Chemotherapy side effects
Each chemotherapy drug or combination has its own side effects. Your healthcare team will give you information about the side effects that are most likely to affect you. Common side effects include:
- Feeling and being sick
- Increased risk of infection
- A sore mouth
- Loose bowel movements (diarrhoea)
- Damage to nerves in your hands or feet (peripheral neuropathy)
Feeling and being sick
Nausea and vomiting are two of the most common side effects of cancer treatment. About 50% of people who have chemotherapy for bowel cancer will have nausea and vomiting.
Many new medications are available to control chemo induced nausea and vomiting (CINV) and it can now be prevented in the majority of people.
Tips for how to manage CINV
- Avoid eating solid foods immediately before and after treatment (although please note that capecitabine tablets do need to be taken with food)
- Avoid caffeine and alcoholic drinks
- Sip clear liquids such as sports drinks, ginger beer, lemon-lime sodas, or diluted, unsweetened fruit juices (avoid grapefruit juice)
- Start with bland foods such as dry toast or crackers, then gradually increase to small, frequent meals throughout the day
- Avoid spicy or greasy foods
- Limit milk and other dairy products
- Avoid high fibre foods like porridge, wholemeal or granary breads and brown rice and pasta
- Avoid favourite foods on days you are sick so they don’t become nausea triggers
- Avoid strong smells that may upset your stomach such as cooking odours, smoke, or perfume
- Avoid lying flat for at least two hours following meals – a short walk may also help
- Contact your specialist team if vomiting is severe or if you cannot keep anything down
- Complementary therapies such as yoga, self-hypnosis, guided imagery, progressive muscle relaxation, acupuncture or acupressure may also help.
Increased risk of infection
Chemotherapy can reduce the number of blood cells made by the bone marrow, including white blood cells, which fight and prevent infection. If the number of your white cells is low you are more likely to get an infection. The main white cells which fight bacteria are called neutrophils, so when they are low you are described as neutropenic.
Your resistance to infection is usually at its lowest seven –14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due. If you get an infection as a result of the side effects of chemotherapy – when the body is already compromised – it is considered to be a medical emergency and you may need hospital admission for treatment with antibiotic intravenous (IV) infusions.
Tips for managing your risk of infection
- Always wash your hands thoroughly after using the toilet and before preparing food
- Stay away from crowds and from people who you know have an infection, such as a cold
- Make sure your food is thoroughly cooked, peel fruit before you eat it and avoid ‘risky’ foods such as unpasteurised cheeses and shellfish
- Wash your hands after handling animals and avoid litter trays and cages.
Managing side effects through diet
Chemotherapy can affect your ability to eat and enjoy food in many ways. Some people only experience side effects briefly or temporarily, others may be affected more seriously and really struggle to enjoy their food. You might find you have a decreased appetite, an altered sense of taste and smell, a sore mouth or throat and you may become more sensitive to hot and cold food and drink.
- If you have nausea and vomiting
Try eating dry food like toast or crackers, eat small portions with plenty of fluids and avoid greasy, fatty or fried foods.
- If you have a sore mouth
Drink plenty of nourishing fluids, such as fruit smoothies or milkshakes, try cold foods and drinks like ice cream or jelly, avoid salty, spiced or rough edged foods.
- If you have a dry mouth
Take frequent sips of drinks, try ice lollies, chewing gum and foods with sauce or gravy. Avoid sticky or dry foods.
You can find more detailed information about diet with and beyond bowel cancer in our information booklet.
Peripheral neuropathy is a possible side effect of oxaliplatin, a common chemotherapy drug, which can cause temporary, and in some cases, more long-lasting side effects, such as tingling or numbness in the hands and feet. This side effect is called peripheral neuropathy, because it only affects the nerve ending in the extremities of your body, in particular the hands, feet and lower legs.
Symptoms can include:
- A change in sensation
- Increased sensitivity and pain
- Difficultly with balance, walking and coordination
- Difficulty with everyday tasks
Tips for managing peripheral neuropathy
- Try to keep yourself warm with gloves, scarves and hot drinks
- Avoid eating or drinking cold or even cool foods. Eat food that is at room temperature
- Try to go for a walk every day, even for a short distance. This will prevent muscle weakness, which adds to your general lack of balance
- Be careful when using hot water, sharp tools or knives and clear your house and garden of things you might trip on.
It is very important to let your oncologist or nurse know if symptoms of neuropathy last beyond a few days after a chemotherapy treatment. Keep track of tingling, pins and needles, numbness, pain or difficulty with normal activities and let your team know if they are getting worse.
Visit our patient forum for tips and support on living with peripheral neuropathy
Updated August 2018. Due for review March 2019