Chemotherapy Side Effects and When to Get Help

Which symptoms need urgent help?

Chemotherapy can reduce white blood cells, which help fight infection. Infection when these cells are low can lead to neutropenic sepsis, a medical emergency. Do not wait for a routine appointment or a blood test result if you become unwell during treatment.

• Call your treatment team immediately for a high or low temperature, shivering, or feeling suddenly unwell, even if your temperature is normal. Follow the temperature limits on your own treatment card.
• Also call for possible infection, including a sore throat, new cough, diarrhoea, pain when passing urine, or redness or pain around a line.
• Contact the team promptly about a painful, swollen arm or leg, new breathlessness, chest pain or coughing up blood. These may be signs of a blood clot.
• For a life-threatening emergency, including severe difficulty breathing, collapse or new confusion, call 999. Tell the responder you are having cancer treatment.

Use your hospital’s 24-hour advice line day or night. If you cannot reach the team or do not know the number, seek urgent help through NHS 111 where available, or your local urgent out-of-hours service. Emergency symptoms need 999 or A&E. This list is not exhaustive; follow your team’s written instructions.

How can I manage feeling sick?

Take anti-sickness medicines according to your prescription. Some are taken regularly and others only when needed. Small meals and frequent sips may be easier to manage. If sickness is not controlled, call your team: a different medicine may help. Get advice promptly if you cannot keep fluids or medicines down; do not wait until you are dehydrated.

What helps a sore mouth or changes to eating?

Use a soft toothbrush and follow the mouth-care instructions from your team. Soft, moist food may be easier to eat. Avoid food or mouthwash that stings. Report ulcers, white patches or pain, especially if they affect drinking or eating. Your team can check for infection, prescribe treatment and arrange dietitian support.

Will I lose my hair?

Some chemotherapy medicines cause hair loss and others cause thinning or little change. Scalp cooling may reduce hair loss for some people, but it does not suit every treatment or work for everyone. Ask before your first session if you want to consider it. Hair usually regrows after chemotherapy, although lasting thinning or hair loss can sometimes occur. Ask about wigs, headwear and scalp care if these would help.

What should I know about fatigue and tingling?

Fatigue can be more intense than ordinary tiredness. Balance rest with manageable activity, pace daily tasks and accept practical help. Tell your team if fatigue is severe or changing so they can check possible causes, such as anaemia.

Report new numbness, tingling, burning or difficulty with buttons, walking or balance. These can be signs of peripheral neuropathy. Early reporting helps your team consider changes to treatment or support; do not wait until the symptoms are severe.

What can I prepare at home?

• Save the treatment team’s daytime and 24-hour numbers in your phone and share them with someone you trust.
• Keep your treatment card, medicine list and a thermometer if your team recommends one.
• Ask which symptoms and temperature readings require a call for your exact treatment.
• Check with the team before taking supplements or new over-the-counter medicines.
• Follow their advice on food hygiene, vaccination timing and avoiding close contact with people who are unwell.