While many of the side effects of chemotherapy are unpleasant, the good news is that you won’t necessarily experience all of them, and they are also not permanent.  Generally, side effects disappear after your treatment has been completed.

Hair loss (alopecia)

The condition is temporary – your hair will grow again, possibly even during the treatment phase. Initially the new hair might have a different texture.

• Hair loss is often the first visible sign of your disease and brings it to the attention of others. Be prepared for this, and for the effect it might have on your appearance and self-image.
• The oncology team will warn you if you can expect hair loss as a side effect of your treatment, so that you can decide beforehand how you want to cope with it. There are various options: you could wear a wig or head covering, or even shave off your hair all in one go.

Your hair will definitely grow again, even before the treatment has been completed, or 8-12 weeks after falling out. Within three months after new hair has started to grow, it should be long enough for a short hair style.

Care of the scalp and hair

• Comb and brush the hair very gently, and not too often
• Use a mild shampoo and gently dab the hair dry
• Avoid hair dryers, curlers and curling tongs
• Do not colour or perm your hair during treatment
• Massage the scalp with a conditioner or hair stimulant
• Avoid elastic bands, tight hair bands and clips

Head coverings

• Experiment with different kinds of head coverings, scarves, caps and hats.
• Wigs are available from special boutiques where qualified staff will assist you. The Cancer Association also has second-hand wigs available. Consult the list in the information booklet  that your Reach for Recovery visitor gave you in the hospital. 
• Preferably select a wig before your hair starts falling out, to ensure that the wig matches your natural hair type and appearance.
• When new hair starts growing, leave the wig off as much as possible when you are at home, until the hair is long enough.

Sense of taste

This may be caused by medication or emotional and social factors. When your sense of taste is affected, loss of appetite may follow. You may experience the following:

A strange taste in the mouth, such as a bitter taste, metal taste or medicine taste.

• Red meat and other food might have a strange taste.
• Familiar foods might have a strange taste, you might prefer new foods.

Preventative measures for affected tastebuds include:

• Visiting the dentist before treatment starts.
• Prevent dryness of the mouth – avoid eating dry foods.
• Stimulate your sense of taste with pleasant flavours.
• Avoid all contact with foods that you find distasteful.

Cystitis (bladder infection)

This may be caused by certain drugs. The oncology staff will warn you and prescribe treatment. The urine may be discoloured – this is not harmful.

How to prevent cystitis:

• Drink more water
• Inform the oncology team if you have of cystitis
• Ask your doctor for an alkaliniser to control the acid level of urine.

Stomatitis

This is a condition that causes inflammation of the mucous membranes of the mouth. Early signs are dryness and a burning sensation in the mouth. 

Symptoms start a few days after treatment and may last 7-10 days.

• Rinse your mouth after meals using a salt solution or alcohol-free mouthwash.
• Maintain good mouth hygiene: use a soft toothbrush. 
• Visit your dentist beforehand to rule out mouth infections.
• Drink lots of fluids to keep you hydrated.
• Avoid acid, spicy foods; avoid alcoholic beverages.
• Soft foods with a fine texture can be chewed and swallowed more easily.
• You may find ice cream and iced drinks soothing.
• Have yoghurt regularly to restore the natural flora in the digestive system.
• Inform the oncology team if the condition becomes worse.

Constipation

Another typical chemo side effect that can be treated as follows: 

Hints for coping with constipation

• Eat more unrefined foods: raw vegetables/fruit, dried fruit, brown rice, wholewheat bread.
• Drink more fluids, particularly warm drinks – this stimulates bowel activity.
• When you have the urge for bowel movement, go! Make a habit of going at set times.
• Use purgatives as little as possible, and then only as prescribed.
• Inform the oncology team if you have problems with constipation.

Diarrhoea

Some drugs used in chemotherapy cause diarrhoea. The staff will inform you in advance. 

Hints for coping with diarrhoea

• Inform the oncology team. Diarrhoea can be controlled with medication.
• Keep the area around the rectum clean. Vaseline is good for protecting the area.

Dietary adjustments 

• Eat more foods low in fibre but high in nutritional value (protein and calories).
• Eat smaller portions more often.
• Avoid gas-producing foods: cabbage, broccoli, onions, cauliflower.
• Avoid strongly spicy foods and caffeine.
• Avoid very hot or very cold food.
• Avoid alcohol and nicotine (cigarettes).

Your skin and complexion

Chemotherapy does not affect the skin directly, but faint marks may occur where drugs have been administered intravenously. These marks will disappear eventually.

• Protect your skin against the sun’s harmful rays, particularly when the UV-factor is high.
• Care for the skin by using bath oils or moisturising creams.
• Treat cuts and abrasions with a disinfectant to prevent infection – particularly after a mastectomy with removal of the lymph nodes.
• Lymph drainage is important if swelling of the arms and fingers occurs. 
• Consult the oncology team and also refer to the pamphlet on Lymphoedema.

Diminished appetite and weight loss

Various factors may cause weight loss during chemotherapy. The disease uses energy and the body’s metabolism is affected. You may tend to eat less owing to anxiety and stress.

The appetite may also be suppressed as a side effect of the drugs. It is therefore extremely important to eat a well-balanced diet. 

If you want to follow an alternative diet therapy, consult your doctor to ensure that it does not interfere with the medication you are using.