After receiving a cancer diagnosis, your first reaction may be to ask your doctor to sign you up for chemotherapy. After all, chemotherapy is one of the most common and most powerful forms of cancer treatment. But chemotherapy does a lot more than get rid of cancer.
While these drugs are powerful enough to kill rapidly growing cancer cells, they also can harm healthy cells. This may cause a number of side effects. The severity of these side effects depends on your overall health, age, and type of chemotherapy.
While most side effects clear up shortly after treatment ends, some may continue well after chemotherapy has ended. And some may never go away. Be sure to discuss any side effects you’re experiencing with your doctor. In some cases, depending on the reactions your body is having, your doctor may need to adjust the type or dose of the chemotherapy.
Learn more about how chemotherapy affects your body.
How the side effects of chemo manifest for each person may depend on other factors, such as age or existing health conditions. But no matter how severe, these effects are noticeable for each individual.
Chemotherapy drugs can affect any body system, but the following are most susceptible:
- digestive tract
- hair follicles
- bone marrow
- mouth
- reproductive system
It’s worth understanding how these cancer drugs can affect your major body systems.
Circulatory and immune systems
Routine blood count monitoring is a crucial part of chemotherapy. That’s because the drugs can harm cells in the bone marrow, where red blood cells are produced. Without enough red blood cells to carry oxygen to tissues, you may experience anemia.
Symptoms of anemia may include:
- fatigue
- lightheadedness
- pale skin
- difficulty thinking
- feeling cold
- general weakness
Chemo can also lower your white blood cell count (neutropenia). White blood cells play an important role in the immune system. They help prevent illnesses and fight infections. Symptoms aren’t always obvious, but you might find yourself getting sick more often than you used to. Be sure to take precautions to avoid exposure to viruses, bacteria, and other germs if you’re taking chemo.
Cells called platelets help blood clot. A low platelet count (thrombocytopenia) means you’re likely to bruise and bleed easily. Symptoms include long periods of nosebleeds, blood in vomit or stools, and heavier-than-normal menstruation.
Finally, some chemo drugs can damage the heart by weakening your heart muscle (cardiomyopathy) or disturb your heart rhythm (arrhythmia). These conditions can affect your heart’s ability to pump blood effectively. Some chemo drugs may even increase your risk for heart attack. These problems are less likely to occur if your heart is strong and healthy when you start chemotherapy.
Nervous and muscular systems
The central nervous system controls emotions, thought patterns, and coordination. Chemotherapy drugs may cause problems with memory, or make it difficult to concentrate or think clearly. This symptom sometimes is called “chemo fog,” or “chemo brain.” This mild cognitive impairment may go away following treatment or may linger for years. Severe cases can even add to existing anxiety and stress.
Some chemo drugs can also cause:
- pain
- weakness
- numbness
- tingling in the hands and feet (peripheral neuropathy)
Your muscles may feel tired, achy, or shaky. And your reflexes and small motor skills may slow down. You may also experience problems with balance and coordination.
Digestive system
Some of the most common side effects of chemotherapy affect digestion. Dry mouth and mouth sores that form on the tongue, lips, gums, or in the throat can make it difficult to chew and swallow. Mouth sores also make you more susceptible to bleeding and infection.
You might even have a metallic taste in the mouth, or a yellow or white coating on your tongue. Food may taste unusual or unpleasant, leading to unintentional weight loss from not eating.
These powerful drugs can also harm cells along the gastrointestinal tract. Nausea is a common symptom and may result in vomiting. Talk to your doctor about antinausea medications to reduce vomiting during treatment.
Learn more: How to stop vomiting »
Other digestive issues include loose or hard stools and diarrhea or constipation. You may also feel pressure, bloating, and gas around the abdomen. You can lessen these symptoms by avoiding dehydration by drinking plenty of water during the day.
Side effects involving the digestive system can contribute to loss of appetite and feeling full even though you haven’t eaten much. As a result, weight loss, general weakness, and a lack of energy are common. It’s important to continue eating healthy foods.
Integumentary system (skin, hair, and nails)
Hair loss is perhaps the most infamous side effect of chemo treatments. Many chemotherapy drugs affect hair follicles and can cause hair loss (alopecia) within a few weeks of the first treatment. Hair loss can occur anywhere on the body, from eyebrows and eyelashes to your legs. Hair loss is temporary. New hair growth usually begins several weeks after the final treatment.
Minor skin irritations like dryness, itchiness, and rash are also possible.
Your doctor can recommend topical ointments to soothe irritated skin. You may also develop sensitivity to the sun and be susceptible to burns. Be sure to take special precautions to avoid sunburn when outdoors, such as wearing sunscreen or long-sleeves.
As the drugs affect your integumentary system, your fingernails and toenails may turn brown or yellow. Nail growth may also slow down as nails become ridged or brittle and start to crack or break easily. In severe cases, they can actually separate from the nail bed. It’s important to take good care of your nails to avoid infection.
Sexual and reproductive system
Chemotherapy drugs are known to alter hormones in both men and women. In women, hormonal changes can bring on hot flashes, irregular periods, or sudden onset of menopause. You may experience dryness of vaginal tissues that can make intercourse uncomfortable or painful. The chance of developing vaginal infections also increases.
Many doctors do not advise getting pregnant during treatment. While some women may become temporarily or permanently infertile as a side effect, chemotherapy drugs given during pregnancy may also cause birth defects.
In men, some chemo drugs can harm sperm or lower sperm count. Like women, men can have temporary or permanent infertility from chemo.
While symptoms like fatigue, anxiety, and hormonal fluctuations may interfere with sex drive in both men and women, many people on chemotherapy are still able to have active sex lives.
Excretory system (kidneys and bladder)
The kidneys work to excrete the powerful chemotherapy drugs as they move through your body. In the process, some kidney and bladder cells can become irritated or damaged.
Symptoms of kidney damage include:
- decreased urination
- swelling of the hands
- swollen feet and ankles
- headache
You may also experience bladder irritation, which causes a feeling of burning when urinating and increased urinary frequency.
To help your system, your doctor will likely recommend you drink plenty of fluids to flush the medication out and keep your system functioning properly. Also, be aware that some medications cause urine to turn red or orange for a few days, but know this isn’t a cause for concern.
Skeletal system
Most people lose some bone mass as they age, but with chemo, some drugs increase this loss by causing calcium levels to drop. Cancer-related osteoporosis tends to affect women more than men, especially post-menopausal women and those whose menopause was brought on suddenly due to chemotherapy.
According to the National Institutes of Health (NIH), women treated for breast cancer are at increased risk for osteoporosis and bone fracture. This is due to the combination of the drugs and a natural drop in estrogen levels. Osteoporosis increases the risk of bone fractures and breaks. The most common areas of the body to suffer breaks are the spine and pelvis, hips, and wrists. You can help keep your bones strong by getting enough calcium and regular exercise.
Learn more: Alternative treatments for osteoporosis »
Psychological and emotional toll
Living with cancer and dealing with chemotherapy can take an emotional toll. You may feel fearful, stressed, or anxious about your appearance and health. Depression is a common feeling as well, as people juggle work, family, and financial responsibilities on top of cancer treatment.
Complementary therapies like massage and meditation can be a helpful solution for relaxation and relief. Talk with your doctor if you have trouble coping. They may be able to suggest a local cancer support group where you can speak with others undergoing cancer treatment. If feelings of depression persist, look for professional counseling or ask your doctors about medication. While emotional side effects are common, there are also ways to reduce them.
No matter what side effects chemo causes, it’s possible to take steps to increase your quality of life during treatment.