Side effects of bowel cancer chemotherapy

• A quick guide to what's on this page
• How chemotherapy may affect you
• Effects of fluorouracil
• Effects of capecitabine (Xeloda)
• Effects of tegafur and uracil (Uftoral)
• Effects of irinotecan
• Effects of oxaliplatin

Chemotherapy has some general side effects. The drugs kill cancer cells because the cells divide quickly. Your blood cells also divide rapidly, so chemotherapy can lower the number of healthy white blood cells, red blood cells and platelets you have. This can mean that you

• Are more likely to get infections
• May be more tired than usual
• Can be prone to nosebleeds and other bleeding problems

If you develop a temperature above 38°C or think you have an infection, it is very important to contact the hospital immediately. You may need urgent treatment with antibiotics. Your doctor or chemotherapy nurse will give you an emergency number to phone if you need to. There is more about the effect of chemotherapy on your blood cells in the main chemotherapy section of CancerHelp UK.

Tiredness or fatigue is the most common side effect for people having chemotherapy. It can reduce how much you are able to do. You may also feel weak and as though you have no energy. Tiredness may carry on for some months after your treatment ends. How quickly you get back to normal will depend on your general health, on the amount of treatment you've had and on other treatments you have had. There is information about how to cope with tiredness in the cancer fatigue section of CancerHelp UK.

Other side effects of bowel cancer chemotherapy can include

• Feeling sick (nausea) and being sick
• Hair loss or thinning
• A sore mouth
• Diarrhoea
• Changes to your periods (menstrual cycle)
• Sore eyes - they may feel as if they have grit in them. Let your doctor know, as eyedrops can help.

You can use the links above to go to pages in the cancer drugs section that tell you about coping with the side effects.

Side effects may seem hard to bear at the time. But most disappear when your treatment ends.

The drugs most often used for bowel cancer treatment are

• Fluorouracil (also called 5FU) - often given with a vitamin called folinic acid
• Capecitabine
• Uftoral (also called tegafur with uracil)
• Irinotecan (Campto)
• Oxaliplatin

The links above take you to detailed information about the individual drugs and their side effects.

Most people cope well with fluorouracil and have few side effects. But it can cause

• Feeling or being sick
• Diarrhoea
• A sore mouth or mouth ulcers
• Drop in blood cell counts
• Tiredness

When fluorouracil is given continuously through a pump it can cause reddening and soreness of the hands and feet. This is called palmar-plantar erythema or hand and foot syndrome. It happens in about 1 in 3 people having this treatment. The skin can begin to peel on the palms of the hands and soles of the feet. For most people, this is reasonably mild and you can just carry on. But if it gets bad, your doctor may lower your 5FU dose or suggest that you delay further treatment until you have recovered.

The effects of capecitabine are very similar to fluorouracil and may also include reddening and soreness of the hands and feet. This is called palmar-plantar erythema or hand and foot syndrome. The skin can begin to peel on the palms of the hands and soles of the feet. For most people, this is reasonably mild and you can just carry on. But if it gets bad, your doctor may lower the capecitabine dose or delay the treatment until you recover.

The effects of capecitabine are very similar to fluorouracil and include skin rashes and sensitivity of the skin to sunlight.

This drug may cause

• Increased sweating
• Increased production of saliva
• Watery eyes
• Cramping pain in the abdomen
• Diarrhoea beginning the day after treatment
• Feeling or being sick
• A drop in blood cell counts
• Tiredness
• Hair loss or hair thinning

Some people have sweating, abdominal pain and diarrhoea while they are having the drug infusion. Diarrhoea after irinotecan infusion can be a serious side effect. If you get diarrhoea a day or so after you have had your treatment, you should tell your doctor. You can become dehydrated very quickly.

This drug may cause

• Numbness and tingling of hands or feet, which can be long term for some people
• Feeling or being sick
• Numb lips

You get numbness and tingling because oxaliplatin affects your nerves. It can make it very difficult to do fiddly things such as doing up buttons. Some people find it hard to walk because the soles of their feet are numb. You should tell your doctor if you have these effects. You may need to have a lower dose of oxaliplatin or stop the treatment. There is more about chemotherapy affecting the nerves in the cancer drugs side effects section of CancerHelp UK.