This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science at CTCA.
This page was updated on February 28, 2022.
If your cancer care team has recommended chemotherapy as part of your cancer treatment, you may be concerned because you know chemotherapy has potential side effects—some mild and some severe, some short-term and some long-lasting.
Not everyone experiences every side effect. Some people may have just a few. Some may have many side effects, but none severe. Others may experience debilitating side effects and serious, long-term complications such as heart or nerve damage.
Your cancer care team is careful to prescribe the right amount of chemotherapy to be effective while keeping side effects to a minimum. You may undergo more than one chemotherapy treatment.
Chemotherapy drugs are designed to kill fast-growing cancer cells. However, as these powerful drugs travel throughout the body, they also destroy normal, healthy cells, which may cause side effects.
The normal cells that chemotherapy drugs are most likely to damage are:
You may find that some side effects come and go surprisingly quickly. But it may take months for you to completely get over other side effects. Some side effects subside between treatments and some, especially serious ones, may last the rest of your life.
Common reactions such as nausea or vomiting and fatigue may start as soon as the first treatment. Others, such as a second cancer, may not appear for many months or years.
Don’t get discouraged. There’s lots that you and your cancer treatment team may do to prevent and reduce side effects of chemotherapy when you work together.
Knowing as much as possible about the different side effects and what to expect may put you more in control and at ease.
Fatigue: A feeling of utter exhaustion, or fatigue, is the most common side effect of chemotherapy. Scientists don’t fully understand why chemotherapy causes extra fatigue in cancer patients, but they suspect it’s the body’s response to having to work harder to rid itself of the toxic substances left behind. Chemotherapy also may wreak havoc on sleep patterns, making it hard for you to get the healing rest you need.
Many patients seem to experience the most chemo-induced fatigue midway through their treatments. Fatigue seems to decrease when treatments stop, but it may take months after the last treatment until you feel like yourself again.
To help manage fatigue:
Hair loss (alopecia): Some chemotherapy drugs may cause your hair to thin, and others cause it to fall out. You may lose the hair not only on your head, including eyebrows and eyelashes, but also on your arms, legs and pubic area.
Some patients find cooling caps reduce their risk of hair loss, but others find them to be uncomfortable and cause headaches.
Some ways to manage hair loss:
Nausea and vomiting: Certain drugs are more likely to cause nausea and vomiting than others, including those that target cancers of the gastrointestinal tract, liver and brain.
These factors also may increase your risk of nausea and vomiting:
You may start feeling nauseated and vomit within the first 24 hours of treatment, especially if it’s administered through an intravenous (IV) infusion. That’s because drugs given intravenously are absorbed faster. You also may experience nausea and vomiting as many as a few days after your latest treatment.
Anticipating treatment or the smells may make some people nauseous and vomit as well.
Tips for managing nausea and vomiting include:
Constipation and diarrhea: Treatment may cause changes in your diet (you’re not drinking as much or eating as much fiber) and activity levels (you’re not moving or exercising as much). These lifestyle changes may also affect your bowel habits.
To reduce constipation:
Check with your care team before taking laxatives for constipation. Using them too often may cause further constipation. Suppositories or enemas may cause bleeding or infections or other side effects in some cancer patients.
Chemotherapy also may cause diarrhea anytime during treatment. How to manage this side effect:
Changes in appetite: You may lose your appetite from nausea and vomiting or from painful mouth sores. You also may lose your desire for food because of all you’re going through.
To manage:
Mouth sores: Chemotherapy may harm the cells of your mouth, throat and lips because they too are fast-growing. You may develop sores, making it hard to eat.
To manage the sores:
Pain: This may come in many different forms, such as headaches, stomachaches or muscle pain. You may experience pain, burning and numbness, especially in your hands and feet, from the cancer as well as the chemotherapy. Pain control is important, and there are many treatments to help you feel better.
To manage:
Some chemotherapy drugs have been linked to a number of different second cancers. Your risk of this side effect increases the longer your treatment and the higher the intensity of your dose.
The most likely second cancers from chemotherapy are blood cell cancers: myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML). You may develop one or both. MDS may occur first and then become AML.
Speak with your health-care team about your risk for developing a second cancer from chemotherapy treatment.
Depending on the cancer and chemotherapy treatment, you also may experience some of the following:
While some chemotherapy side effects are minor and likely to subside, others may be alarming and long-lasting. Alert your cancer care team immediately if you have any of the following: