Side effects of chemotherapy

A discussion of the most common side-effects of chemotherapy such as low blood count, sore mouth, nausea and vomiting, loss of appetite, constipation, sun sensitivity, hair loss and fatigue.

Nausea and vomiting is a common problem experienced during cycles of chemotherapy, and can sometimes last for several days after the chemotherapy treatment stops. Because the effects are so variable, the management of nausea and vomiting must be worked out for each child's individual needs.

The lining of the mouth and throat becomes weak during chemotherapy treatment and may lead to inflammation and ulcers. Good mouth care will help avoid infection and will increase comfort.

Blood cells are the normal cells most often affected by chemotherapy. A low blood count means having fewer new cells in the blood than is normal.

A low white cell count is called neutropenia, and neutropenia leads to an increased risk of infection. Infection in a neutropenic child can become serious quickly. Measles, chickenpox, gastroenteritis, mumps and rubella (German measles) are a risk for your child. Tell your child's doctor or nurse if your child has gastroenteritis or has had contact with anyone with any of these diseases. 

A low red blood cell count is called anaemia, and causes tiredness, shortness of breath, pale skin and gums, headache and dizziness. To correct anaemia a transfusion of red blood cells may be given.

A low platelet count is called thrombocytopenia. Signs of a low platelet count are bruising, bleeding from the nose, gums or other parts of the body, black bowel motions, or vomit with specks of blood in it. To correct a low platelet count or to help stop bleeding, a transfusion of platelets may be given.

The loss of an appetite for food, known as anorexia, is one of the most common problems caused by cancer treatment. Your child's health care team will monitor weight carefully throughout treatment. There are things you can try to encourage your child's appetite.

Hair loss happens when chemotherapy interrupts normal hair growth. Hair loss is in most cases temporary and regrowth may happen even before treatment has been completed. You and your child can get more information about managing hair loss from your doctor, nurse, or social worker. The Ministry of Health, through HealthPAC, has a service payment available to help purchase and maintain a wig, hairpiece or headwear.

Fatigue is associated with several childhood cancers at diagnosis and most childhood cancers during treatment. Fatigue in the cancer patient is usually chronic (long lasting) and includes both physical and psychological tiredness. Some of the factors which may contribute to chronic fatigue are fear and anxiety about treatment, inadequate nutrition, infection, anaemia, sleep disturbance and altered mobility. 

A child is constipated when they are passing bowel motions less often than usual, and/or are having difficulty passing the bowel motion, and/or the bowel motion is hard. Constipation can be caused by some medicines and is more likely during periods of immobility. Dehydration can also be a contributing factor. The chemotherapy medicine most likely to cause constipation is Vincristine. 

Chemotherapy will make your child's skin more sensitive to the sun and more likely to burn more easily. Sunscreen (SPF30 or more), a hat and clothing which covers the skin are very important.