Side effects of chemotherapy

The side effects of chemotherapy depend mainly on the medicines you receive. As with other types of treatment, side effects vary from person to person.

In general, chemotherapy affects rapidly growing and dividing cells. These include blood cells, which fight infection, cause the blood to clot, and carry oxygen to all parts of the body. When blood cells are affected by chemotherapy, you are more likely to get infections, bruise or bleed easily, and have less energy during treatment and for some time afterward.

Hair cells and cells that line the digestive tract also divide rapidly. After treatment with chemotherapy, you may lose your hair and have other side effects, such as loss of appetite, nausea, vomiting, diarrhea, or mouth sores.

Many side effects caused by chemotherapy, such as nausea and vomiting, can now be controlled. Your doctor can prescribe medicines to manage nausea and vomiting. Side effects generally are short-term problems. They gradually go away during the recovery part of the chemotherapy cycle or after the treatment is over.

Fatigue is a common side effect of chemotherapy. Some people notice that they feel a little more tired than usual, and other people feel completely out of energy. After treatment is finished, this fatigue goes away over time.

Some people have a mild decline in the ability to think, learn, reason, and remember (cognitive function) during the first years after some types of chemotherapy. Cognitive function can take a few years to return to normal.¹

Treatment with chemotherapy has been linked with poorer overall quality of life in areas such as urinary incontinence and decreased frequency of sexual intercourse. Although most people report minimal changes in physical and emotional well-being, breast cancer survivors who reported problems with quality-of-life issues continued to have problems for many years after treatment.²

With modern chemotherapy, long-term side effects are rare, but there have been cases in which the heart is damaged and second cancers such as leukemia have developed.

For women

Some chemotherapy can damage the ovaries. If the ovaries fail to produce hormones, you may have symptoms of menopause, such as hot flashes and vaginal dryness. Your periods may become irregular or may stop, and you may not be able to become pregnant.

But some women are still able to become pregnant during treatment. Because some chemotherapy medicines cause birth defects and the effects of other chemotherapy drugs on a fetus are not known, it is important to talk to your doctor about birth control before your treatment begins. After treatment, some women regain their ability to become pregnant, but for most women older than age 35, infertility is likely to be permanent.

For men

For a short time after chemotherapy, some men have a decrease in erections and desire for sex.

Some chemotherapy drugs can cause birth defects, so it is important to talk to your doctor about birth control before your treatment begins.

Citations

1. Silverman DHS, et al. (2006). Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5-10 years after chemotherapy. Breast Cancer Research and Treatment, 103(3): 303–311.

2. Ganz PA, et al. (2002). Quality of life in long-term, disease-free survivors of breast cancer: A follow-up study. Journal of the National Cancer Institute, 94(1): 39–49.