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Chemotherapy Side Effects

  • Anemia
  • Bone Marrow Suppression (low white blood cells, nautropenia)
  • Constipation
  • Decreased Platelets
  • Diarrhea
  • Febrile Neutropenia
  • Hair Loss
  • Nausea and Vomitting
  • Mouth Sores
  • Sensitive Skin
  • Urinary

These are just some of the most common side effects from treatment. Please speak to your team if you have any questions or concerns regarding your treatment.
Please phone your doctor when:

  • Experiencing persistent/severe vomiting
  • Unusual bleeding or bruising
  • Dizziness, extreme fatigue or shortness of breath
  • Cough that doesn't get better
  • Severe sore throat or mouth
  • You have a burning sensation or bleeding on urination
  • Experience sudden or severe rash/hives/itching

For a temperature of 38.2°C or higher you must go to your nearest emergency room immediately.


Chemo Unit  -  416-586-4800 ext. 2845

11 South Unit  -  416-586-4800 ext. 4580

Dr. Blackstein, Medical Oncologist  -  416-586-4800 ext. 5371

Bone Marrow Suppression

White blood cells protect your body by fighting germs/bacteria that cause infection. Your white cells normally decrease 7 to 14 days after treatment. Sometimes your medical oncologist will give you a prescription for oral antibiotics to take during the time your white count is at its lowest. It is very important that you follow the directions and finish the entire prescription. Your oncologist might also consider growth stimulating drugs such as Neupogen or Neulasta should you encounter frequent problems with low white counts. These drugs can be quite expensive so it might be good to see if these are covered under a drug insurance plan if you have one. The important thing for patients to do is to prevent exposure to infection.


  • Avoid crowds and people who are sick
  • Good handwashing
  • Wash fresh fruits and vegetables well
  • Avoid pet excreta
  • Take good care of skin and mouth (includes daily bathing and mouth care after meals and before bed)
  • Ensure your food is properly prepared and cooked well
  • Let your doctor know if you are experiencing chills, cough, burning when passing urine or a sore throat (these might be indications of infection)

Febrile Neutropenia

Febrile Neutropenia is a medical emergency as a result of low white cell counts. You should keep an eye on your temperature during the time you are at home. If you have a temperature of 38.2°C or greater, immediately seek medical attention at your nearest emergency department. Do not take any medications such as Tylenol (acetaminophen) or Aspirin (ASA) before going to emergency. Tell the triage nurse that you have had chemo and your temperature is 38.2°C or greater. They will know what action to take. Usually they will draw blood, take a urine sample, chest X-Ray and start you on antibiotics. Most times we will never know what caused your temperature to go up however it is much better to be safe than sorry.

Information you should always carry with you: Name of your oncologist, date of last chemo treatment, drugs that you received.

Decreased Platelets

Your platelets help your blood to clot when you hurt yourself. These may decrease 5-15 days after treatment. You should focus on trying to prevent any bleeding problems such as bruising, burns or cutting yourself.


  • Wear gloves when gardening or protective gloves when cooking
  • Blow your nose gently; Do not pick your nose
  • Use electric razors
  • Use a soft toothbrush to avoid bleeding gums
  • Avoid constipation
  • Avoid enemas, rectal temperatures, tampons
  • For minor pain use acetaminophen (Tylenol)
  • Avoid painkillers such as ASA (Aspirin) or Ibuprofen (Advil)


Your red blood cells (hemoglobin) are responsible for carrying oxygen throughout your body. When these cells decrease you may feel very tired/fatigued or even short of breath on exertion.


  • Rest and conserve your energy as much as possible
  • Eat foods rich in iron (e.g. dark, leafy greens; liver)
  • Occasionally your red cell count may be so low you might require a transfusion or we may start you on a growth hormone called Epoetin Alpha or Eprex
  • Again, if you have a drug plan please investigate whether this drug is covered

Hair Loss

Hair loss may occur and begin within a few days or weeks of treatment. It may include all facial and body hair. It is important to remember that your hair will grow back once your treatments are over.


  • Use a soft brush
  • Consider attending the Look Good Feel Better Program
  • Consider the use of a wig
  • Protect your scalp with a hat, scarf or wig in cold weather
  • Cover your head or apply sunscreen on sunny days
  • Consider cutting your hair short before it begins to fall out
  • If you lose your eyelashes protect your eyes by wearing glasses, a hat and investing in rewetting eye drops

Nausea and Vomiting

These symptoms may occur during or after chemotherapy. You will be given medications during treatment as well as additional prescriptions for anti-nausea medication(s) to be taken while at home. There are other things that might also help decrease your nausea/vomiting.


  • Follow directions of prescription closely
  • Drink plenty of liquids
  • Rather than eat large meals, eat smaller more frequent meals
  • Avoid sweet, fatty, salty or spicy foods
  • Eat a high protein diet
  • Avoid foods that are gas forming
  • Drink cool, clear beverages between meals
  • Stay away from the kitchen during food preparation if smells make you nauseous
  • Consider using supplementary drinks such as Resource or Ensure to keep your calorie intake up
  • Eat slowly
  • Try slow, deep breathing through your mouth

Mouth Sores

Mouth sores or ulcers can develop after treatment. You might notice pain when swallowing; burning sensation in the mouth; or ulcers on your tongue, sides of mouth and throat. Below are suggestions on how to prevent or minimize mouth sores. However should you develop mouth sores please let your medical team know. There are medicated mouthwashes that can be prescribed to help relieve the discomfort and treat the sores.


  • Brush your teeth gently after every meal and before bedtime
  • Rinse mouth frequently with a mouth rinse of ½ teaspoon of baking soda or salt in 1 cup of warm water
  • Avoid mouthwashes with alcohol in them
  • Avoid spicy, crunchy or acidic food
  • Avoid foods high in sugar
  • Suck on ice chips
  • Eat moist foods (e.g. fruit, ice cream, scrambled eggs)
  • Avoid alcohol and tobacco


Constipation may occur after therapy.


  • Increase fluid intake
  • Increase fibre in diet (high fiber foods are: bran, raw fruits and vegetables, dried fruits, whole grains breads, cereals and nuts)
  • Increase regular exercise
  • Avoid harsh laxatives


Diarrhea may occur after therapy.


  • Try to drink only broth and/or diluted juices as soon as diarrhea starts
  • Avoid raw fruits and vegetables and high fiber foods
  • Avoid gassy food
  • Try eating small meals more often
  • Avoid milk and foods made with milk
  • Drink plenty of fluids to replace those you have lost (better to drink room temperature rather than cold or hot)

Sensitive Skin

Your skin will become very sensitive to light.


  • Wear sunscreen at all times
  • Wear a long sleeve shirt when out in the sun
  • Wear a broad brimmed hat


Some chemotherapy drugs may affect your bladder. It is important to let us know if you are experiencing frequency, burning on urination or blood in your urine. If you receive the drug Doxorubicin/Adriamycin do not be surprised if your urine turns pink for 24 hours after treatment.


  • Void often
  • Drink plenty of fluids