What are less common side effects to chemo?
What are less common side effects to chemo?

Side effects from chemotherapy vary. Among the more common side effects are feeling tired (fatigued, lethargy), nausea, diarrhea or constipation, and body hair loss (due to the effect of the drugs on the DNA of hair follicles). Every cancer patient responds differently to the combination of chemotherapy drugs. What is very important to remember is that these side effects are temporary and gradually go away after the chemotherapy treatments end.

Examples of side effects, of which most chemotherapy patients experience at least a few, include the following:

The most common side effects are vomiting and nausea, fatigue (anemia and neutropenia), diarrhea and constipation, weight changes, and hair loss. Each of these side effects has a separate leaf. You may click on each one you want more information about now.

Less common side effects are described here (reminder, these are usually due to the chemo affecting fast-growing cells):

Common changes to the skin include:

  • Itching
  • Redness
  • Drying or peeling
  • Acne
  • Sun sensitivity
  • Brittle nails
  • Blackened nails
  • Shingles

How to manage skin changes

  • Check with your provider about what types of lotions to use or avoid. Many patients automatically want to use lotions with aloe, but for some types of skin reactions, you may need to avoid lotions that contain aloe. The same is true for lotions that contain lanolin
  • You need to use very mild soaps, lotions and skin creams
  • Dont use perfumes, colognes, after shaves or perfumed deodorants
  • Dont shave your arms or legs until you are done with your chemo
  • Use sunscreen even if you are only going out for a short walk.
  • Wear a wide-brimmed hats to help protect you from the sun
  • Wear long-sleeved cotton shirts and pants to protect you from the sun and reduce the rubbing of the material against your skin (avoid wearing heavy jeans)
  • Wear soft cotton socks in your sandals or shoes to avoid irritation to your feet and ankles (especially if you are diabetic)
  • Wear plastic gloves when washing dishes, cleaning fish or game or gardening. Be extra careful with knives when cleaning fish or game or cutting vegetables to avoid cutting your skin. You are more likely to get infections throughout your chemo
  • Use corn starch as a dusting powder on itchy skin. Avoid making a poultice of corn starch and water on your skin. It is likely to take skin off when you remove the poultice. Avoid using a tobacco poultice for the same reason.

Brittle or blackened nails

  • Avoid using nail polish to hide the blackened finger and toe nails. This blackening will disappear after chemo ends.
  • For nails that become brittle, cracked, peeling or develop vertical lines or bands, you can
    • Use nail strengtheners
    • Add 1-2 servings of gelatins (like Jell-o) to your daily diet.
    • You can also drink a gelatin liquid (like Knox orange flavored liquid gelatin) to help strengthen your nails.
    • Wear gloves whenever you are doing dishes, cleaning fish or game or working in the garden to avoid additional damage to your nails and skin.


  • Let your provider know you are having headaches.
  • They may tell you to use an over-the-counter headache tablet, other than aspirin, like you normally do, or ask you to try another. Aspirin is not recommended because of the blood thinning reactions and its harshness on the stomach lining that is probably already sensitive

Muscle aches

  • Let your provider know where you ache. The provider may have you take an over-the-counter anti-inflammatory drug or a prescription. Sometimes gentle massage is recommended for these aches.
  • Burning or painful sensation during urination
    • Be sure to tell the provider so that you can be checked for a bladder infection. If that is the cause, they will give you some medication to cure the infection.

Discolored urine (or pee)

  • Sometimes this discoloration is related to a bladder infection and the provider will test you and then give you medication to control the infection
  • Sometimes the discoloration is caused by the type of chemo drugs you are using and is nothing you need to worry about. It may be red, orange, bright yellow or blue-green. It may also smell like medicine. The color of your pee will go back to normal after you are done with your chemo.

Vaginal infections (itching, burning, redness, smelly, white or heavy discharge from your vagina; if you have these symptoms, see your provider so that you can receive the correct type of ointment to control the infection)

  • The changes in your tissues from the chemo may make you more likely to get vaginal infections
  • Wear cotton underwear
  • Avoid wearing nylon panty hose
  • Avoid wearing jeans or tight slacks or pants
  • Avoid using Vaseline in or around your vagina (it may make you more likely to get an infection because it is not water-based)

Changes in the mouth and throat

  • Chemo can cause sores or ulcers in the mouth and the lining of the mouth to become sore and tender. These ulcers can be very painful
  • While you are doing chemo, your white blood cells that help fight infection, are reduced. The most common infection is called thrush or candidiasis).
    • This is a fungus infection in the mouth.
    • It looks like white patches or a white coating on the tongue and lining of the mouth.
    • It can also be in the vagina.
    • It needs to be treated by anti-fungal medication
    • It can take several days before you notice relief

Dry Mouth

  • This means your have very little saliva
  • You may have trouble swallowing because you need saliva to swallow easily
  • Drink a lot of water and mild juices, like apple or carrot juice.

Sore or bleeding gums

  • You may only notice this when you brush your teeth or when you eat
  • Occasionally, they bleed when you are not brushing your teeth or eating
  • Avoid hard, sugary, or acid foods or drinks (like vinegar dressing on your salads)

Changes in your tastes and smells

  • A side effect of some chemo drugs is the change in your senses.
  • A metallic taste sometimes occurs and makes food and drinks that you frequently enjoy, suddenly taste badly. Rinse your mouth with small sips of 7-up® in between bites of food to see it that helps you.

How to manage changes in your mouth

  • Sores in your mouth can easily become infected, so you need to treat them as soon as they appear
  • Drink a lot of water or herbal teas (about 12 glasses)
  • Try herbal teas (especially ginger teas)
  • Eat soft, bland foods like gelatin, cottage cheese, pastas, mashed potatoes, milkshakes, bananas applesauce, oatmeal, puddings
  • Avoid alcoholic drinks
  • Avoid acidic drinks like orange or grapefruit juice
  • Avoid hot spices, garlic, onion, vinegar and salty foods
  • Use a very soft toothbrush or use a gentle toothpaste or baking soda and water on a Q-tip to gently rub against your gums
  • Use baking soda and water rather than commercial toothpaste if the toothpaste is too irritating or if it contains abrasives.
  • Use a sensitive toothpaste (like Sensodyne®)
  • Gentle rinse your mouth with baking soda and water (and spit out the solution after youve gargled or swished the solution around)
  • Ask your provider if there is a mouthwash that you should use to reduce the irritation and sores in your mouth and throat
  • Avoid Mouthwashes with a lot of salt or alcohol
  • Use numbing medications like those that are used for teething children (do not use tobacco paste or chew)
  • Use a lip balm to keep your lips from chapping

Tingling, burning sensation in hands or feet

  • You need to tell your doctor about this. It may mean that your nerves are being damaged by the chemo and the provider may change the medications.


  • If your fever is over 100°, call the provider. A fever that high is probably due to some infection.
  • Chills
    • If you find yourself shivering or shaking and you cannot stay warm, call the provider. This is probably due to some infection.

Fluid retention

  • Some of the chemo drugs cause you to retain fluid.
  • Check with your provide and keep track of changes in your weight.
  • Providers usually do not want you to take a diuretic to get rid of the excess fluids while you are on chemo.
  • They may tell you to avoid foods or drinks with a lot of sodium (like tomato juice) in them.

Blood clotting problems

  • These may be aches in your calves or feet.
  • Most providers will change your chemo drugs to avoid these types of problems.

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