Chemotherapy Side Effects

People with cancer are often concerned with what chemotherapy side effects are going to occur during their treatment. They often hear about how terrible chemotherapy side effects are and how sick you can feel. What many people don't realize is that these days, many people do not suffer as many side effects. Medications can prevent some of the more unpleasant complications.

How your medication affects you depends on many factors, such as how aggressive treatment is, overall general health, and what type of cancer.

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Side Effects

Chemotherapy can produce many side effects, including:

  • Anemia, low red blood cell count
  • Low white blood cell count (this increases the risk of infection)
  • Hair loss, or thinning hair
  • Fatigue
  • Diarrhea, constipation
  • Nausea or vomiting
  • Fertility and sexuality problems

There is a wide range of side effects from chemotherapy. Remember that not everyone will experience side effects. One person may experience many effects, while someone else may only suffer from one or two side effects.

Why Are There so Many Side Effects?

Chemotherapy works by killing cancerous cells. However, sometimes it is aggressive against healthy cells, too. Since chemotherapy travels everywhere in the body, damage to healthy cells can occur at various places in the body.

Hair loss is one of the most emotionally devastating side effects of chemotherapy. Chemotherapy can affect the hair on your head, facial hair, pubic hair, and body hair. This includes eyelashes and eyebrows, also.

Hair Loss

Hair loss occurs because chemotherapy can sometimes damage healthy cells. It is so common because hair follicle cells multiply very quickly like cancer cells and chemotherapy drugs have difficulty in discerning the difference.

Will You Lose All of Your Hair?

There is no way to tell if someone will lose their hair during chemotherapy. Some people do not lose any at all. Some only suffer from thinning of the hair. However, there are many people who do lose all of their hair.

Hair loss all depends on the medications you are taking, dosage frequency, and how aggressive your treatment is.

Can You Do Anything to Prevent It?

Unfortunately, there is no guaranteed way to prevent hair loss during chemotherapy treatment. Scalp hypothermia, in which ice packs or cooling caps are placed on the scalp before a chemotherapy treatment, can be effective at preventing hair loss in some people with certain types of cancers.

Many people try to use over-the-counter hair growth shampoos, like Rogaine. Research has not proven this to be effective at reducing hair loss for chemo patients.

The National Cancer Institute says, that hair usually starts to grow back two to three months after chemotherapy ends.

Coping With Hair Loss

Hair loss can be devastating. Many patients feel like they can't go out in public, or that they will embarrass their family members. It's completely normal to feel this way. But, you can do many things to make your hair loss more acceptable and easier to cope with.

  • Purchase a wig prior to treatment that matches your hair color. This way, you will have one ready in case you do experience hair loss. Hair usually falls out in clumps during chemo, not evenly.
  • If you have ever wanted to experiment with different hair colors, now is the time to do so. Have fun with the different looks you can create with a hairpiece.
  • Cut your hair short. Short hair is easier to maintain and allows wigs to fit more comfortably. Plus, it appears fuller. Some people choose to shave their heads right when hair loss begins. Many feel it is less devastating to lose it all at once than a little bit at a time.
  • Scarves, hats, and turbans are becoming more fashionable, even for people without cancer. Many chemo patients use scarves or hats to cover their heads. They come in a variety of styles and can be tied in many ways for different looks.

Hair may be different when it begins to grow back. Some people find their hair a different color or texture.

Hair Care Tips During Chemotherapy

Tips for maintaining hair during chemotherapy, whether you have very thin hair, or haven't lost any at all.

  • Do not color or get a perm during chemotherapy. If you haven't experienced hair loss, remember that chemo can still affect follicles and the outcome might not be what you were looking for. With perms, not all strands may curl, and with hair color, not all strands may color.
  • Use a gentle shampoo, like baby shampoo and mild conditioner, every 3 to 5 days to keep hair healthy-looking.
  • Rinse hair thoroughly and pat dry. Do not use blow dryers, as they are very damaging to the hair.
  • Wear a scarf or hat when outdoors to prevent sunburn and heat loss.

Coping With Hair Loss

Coping with hair loss can be difficult. We often associate our hair with physical beauty. Without it, it's hard to feel attractive.

Wigs and hairpieces can make a big difference. Many look so natural, no one will recognize you are wearing a wig. Have fun exploring different looks with wigs.

Have comfort in knowing that your hair will grow back. Many times, it will grow back in better condition than what it was prior to treatment. Call it "Chemotherapy's Compensation Policy."

Prevent and Manage Diarrhea

Diarrhea is the passage of loose or runny stools. Frequent diarrhea can irritate the skin around the anus, making sitting or lying down very uncomfortable. It can also result in weight loss.

  • Drink plenty of liquids. Try clear liquids like water, Gatorade, Jell-O, or ginger ale. Drink them at room temperature and ingest them slowly.
  • Avoid high-fiber foods. Try to eat foods like chicken or turkey without the skin, skinned potatoes, white rice, noodles, pureed vegetables, and yogurts without the seeds.
  • Eat several small meals instead of three large meals.

If diarrhea persists, talk to your healthcare provider about using an over-the-counter anti-diarrheal medication, like Pepto Bismol, Immodium, or Kaopectate.

If symptoms persist, your practitioner can prescribe a medication such as Lomotil, to combat diarrhea.

Nausea and Vomiting

Nausea and vomiting during chemotherapy can cause severe loss of appetite, which in turn, causes nutrient deficiencies.

Odors and certain smells can cause nausea as well. Usually, this is from the smell of food cooking or laundry detergents, and sometimes even shampoos or perfumes.

Tips to Prevent and Manage Nausea and Vomiting

  • Avoid drinking liquids at meals. Wait at least one hour to have a beverage.
  • Drink lots of liquids. Most chemotherapy patients need at least two quarts a day. Ask your healthcare provider if this applies to you. Liquids are necessary to replace the liquids lost from vomiting.
  • Avoid large, heavy, fatty, or fried foods before and during treatment.
  • Eat small meals several times a day as opposed to three large meals.
  • Do not lay flat for at least two hours after you have eaten a meal

Healthcare providers usually prescribe an antinausea medication if it is likely you will suffer from nausea or vomiting from the medications. Common medications to fight nausea and vomiting are:

  • Ativan
  • Zofran
  • Pepcid

You can still continue to experience nausea and vomiting after taking these medications. There are several medications for your healthcare provider to prescribe. You might need to try a few different ones before you find the right one for you.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Lisa Fayed
Lisa Fayed is a freelance medical writer, cancer educator and patient advocate.