Breast cancer chemo side effects

• A quick guide to what's on this page
• What side effects are and why you get them
• General chemotherapy side effects
• Taking other medicines with chemotherapy
• Specific side effects of the drugs
• Where to find more information

Side effects are the unwanted effects of any treatment. Chemotherapy drugs kill cells that are dividing. Cancer cells divide more often than normal cells. But some normal body cells divide quickly and so are also affected by chemo. These include your skin, hair, nails, the lining of your digestive system and your blood cells. Unlike cancer cells, these normal body tissues can recover. This is why you usually have a couple of weeks break between treatments - it allows your normal body tissues to get over the effects of the chemotherapy.

Chemotherapy affects different people in different ways. Your doctor can tell you what may happen, but can't tell beforehand what treatment will be like for you. It isn't something you can predict beforehand. Some people are more affected by side effects than others. Many people lead normal lives during their treatment and can carry on working. Others find they are very tired and have to take things more slowly.

Remember that not all chemotherapy drugs cause the same side effects and some people have very few.

Chemotherapy has some general side effects. The drugs kill cancer cells because they 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 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 (fatigue) is the most common side effect for people having chemotherapy. It may continue for some months after your treatment has ended. 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.

Other side effects of chemotherapy can include

• Feeling sick (nausea) and being sick
• Hair loss or thinning
• 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 main chemotherapy 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.

Always let your doctor know about any other medicines you are taking, as some drugs can react with chemotherapy. Even some 'over the counter' medicines, herbal medicines or complementary therapies may be harmful to take with chemotherapy.

Long term side effects

Sometimes chemotherapy causes long term side effects. You will probably feel tired for some time after your treatment has finished. For a few people, it can take up to a year to get their energy back.

If you had not had your menopause before you had breast cancer, you need to know that chemotherapy can affect your ability to get pregnant. If you are still having periods, they may stop when you have chemotherapy. This depends on how old you are. Or more exactly, how near you are to the age when you would naturally start your menopause. Your periods may start again 6 months to a year after your treatment finishes. Or they may never start again and you may have an early menopause. If you do continue to have periods, they may not be as regular as they were.

If your periods stop, it is because the treatment has stopped your ovaries working. If your ovaries are not working, you will produce much less oestrogen. You will no longer have periods and may have menopausal symptoms such as

• Hot flushes and sweats
• Mood changes

There is more about early menopause and infertility in the living with breast cancer section of CancerHelp UK. We have information about dealing with sweating in our section on coping physically with cancer.

There is detailed information about cyclophosphamide, methotrexate, fluorouracil, doxorubicin, epirubicin,mitozantrone, mitomycin and taxotere in the main chemotherapy section of CancerHelp UK. But we've listed the most common side effects for each drug used for primary breast cancer below.

Cyclophosphamide

The most common side effects of this drug are

• Feeling and being sick
• Loss of appetite
• Low blood cell counts (causing increased risk of infection)
• Hair loss or thinning

Fluorouracil

This commonly causes

• Diarrhoea
• Feeling or being sick
• Mouth ulcers
• Low blood cell counts (causing increased risk of infection)
• Sensitivity of skin to sunlight

Methotrexate

This drug can cause

• Low blood count (causing increased risk of infection)
• Taste changes
• Sore mouth
• Gritty eyes
• Diarrhoea
• Hair loss or thinning
• Sensitivity of skin to sunlight

Epirubicin and doxorubicin

These drugs are similar. The most common side effects include

• Hair loss
• Feeling and being sick
• Low blood cell counts (causing increased risk of infection)
• Mouth ulcers
• Skin changes

These drugs tend to cause quite a bit of sickness. They are also likely to cause complete hair loss. You may notice that your urine turns red after having either of these drugs. This is because the drugs themselves are red and is nothing to worry about.

Doxorubicin can make your skin darker. This is goes back to normal when the treatment is finished. Your skin may also be sensitive to the sun while you are having treatment with doxorubicin. So cover up or wear a sunblock throughout your treatment and for a few months after it is finished.

Mitoxantrone

This drug can cause

• Hair thinning
• Feeling or being sick

Complete hair loss is very unlikely, but some of your hair may fall out with this drug. The drug is blue and may turn your urine green for about 24 hours after it is given to you. This is nothing to worry about.

Mitomycin C

This drug can cause

• Low blood cell counts (causing increased risk of infection)
• Feeling or being sick

Taxotere (docetaxel)

This drug can cause

• Low blood cell counts (causing increased risk of infection)
• Complete hair loss (inlcuding all body hair)
• Swollen legs or hands
• Skin and nail changes

The side effects of cancer drugs section of CancerHelp UK tells you about the side effects of individual chemo drugs and combinations and how to cope with them. You can get your doctor or nurse to write down the names of your chemotherapy drugs so you can look them up for yourself. See the questions for your doctor page in this section for suggestions of questions to ask about chemotherapy.

You can also ask your doctor or nurse if you can meet other patients who've had chemo for breast cancer. Then you can chat about how they got on. Or you could contact a local support group to get in touch with other people with breast cancer. Some of the breast cancer organisations can put you in touch with your nearest support group. They can also give you more information about chemotherapy for breast cancer.

If you want to find people to share experiences with on line, you could use CancerChat, our online forum. Or go through MyWavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.