10 Surprising Side Effects of Chemotherapy-And How to Manage Them

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    How to Cope With Chemo
    Most people know chemotherapy can cause hair loss, nausea and vomiting. But did you know chemotherapy can also affect your heart and thinking? The more you know about chemotherapy side effects, the better prepared you’ll be to identify–and treat–these sometimes uncomfortable, almost always inconvenient reactions. While each person’s treatment experience is unique, these 10 side effects often catch people by surprise.



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    1. Peripheral Neuropathy
    Chemotherapy kills cancer cells. It can also damage nerves. One possible side effect of chemotherapy is peripheral neuropathy, or damage to the nerves that carry messages from the brain to the rest of the body. Symptoms of peripheral neuropathy include numbness, tingling, weakness, pain or a burning sensation in the hands or feet. Tell your doctor if you experience any symptoms of peripheral neuropathy. Early treatment may prevent further nerve damage. Your doctor can also prescribe medication to relieve neuropathy-related pain.



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    2. 'Chemo Brain'
    Many cancer patients report feeling a 'mental fog' during and after chemotherapy treatment; this condition has been dubbed 'chemo brain.' Symptoms include memory lapses, difficulty recalling details and dates, a shortened attention span, disorganized thinking, slower-than-normal processing, and trouble remembering common words. Approximately 14% to 85% of cancer patients develop chemo brain. The good news: Most people recover their full mental capacity a few months after stopping chemotherapy. In the meantime, use a written planner or your phone to keep track of important events and daily to-do lists. Get plenty of rest and avoid multitasking.

  • Woman With Headache Holding Hand on Head
    3. Extreme Fatigue
    Fatigue is the most common chemotherapy side effect. However, you might be surprised by the intensity of chemo-related fatigue. Rest and naps can help, but they don’t relieve chemotherapy-caused fatigue. The best way to cope is to revise your expectations. Don’t plan to work a full day after chemotherapy; give yourself the remainder of the day (and the following day, if possible) to rest. Allow others to make your meals and assist with childcare and household tasks. Report your fatigue to your healthcare provider. Sometimes, low blood counts contribute to fatigue; treatment may boost your energy.



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    4. Heart Disease
    Some common chemotherapy drugs can contribute to the development of heart problems, including enlargement and weakening of the heart and heart rhythm problems. Chemotherapy may also increase your risk of heart attack, stroke, high blood pressure, and blood clots. Not everyone who undergoes chemotherapy will develop heart trouble. However, if one (or more) of your chemo drugs is associated with an increased risk of heart problems, your healthcare providers will carefully monitor your heart health during and after completion of your treatment.



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    5. Mouth Sores
    Because chemotherapy targets fast-growing tumor cells, it can also affect other fast-growing cells in the body, including those inside your mouth. Many people develop sores on the inside of their mouths during chemotherapy treatment. These sores can be uncomfortable and make it difficult to eat or drink. Report any mouth sores to your healthcare team. Prescription mouthwashes that contain numbing medication can ease the pain. Your healthcare provider may also recommend a homemade mouth rinse of baking soda, warm water and salt.



  • woman eating breakfast food with bad taste in mouth or feeling of nausea
    6. Taste Changes
    Chemo can affect your sense of taste and smell. As a result, food may not taste the same. Some people also say chemotherapy causes a metallic taste in the mouth. It’s hard to eat when food doesn’t taste right, especially if your appetite is decreased and you have sores inside your mouth. But nutrition is important to your overall health and healing, so it’s essential to eat nutrient-dense foods throughout the day. If you have a metallic taste in your mouth, switch to plastic utensils and avoid cooking in metal pans. Try adding extra spice to food to enhance its flavor.



  • older woman with arm bruise
    7. Bruising
    Chemotherapy decreases the number of platelets in your blood. Platelets play an essential role in the blood clotting process, so people with low platelet levels are prone to bruising and bleeding. You may find that a simple bump into a table now causes a large bruise that lasts for days. Some people undergoing chemotherapy also develop tiny purple or red spots on their skin, a condition called thrombocytopenia. You can decrease your risk of bruising and bleeding by avoiding aspirin and ibuprofen; both thin the blood slightly and increase the risk of bleeding. Decreasing your alcohol intake may also help.



  • Couples Feet in Bed
    8. Sexual Difficulty
    No one expects cancer treatment to be an aphrodisiac, but many people are still surprised and distressed by the impact of chemotherapy on their sex lives. Chemotherapy may lower testosterone and estrogen levels in men and women, which can cause a reduced sex drive. In women, low estrogen levels are also associated with vaginal dryness. Chemotherapy also can cause sores on vaginal lining, just as it does inside the mouth. While undergoing chemotherapy, it’s important to remember that sexual intimacy doesn’t have to include penetration and intimacy doesn’t even require sexual contact. Embrace the freedom to get creative.



  • woman-putting-moisturizer-on-hand
    9. Dry Skin
    Some people develop dry, itchy skin during chemotherapy. Some also become extremely sensitive to the sun. It’s a good idea to use mild skin care products throughout your treatment; your healthcare team should be able to recommend cleansers and lotions. Sun protection is essential; slather on sunscreen before heading outside and wear protective clothing whenever possible. If your skin becomes very inflamed or irritated, tell your physician; in some cases, prescription lotions can help.



  • smiling caucasian woman standing in front of lake
    10. Hair Changes
    Most people know chemotherapy can cause hair loss. What you may not realize is that hair often regrows in surprising ways. Some people who normally have stick-straight hair are stunned to see curly hair sprouting atop their formerly bald heads. Sometimes, the hair is even a different color! In most people, hair will eventually recover back to its usual color and texture. In the meantime, experiment with your new hair. An experienced hair stylist can help you find a style that suits you both now and in the future.



10 Surprising Side Effects of Chemotherapy—And How to Manage Them

About The Author

Jennifer L.W. Fink, RN, BSN is a Registered Nurse-turned-writer. She’s also the creator of BuildingBoys.net and co-creator/co-host of the podcast On Boys: Real Talk about Parenting, Teaching & Reaching Tomorrow’s Men.
  1. Chemotherapy Side Effects. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html
  2. Nerve Problems (Peripheral Neuropathy) and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/nerve-problems
  3. Managing Peripheral Neuropathy. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/peripheral-neuropathy/managing-peripheral-neuropathy.html
  4. Chemobrain. Fred Hutchinson Cancer Research Center. https://www.fredhutch.org/en/treatment/survivorship/survival-strategies/chemobrain.html
  5. Memory or Concentration Problems and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/memory
  6. Chemotherapy to Treat Cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/chemotherapy
  7. Fatigue and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/fatigue
  8. Chemotherapy Side Effects: A Cause of Heart Disease? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/expert-answers/chemotherapy-side-effects/FAQ-20058319?p=1
  9. Appetite Loss and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss
  10. Mouth and Throat Problems and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat
  11. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/bleeding-bruising
  12. Hair Loss (Alopecia) and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/hair-loss
  13. Sexual Health Issues in Men with Cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-men
  14. Sexual Health Issues in Women with Cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-women
  15. Skin and Nail Changes and Cancer Treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes


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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jun 28
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.