alone when you have cancer. Having cancer and going through treatment raises many challenges and emotions. These may be harder to deal with when you live alone.How many days do you feel weak after chemo? ›
You might feel the most tired when your blood cells are at their lowest (nadir). This is usually 7 to 14 days after treatment. When the chemotherapy ends, the blood cell levels gradually go back to normal over a few weeks.When are chemo symptoms worse? ›
Q: Do chemo side effects get worse with each treatment? A: Some people undergoing chemotherapy report that they feel more fatigue the further along they get in their regimen. Nerve damage can occur with chemotherapy, and this may get worse with each dose. Sometimes, treatment has to be stopped because of this.How long after chemo does it affect your body? ›
Most chemotherapy side effects are temporary and disappear once your treatment is over. For some people chemotherapy can cause long term changes in the body months or years after treatment. Many people feel more tired than usual for a long time after chemotherapy treatment.