The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help to minimize them and provide the best possible experience for the person receiving chemotherapy.
Chemotherapy’s potential effects on the kidneys and bladder
Chemotherapy’s potential effects on the nerves and muscles
How can I cope with nerve and muscle problems?
Chemotherapy’s potential effects on the sexual organs
Chemotherapy’s effects on organs
As each person’s individual medical profile and diagnosis is different, so is his or her reaction to treatment. Side effects may be severe, mild or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.
Because anti-cancer drugs are made to kill growing cells, they also affect normal, fast-growing cells such as blood cells forming in the bone marrow and cells in the digestive tract (e.g., mouth, stomach, intestines, esophagus), reproductive system (e.g., sexual organs) and hair follicles. Some anti-cancer drugs may affect cells of vital organs, such as the heart, kidney, bladder, lungs and nervous system.
In some cases, chemotherapy can cause long-term problems for the heart, lungs, nerves, kidneys and reproductive or other organs. Further, certain types of chemotherapy may have delayed effects, such as a second cancer, that develop many years later. Discuss any long-term effects that may result from your treatment with your physician.
Some anti-cancer drugs cause bladder irritation or result in temporary or permanent damage to the bladder or kidneys. You may need to collect a 24-hour urine sample for laboratory evaluation, and your physician may ask for a blood sample before you begin chemotherapy to evaluate your kidney function. Some anti-cancer drugs cause the urine to change color (orange, red, green or yellow) or take on a strong or medicine-like odor for 24 to 72 hours. Consult your nurses to determine if the chemotherapy drugs you have been prescribed will cause any of these side effects.
Drinking plenty of fluids will ensure good urine flow and help to prevent problems — especially if you are taking drugs that affect the kidney and bladder. In addition to water, juice, soft drinks, broth and soup, you may include ice cream, Popsicles® and gelatin to increase fluids.
Because drugs can affect your kidney and bladder, be sure to let your cancer care team know immediately if you experience any of the following symptoms:
- Pain or burning during urination
- Frequent urination
- Inability to urinate
- Urination urgency (a feeling that you must rush to urinate)
- Reddish or bloody urine
- Chills, especially chills that cause your body to shake
The following are the most common symptoms of nerve and muscle involvement due to chemotherapy. However, each individual experiences symptoms differently. Symptoms may include the following:
- Weak, sore, tired or achy muscles.
- Walking problems and/or pain when walking.
- Loss of balance.
- Clumsiness and/or difficulty picking up objects.
- Shaking or trembling.
- Hearing loss.
- Jaw pain.
- Stomach pain.
Most of the time, these symptoms will resolve with time, which may take up to one year following treatment. The symptoms of nerve and muscle involvement due to chemotherapy may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.
The following strategies may reduce nerve and muscle problems related to chemotherapy:
- If your fingers are numb, they will not react appropriately when you touch something sharp or hot. Handle objects with care.
- To prevent falls or accidents, move slowly and use handrails, especially if you have weak muscles or if you are experiencing problems with balance. Use bath mats in the tub or shower to reduce your risk of slipping. Also, consider wearing shoes with rubber soles for better traction.
- Consult your physician and nurses regarding pain medication, if necessary.
Many patients, both men and women, find that chemotherapy affects their sex organs as well as their ability to have sex. Your age and general health will influence how the drugs will affect your sexual function. The following advice may help in coping with sexual problems associated with cancer and chemotherapy:
Chemotherapy drugs cause temporary or permanent infertility by reducing the number of sperm cells and their ability to move. While it does not necessarily affect a man’s ability to have sexual intercourse, it could create difficulty in getting or keeping an erection. Chemotherapy also can damage the chromosomes, which could lead to birth defects.
Discuss with your physician or nurse practitioner the use of birth control during treatment, including using a condom for the first 48 hours following the last dose of chemotherapy, as some chemotherapy agents can be detected in the sperm. Your physician or nurse practitioner can advise you regarding how long to use birth control.
If you wish to father a child, you should consult your cancer care team to determine whether the treatment will affect your fertility and about the possibility of sperm-banking before you begin your treatment.
Chemotherapy can have an impact on a woman’s menstrual periods, fertility and menopause. If you wish to maintain your fertility after chemotherapy, consult with your health care provider before you begin treatment. Consider the following:
- Effects on ovaries -- anti-cancer drugs can affect the ovaries and reduce their ability to produce hormones. Some women find that their menstrual periods become irregular or stop completely during chemotherapy. Related side effects that affect the ovaries may be temporary or permanent.
- Infertility -- damage to the ovaries may result in infertility that can be either temporary or permanent. Whether infertility occurs and how long it lasts, dependes on many factors, including type of drug, the dosage given and the woman's age.
- Menopause -- a woman's age and the chemotherapy drugs and dosages will determine whether she experiences menopause while on chemotherapy. Chemotherapy also may cause menopause-like symptoms such as hot flashes and dry vaginal tissues. These tissue changes can make intercourse uncomfortable and can make a woman more prone to bladder and/or vaginal infections. Any infection should be treated immediately.
Discuss with your physician and cancer care team the best ways to reduce symptoms such as hot flashes and vaginal symptoms, as well as ways to prevent infections. Dressing in layered clothing and avoiding caffeine and alcohol can help reduce hot flashes. The right kind of clothing also makes a difference in reducing vaginal infections. Avoid wearing tight slacks or shorts; choose cotton underwear and pantyhose with a ventilated lining.
Care should be taken when using vaginal lubricants; a water or mineral oil-based lubricant is recommended, not petroleum jelly. Your physician or nurse proacticioner may prescribe a vaginal cream or suppository.