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Coping with Chemotherapy: What to Expect

Although chemotherapy is a powerful weapon against cancer, it has a reputation for causing unpleasant side effects like nausea, vomiting, fatigue and hair loss. If you or someone you love is facing chemotherapy treatments, learning what to expect can help you prepare to prevent, reduce or cope with unwanted effects and complete your treatment.

Why Chemotherapy Causes Side Effects

Your oncologist will choose your treatment from more than 100 anti-cancer drugs. Many people take more than one drug, called combination therapy. Cancer cells typically multiply rapidly, and the chemotherapy drugs attack cancer cells by targeting fast-growing cells in the body.

However, chemotherapy drugs can also harm other noncancerous cells that grow rapidly, such as those in hair follicles, bone marrow and the digestive tract. Damage to healthy cells is what causes side effects, but these healthy tissues usually recover and repair themselves after treatment ends.

Some people have few side effects and some have none. Whether you will suffer side effects depends on the anti-cancer drugs your doctor prescribes, how often you receive treatment and for how long.

To prepare for your treatment, talk to your oncologist or nurse about what to expect and take these preventive and coping measures:

Fight fatigue. An overwhelming feeling of tiredness and lack of energy is the most common symptom reported by people with cancer. Fatigue can be caused by a number of factors related to your cancer, including the cancer itself as well as chemotherapy, surgery, radiation therapy, low blood count and poor sleep or appetite. To cope with fatigue:

  • Plan your day so you can take short breaks or naps and save your energy for the most important activities.
  • Eat nutritious foods as often as you can and drink plenty of fluids.
  • Take short walks or try light exercise.
  • Accept help from friends and family.
  • Tell your doctor or nurse about your fatigue. If you’re anemic, you may need drugs or a blood transfusion to boost your red blood cells.

Combat nausea and vomiting. These two side effects are among the most dreaded—but manageable—effects of cancer treatment. Powerful drugs, called anti-emetics or anti-nausea drugs, have made nausea and vomiting far less common and less severe. To prevent nausea and vomiting:

  • Ask your oncologist to prescribe an anti-emetic drug to take before or during your chemotherapy treatment. Not all medicines work the same for everyone, and you may need more than one drug.
  • Eat a light meal before your treatment. Afterward, plan to eat more frequent but smaller meals and drink cool, clear, unsweetened juices or flat ginger ale.
  • Suck on mints or tart candies and avoid sweet, fried or fatty foods.

Cope with hair loss. Losing hair may not happen right away, and not everyone suffers hair loss with chemotherapy treatments. Some people experience only thinning while others’ hair falls out entirely. Hair usually grows back after treatments are completed. To help cope:

  • Cut your hair short to make it look fuller. It will be easier to manage if hair loss occurs.
  • Baby your hair with a mild shampoo, soft brush and a low hair-dryer setting and avoid dyeing, perming or relaxing your hair.
  • Protect your scalp from the sun with a scarf, hat or sunscreen.
  • Shop for a wig or hairpiece before you lose all your hair to more closely match your color and style. Check your health insurance policy; it may be a covered expense.

Manage mouth sores. Some chemotherapy drugs cause mouth or throat tissues to become irritated or develop sores, and gums may become very sensitive. To keep your mouth, throat and gums healthy:

  • See your dentist several weeks before your treatment for a cleaning and to address any cavities, repairs or poorly fitting dentures.
  • Brush your teeth and gums with a soft toothbrush after every meal.
  • Eat soft, soothing foods such as ice cream, milkshakes, applesauce, cooked cereals, mashed potatoes, macaroni and cheese, scrambled eggs or pudding. Avoid irritating, acidic foods like tomatoes and citrus, spicy and salty choices.
  • Avoid mouthwashes that contain alcohol. Rinse your mouth with warm salt water or ask your doctor to prescribe a mild, medicated mouth rinse.
  • If you already have sores, your doctor can prescribe medicine to apply to them to ease pain.

Sticking with chemotherapy is important for treating your cancer. If side effects are making it difficult to cope, don’t suffer in silence. Tell your oncologist or nurse about any side effects you have. He or she can help you manage your symptoms to get relief. Most side effects will start to disappear once treatment ends.

Serious chemotherapy side effects

Some side effects could warn of a potentially serious problem. Let your physician or nurse be the judge and call right away if you suffer any of the following:

  • A fever of 100.5 F or greater
  • Bleeding or unexplained bruising
  • A rash or allergic reaction like wheezing, swelling or severe itching
  • Intense chills
  • Pain or soreness at your chemotherapy injection or catheter site
  • Unusual pain or intense headache
  • Shortness of breath
  • Prolonged diarrhea or vomiting
  • Blood in your stool or urine

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