Some of the most common short-term side effects of chemotherapy are hair loss (alopecia), nausea and vomiting. The side effects you are likely to have depend on the chemotherapy drugs you are given.
Learn about long-term side effects of chemotherapy.
Hair loss (alopecia)
Hair loss (also called alopecia (A-loh-PEE-shuh)) is a well-known side effect of chemotherapy. Though it's most visible on your head, hair loss may occur all over your body.
Over the years, people have tried many things to prevent hair loss with chemotherapy. Using a gentle shampoo and washing your hair less often may reduce hair loss. A technique called scalp cooling is currently under study as a way to reduce hair loss . A special cap is filled with a very cold substance and worn during each chemotherapy session. At this time, it is not known whether scalp cooling reduces hair loss.
With some chemotherapy drugs (including anthracyclines such as doxorubicin, and taxanes such as paclitaxel or docetaxel), however, you almost always lose your hair.
Coping with hair loss
During treatment, you will deal with many emotional aspects of breast cancer. Losing your hair can be especially hard. As with breast surgery, losing your hair can feel like an "assault" on another part of your body that is tied to your identity.
Wigs, hats and scarves may help you cope with hair loss. If you are thinking about wearing a wig, you may want to pick one out before you start chemotherapy. This may help you find a good match for your natural color and cut. Many insurance plans cover all or part of the cost of a wig for people getting chemotherapy if the claim includes a health care provider's prescription or letter.
Some people cut their hair short once they start chemotherapy to prepare for the loss of their hair. This may help you feel in control.
When will hair grow back?
Hair will begin to grow back two to three months after treatment ends, though it may be a different color and texture than it was before . It often comes in curlier and grayer. Hair texture will return to normal over many months. You may dye, color or treat your hair whenever you like.
A note if you are traveling by air
Susan G. Komen® wants to ensure breast cancer survivors are treated with respect and dignity. If you have lost your hair due to chemotherapy and wear a scarf or other head covering, below are some steps you can take that may help you as you plan your air travel. You do not need to do so, but if you wish, tell the Transportation Security Administration (TSA) agent you are undergoing breast cancer treatment. If you prefer to give this information more discreetly, the TSA now offers a notification card you can give to the agent (find this card on the TSA website).
- You may want to arrive earlier than usual at the airport, so you have time to go through secondary screening if necessary.
- If you are concerned about going through the body scanner for any reason, you may request a private pat-down screening.
- If you choose, or are selected for, a pat-down screening, you may request a private screening away from public areas.
- If you wear a scarf or other head covering, you do not have to remove the covering to pass through the security checkpoint. However, you may have to undergo a pat-down search of your head. In some cases, the TSA agent may then ask you to remove the scarf or head covering, but you may request a private screening away from public areas.
If you have concerns about airline security screening, visit the TSA website for the latest information and a list of other tips to make the process as comfortable as possible.
Nausea and vomiting
Nausea and vomiting are well-known side effects of chemotherapy, but some types of chemotherapy cause more nausea and vomiting than others. To help prevent and control these symptoms, your health care provider will prescribe anti-nausea medications and give you instructions on how to use them. The anti-nausea medications you are prescribed will depend on the chemotherapy drugs you are given.
Tips to manage nausea
- Eat four to six small meals (instead of larger meals) each day.
- Try ginger tea, ginger ale or crystallized ginger, or add fresh ginger when you are cooking.
- Drink lemonade or lemon water.
- Eat bland, easy-to-digest foods that do not have an odor.
- Eat cool or frozen foods. These may have fewer odors than warmer foods.
- Avoid foods that are spicy, fried, very greasy or very sweet.
- Cook and freeze meals to reheat during times when you feel nauseous. Reheating causes fewer odors than cooking.
- Open the windows when possible to keep fresh air flowing. Use an overhead fan to decrease cooking odors.
- Take walks (when you are able) to get fresh air.
- Talk with your health care provider about integrative and complementary therapies that may help.
Fingernail and toenail weakness
Some chemotherapy drugs (such as paclitaxel and docetaxel) often cause damage to the fingernails and toenails. The nails may:
- Become brittle and sore
- Develop ridges
- Become more pigmented (get darker)
- Fall off
Like hair loss, nail problems are temporary. Keeping your nails short during treatment may make nail care easier. Your nails will return to normal once chemotherapy ends. You may use nail polish whenever you wish.
Chemotherapy drugs (including vinorelbine, cisplatin and taxanes such as paclitaxel and docetaxel) can cause nerve damage. If this happens, you may feel a burning or shooting pain (neuropathy) or numbness, usually in your fingers or toes. These side effects almost always go away after chemotherapy ends, though it may take weeks or months. In rare cases, the numbness or pain can persist.
Chemotherapy can also cause muscle pain (myalgia) or numbness. If you have these side effects, tell your health care provider right away. He/she may want to adjust your chemotherapy plan to ease these symptoms. Your provider may also prescribe mild pain relievers or suggest other treatments to ease the pain or numbness.
Learn more about managing pain related to treatment.
Mouth and throat sores (mucositis, stomatitis)
Some chemotherapy drugs (including doxorubicin and docetaxel) can harm the tissues lining your mouth and throat, causing sores (called mucositis or stomatitis). These sores can make it painful to eat and drink. Mouth sores go away once chemotherapy ends. However if you have any pain or see any problems in your mouth or throat, contact your health care provider. He/she can prescribe a special mouthwash or other medication to relieve pain and treat the sores.
Chemotherapy can cause fatigue. When fatigued, people feel like they don’t have any energy and are tired all of the time. Sometimes, getting enough rest doesn’t help.
Regular exercise, even just walking for 10 to 20 minutes every day, can help reduce fatigue [27-28]. Getting a good night’s sleep is also important. Talk to your health care provider if you have fatigue or problems sleeping (insomnia).
Although studies of ways to ease fatigue are limited, these tips may help :
- Switch up tasks that take more energy with those that take less energy.
- Plan your daily tasks. Develop a routine that prevents you from doing too many activities in one day.
- Delegate as much as possible (let others prepare meals and help with chores).
- Take breaks, even when you are having a good day.
- When possible, sit down to do daily tasks.
Other short-term side effects
Chemotherapy drugs can cause other short-term side effects, including:
Some of these side effects, such as loss of menstrual periods, may last after treatment ends.
Chemotherapy can cause a drop in the red blood cell count (called anemia). Anemia can cause fatigue and shortness of breath. It can also make you look pale. Sometimes, anemia can be treated by increasing iron or folate in the diet. Severe anemia can be treated with a blood transfusion.
Growth factors, such as erythropoietin (Procrit, Epogen and Aranesp) and similar drugs can increase red blood cell count. However, safety analyses have raised questions about whether people with breast cancer should get erythropoietin (for more on these safety analyses, visit the FDA website).
Chemotherapy can also cause a drop in the white blood cell count (called leukopenia or neutropenia). Some chemotherapy plans include white blood cell growth factors such as filgrastim (Neupogen) and pegfilgrastim (Neulasta). These growth factors help maintain white blood cell counts and reduce the risk of infection while you are undergoing chemotherapy. Growth factors are given by injection. A nurse can inject these medications, or you can learn to do it yourself.
Learn about long-term side effects of chemotherapy.