Side effects of cancer treatment

Treatment side effects vary depending on the type of cancer you have, the stage of the cancer, and the type of treatment you are given. The changes can be both physical and emotional. Some side effects resolve quickly; others can take weeks, months or even years to improve.

Your body will cope with the treatment and recovery in its own way. Try not to compare yourself to others. You should talk to your doctor or nurse about possible side effects before your treatment begins. It is important to know what to watch out for or report, and who to contact out of hours if you have immediate concerns.

On this page you will find details about the following common side effects:

For more information on the specific side effects of each cancer treatment please refer to the Understanding Cancer Treatment booklet series.

Fatigue

Feeling tired and lacking energy (fatigue) is the most common and often the most debilitating side effect of cancer treatment. Fatigue can include feeling exhausted, drowsy, confused or impatient. You may have a heavy feeling in your limbs, get worn out quickly, or find it difficult to do daily activities.

Fatigue can appear suddenly and rest may not relieve it. You might still feel tired for weeks or months after a treatment cycle ends.

Tips for managing fatigue:

  • Ask for help. Get a friend to help with school pick-ups, shopping or running errands.
  • Plan activities for the time of day when you tend to feel most energetic.
  • Be realistic.  Don’t expect to be able to instantly do everything you used to do. Your body is still recovering and it will take time for your energy levels to return.
  • Regular light exercise can help reduce fatigue and increase your appetite. Talk to your health care team about suitable activities for you.
  • Try to eat a well balanced diet with plenty of fruit and vegetables.

Hair loss

Many people having chemotherapy and radiotherapy worry about hair loss. Some people lose all their hair quickly, others lose it after several treatments, or others may only lose a little hair or none at all.

When hair loss does occur, it usually starts 2–3 weeks after the first treatment. Before and while your hair is falling out, your scalp may feel hot, itchy, tender or tingly. Some people find that the skin on their head is extra sensitive and they may develop pimples on the scalp. Although losing head hair is most common, you may also lose hair from your eyebrows, eyelashes, arms, legs, chest and pubic region.

Many people find losing their hair very difficult. You may feel your hair is part of your overall image and its loss can make you feel physically unattractive, vulnerable or sad. It’s natural to feel this way. Talking to your medical team may be helpful.

Tips for managing hair loss:

  • Keep your hair and scalp very clean.
  • Use a mild shampoo like baby shampoo.
  • If you want to use lotion on your head, use sorbolene. Check with your nurse before using any other hair or skin care products.
  • Wear a light cotton turban or beanie to bed if you are cold at night, or to collect hair.
  • Use a cotton, polyester or satin pillowcase as nylon can irritate your scalp. If you prefer to leave your head bare, protect it against sunburn and the cold.
  • Wear a wig, hat, scarf or turban, or go bareheaded, whatever feels best to you.

Cancer Council offers a Wig and Turban service for all cancer patients free of charge. Submit an enquiry online or phone 13 11 20 to find out more.

For more information, read our hair loss fact sheet.

Lymphoedema

Lymphoedema is swelling of parts of the body, usually a limb such as the arm. When lymph nodes have been damaged or removed, lymph fluid may not drain properly. The fluid builds up, causing swelling.

Symptoms of lymphoedema are easier to manage if the condition is diagnosed and treated early. Signs of lymphoedema include swelling, heaviness or fullness in the arm, redness and skin warmth. These signs may begin gradually and they may come and go. Some people experience pain of fever, which may mean an infection. If you have swelling see your doctor as soon as possible.

In many hospitals, a lymphoedema practitioner will assess you before you have surgery. Some hospitals have specialist physiotherapists who can teach you simple exercises to reduce your risk of developing lymphoedema.

If you develop lymphoedema, the swelling can be reduced by wearing a professionally-fitted elastic sleeve or by massage from a trained lymphoedema practitioner, physiotherapist, nurse or occupational therapist.

Appetite changes

You may lose your appetite because of the effects of cancer itself, the treatment, or other side effects, such as feeling sick, not enjoying the smell of food, or feeling upset. This is a common issue for people diagnosed with cancer.

Tips for managing loss of appetite

  • Eat small meals frequently, e.g. every 2-3 hours.
  • Use a smaller plate – a big full plate may put you off eating
  • Eat what you feel like, when you feel like it.
  • Include a variety of food in your diet as this may improve your overall intake.
  • Sip fluids throughout the day, and replace water, tea and coffee with drinks that add energy, such as milk, smoothies or soup.
  • Relax dietary restrictions. During treatment, maintaining your weight or regaining weight you have lost is more important than avoiding full fat and other high-energy foods.
  • Gentle physical activity can stimulate appetite.
  • Make meals as enjoyable as possible.

For more information on appetite changes, please refer to the Nutrition and Cancer booklet.

Nausea and vomiting

Feeling sick (nausea) and vomiting are often side effects of cancer, its treatment and some medicines. They often occur together, but not always. Some people experience nausea and vomiting a few hours after treatment, while for others it starts 24 hours later.

Tips for managing nausea and vomiting:

  • Have a light snack before treatment, and wait a few hours before eating again.
  • Eat small meals 5-6 times during the day
  • Snack on dry or bland foods, and choose cold foods or foods at room temperature instead of hot, greasy or spicy foods.
  • Try to keep your fluids up so that you don’t get dehydrated.
  • If you aren’t able to keep fluids down, contact your doctor immediately.
  • Sip small amounts of fluids as often as possible. Try dry ginger ale, cold flat lemonade, soda water.
  • See your doctor if you can’t keep fluids down, or if the vomiting lasts more than 24 hours, as you may become dehydrated.

For more information on managing nausea and vomiting, please refer to the Nutrition and Cancer booklet.

Constipation and diarrhoea

Cancer treatments may cause constipation and/or diarrhoea.

Tips for managing constipation:

  • Drink plenty of fluid, 8-10 glasses a day.
  • Eat foods high in fibre
  • Ask your doctor about using a laxative
  • Exercise every day – check with your doctor about the amount and type of exercise that is right for you

Tips for managing diarrhoea:

  • Drink plenty of fluids
  • Choose low fibre foods
  • Avoid foods that increase bowel activity
  • Don’t eat too many raw fruit and vegetable skins and wholegrain cereals

For more information on managing bowel changes, please refer to the Nutrition and Cancer booklet.

Sexuality, intimacy and fertility

Cancer can affect your sexuality in physical and emotional ways. The impact of these changes depends on many factors, such as treatment and side effects, your self confidence, and if you have a partner. Although sexual intercourse may not always be possible, closeness and sharing can still be part of your relationship.

If you are able to have sex, you may be advised to use certain types of contraception to protect your partner or avoid pregnancy for a certain period of time. Your doctor will talk to you about the precautions to take. They will also tell you if treatment will affect your fertility permanently or temporarily. If having children is important to you, talk to your doctor before starting treatment.

Tips for managing changes to sexuality, intimacy and fertility:

  • Plan sexual activity for the time of day when your pain is lowest. To be most effective, pain medication should be taken shortly before sex.
  • Talk to your partner if you have little or no interest in sex (low libido). They may be able to help you get in the mood. They may also need to accept that you may not be able to get in the mood for some time.
  • Ask your doctor if any medications can help with sexual problems, such as difficulties getting or maintaining an erection.
  • Physical activity can stimulate sexual desire by increasing energy and lifting your mood

For more information view our Sexuality, Intimacy and Cancer or Fertility and Cancer booklet.