Chemotherapy side effects

If your cancer treatment plan involves chemotherapy, dealing with the symptoms of chemo is a top priority.

Chemo drugs kill fast-growing cells throughout the body, including cancer cells. But the drugs also attack healthy fast-growing cells. This damage can result in side effects ranging from mild to severe.

Chemo is most likely to damage these types of cells:

  • Hair follicles.
  • Bone marrow cells, which create the body’s blood supply.
  • Endothelial cells, which line the mouth, digestive tract, and reproductive system.

Many people with cancer worry about developing side effects from chemotherapy. Share your concerns with your care team. They will discuss possible side effects in detail before you start treatment.

Your doctor may be able to prescribe medications to prevent or limit side effects. Your care team will also manage any side effects throughout your treatment, so keep those lines of communication open.

Here’s what you need to know about the most common chemo side effects and how to manage them.


The American Society of Clinical Oncology (ASCO) reports that fatigue is the most common side effect of chemotherapy. Get as much rest as possible, both at night and by building short naps into your day. Talk to your doctor if you’re having trouble sleeping at night or fatigue affects your daily life.

With chemotherapy, fatigue is likely to peak a few days after each treatment. To adapt, plan tasks and activities for days when you’re likely to have more energy. Build in time for regular, gentle exercise to fight fatigue.

Ask friends and family for help when you need it.

Never Miss a Beat!

Get Healthy Tips Sent to Your Phone!

Message and data rates may apply. Text the word STOP to opt out and HELP for help. Click here to view the privacy and terms.

Nausea and Vomiting

Nausea and vomiting are common with chemotherapy. The good news is that doctors have many effective anti-nausea drugs. Sometimes you may need to experiment to find the right anti-nausea drug for you.

Be sure to take your anti-nausea medication exactly as directed. Keep your medical team informed if you experience nausea or vomiting.

Eat small, light meals throughout the day. Limit caffeine and avoid greasy or spicy foods. Drink plenty of fluids to avoid dehydration.

Acupuncture may help. The National Cancer Institute reports that many clinical trials have found that acupuncture can relieve nausea and vomiting.

Hair Loss

Losing your hair can be an emotional part of chemotherapy, but it’s not inevitable. For some patients, wearing a cooling cap during chemotherapy can help protect their hair. UPMC is proud to offer scalp cooling to certain patients with cancer.

A cooling cap system consists of a helmet-like headpiece attached to a hose and machine. This system circulates cold fluid over your scalp at each chemotherapy appointment. The coldness constricts the blood vessels in your scalp, so less chemo reaches hair follicles.

Scalp cooling treatment isn’t for everyone. Talk to your care team before your first chemo treatment if you’d like to explore this option.

Some ways to minimize hair loss include avoiding heat (like hair dryers and curling irons) and chemical treatments (like dyes and perms). You may also want to minimize brushing, which can encourage breakage. Using a soft hairbrush or wide-toothed comb may help.

Mouth Sores

Chemo can damage healthy cells in the lining of your mouth. This can lead to redness, swelling, or sores in your mouth or on your tongue, throat, or lips. According to ASCO, sores most often develop five to 14 days following treatment.

Rinse your mouth every four to six hours with an alcohol-free mouthwash. Your medical team may also give you instructions for making your own saltwater rinse. Swish, gargle, and spit without swallowing.

Avoid acidic, salty, or spicy foods — and avoid too-hot foods that might burn your mouth. Choose a soft toothbrush and use lip balm frequently to keep lips from cracking, which increases your chances of developing a sore.

Contact your medical team if you think a sore might be infected. Signs of an infected sore include unusual warmth or swelling, increased pain or discharge, and fever.

Chemo Brain

You might have heard the terms “brain fog” and “chemo brain” as side effects of chemotherapy. That’s because many people with cancer experience concentration and memory problems.

No one knows exactly what causes chemo brain, but there are probably many factors. These include specific cancer drugs, your overall health and age, and even the cancer itself.

Talk to your doctor if you notice any mental changes during cancer treatment, even if they’re mild. Don’t wait for chemo brain to affect your everyday life before taking action.

To help you cope with chemo brain, do all the things that generally support good health. That means you should:

  • Get plenty of rest.
  • Exercise regularly.
  • Drink lots of water.
  • Eat a balanced, vegetable-rich diet.
  • Limit alcohol and caffeine.

You can also use reminder notes, a daily planner, or your smart phone to help you cope with chemo brain on a daily basis. Stick to a regular schedule as much as possible.

Plan your most important tasks for when you feel most alert. Try not to multitask. Ask your friends and family for help when you need it.

Stay in Touch with Your Care Team

Side effects from chemo can be mild or severe, short-term or long-lasting. That’s why you’ll want to keep your doctor informed about all chemo side effects.

Here are some general suggestions about when you should call your doctor during chemo. Call if you have:

  • A fever above 100.5°F.
  • Bleeding or unexplained bruising.
  • Diarrhea or vomiting even after taking medication to treat these symptoms.
  • Pain or redness at your chemo injection site or chemo port .
  • A new sore throat, cough, or rash.
  • Severe chills.
  • Mouth sores that prevent you from swallowing, eating, or drinking.

Your doctor will give you specific instructions about when to call to discuss treatment side effects. Always follow those instructions.

Throughout your cancer journey, your care team will manage your treatment and any chemo side effects that develop. Don’t hesitate to talk to your doctor or nurse with any questions or concerns.

Chemotherapy Side Effects. American Cancer Society. Link

Side Effects of Chemotherapy. American Society of Clinical Oncology. Link

What Is Chemo Brain? American Cancer Society. Link

Acupuncture (PDQ®)–Patient Version. National Cancer Institute. Link

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.