Side effects are relatively common with chemotherapy but they usually stop once treatment has finished

Chemotherapy affects healthy body cells as well as cancer cells – and this is what causes side effects. The dose of chemotherapy you are given will be calculated very carefully to have the greatest impact on cancer cells and the least impact on normal body cells. However, most women suffer some short-term side effects with chemotherapy.

Side effects can vary a great deal, depending on the exact drugs you are given. Different people’s bodies can also react differently to the same type and dose of drugs.

Common short-term side effects include: 

  • Hair loss
  • Risk of infections
  • Anaemia
  • Changes to your menstrual cycle
  • Tiredness
  • Nausea
  • Vomiting
  • A sore mouth
  • Mouth ulcers
  • Altered sense of taste
  • Muscle and joint aching
  • Diarrhoea
  • Weight gain
  • Bruising or bleeding more easily

There are treatments available to eliminate or reduce many of the most common side effects. Ask your breast care nurse or oncologist for help if you are having problems. Most side effects will stop after each treatment cycle ends.

Hair loss

You may experience anything from slight to complete hair loss as a result of chemotherapy, although not all drugs will cause this. If you do experience hair loss, it will normally start growing back at the end of your treatment, or sometimes before.

Losing your hair can be a very emotional and distressing experience, and you may want to wear a wig during this time, which the NHS can provide. This may be offered free of charge or for a small cost, depending on your circumstances.

Your breast care or chemotherapy nurse should be able to guide you through the process of getting a wig and having it fitted.

Losing your hair can be a very emotional and distressing experience, and you may want to wear a wig during this time, which the NHS can provide free of charge. Your breast care or chemotherapy nurse should be able to guide you through the process of getting a wig and having it fitted.

Losing your hair can be a very emotional and distressing experience, and you may want to wear a wig during this time, which the NHS can provide free of charge. Your breast care or chemotherapy nurse should be able to guide you through the process of getting a wig and having it fitted.

Losing your hair can be a very emotional and distressing experience, and you may want to wear a wig during this time, which the NHS can provide free of charge. Your breast care or chemotherapy nurse should be able to guide you through the process of getting a wig and having it fitted.

Some hospitals offer scalp cooling which may help reduce hair loss. This involves wearing a ‘cold cap’ which cools your scalp during chemotherapy. However, scalp cooling does not work for everyone and it isn’t currently available in all hospitals.

Infections

You are at an increased risk of getting an infection during chemotherapy because it can reduce the level of infection-fighting blood cells, called neutrophils, in your blood. This is called neutropenia. If you are at risk of neutropenia or you develop neutropenia during your chemotherapy, you might be prescribed granulocyte-colony stimulating factor (G-CSF) injections to treat it and reduce your risk of infection. Your chemotherapy dose may be reduced or chemotherapy delayed until your neutrophil levels improve.

You’ll be given information about neutropenia and how you can reduce your chances of getting an infection. Infections can become serious if untreated, so your breast care nurse or oncologist will let you know what to look out for and when you should seek prompt medical advice. For example, if you feel feverish, ‘fluey’, or unwell, you should seek medical advice from your breast care team or out-of-hours care.

Anaemia

Chemotherapy can sometimes cause a reduction in the number of your red blood cells, known as anaemia. Anaemia caused by chemotherapy treatment is usually mild, but can sometimes affect you quite severely, making you feel very tired and unable to do most things. During the course of your chemotherapy you will have regular blood tests to check your blood cell levels. If necessary, you may be given a blood transfusion to boost the levels of red cells in your blood.

Effects on fertility

Chemotherapy can affect your fertility either temporarily or permanently. This depends on your particular chemotherapy regimen as well as your age. If you have not been through the menopause you might have menopausal symptoms during chemotherapy, such as your periods stopping, hot flushes, sleep disturbance and vaginal dryness. If you are under 40, these symptoms will usually end after your treatment and your fertility will return to normal. However, you may enter an early menopause and become permanently infertile. This is more common in older women.

If you would still like the option of having a child after chemotherapy, your breast care team will discuss your options with you before you begin treatment. Some hospitals can offer fertility services such as the collection and freezing of embryos or eggs, with the aim of carrying out in vitro fertilisation (IVF) once your treatment is complete. However, these methods are not always successful and can take a few weeks, potentially delaying the start of your treatment. Your breast care team will advise you on how this could affect your treatment.

An early menopause may also increase your risk of osteoporosis (weakening of the bones) and heart problems. If you enter an early menopause, you should be given a bone density scan to monitor your risk of osteoporosis.

Long-term side effects

Some types of chemotherapy can cause longer-term side effects including heart problems and leukaemia but these are very rare. Your breast care team will explain any potential long-term side effects of your chemotherapy regimen.

Need more information?

For practical and emotional support you can contact Breast Cancer Care (0808 800 6000) or Macmillan Cancer Support (0808 800 0000)

For practical and emotional support you can contact Breast Cancer Care (0808 800 6000), Macmillan Cancer Support (0808 800 0000) or Tenovus Cancer Care (0808 800 1010)

Breast Cancer Care has more information on fertility and dealing with hair loss.

Information Standard

Information last reviewed: November 2017

Next review due: November 2020

Breast Cancer Now's health information is covered by NHS England's Information Standard quality mark. Find out how this resource was developed.