Coping with chemotherapy side effects

A black woman with a headscarf

Side effects from chemotherapy vary.  There are many different types of chemotherapy treatment.  Most of them aim to kill cells that are dividing and multiplying faster than most normal cells. This effectively targets cancer cells, which are dividing and growing quickest.

But other fast growing cells – such as those that line the digestive tract, some skin cells, some of your blood cells, including your red cells, white cells and platelets, and the cells that make your hair – are also affected, giving rise to the different side effects that people may suffer to some degree during chemotherapy treatment.

In most kinds of chemotherapy there will be a gap of 2–3 weeks between each chemotherapy treatment.  This can give time for your normal, healthy cells to recover, and for you to start feeling a bit better.  Cancer cells are hit harder by the chemotherapy don’t have time to recover before the next dose of chemo knocks them back again.

There are lots of things you can do to help yourself stay as healthy and resilient as possible during treatment, and lots of things that can help you manage any side- effects you experience.

We can give more information in our Treatment Support Programme, especially if you are looking to find other strategies as the below haven’t worked for you. Click here to find out more about our Treatment Support Programme.

Top Tips for Trouble with Eating and Digestion during Chemotherapy

The cells throughout your digestive system can be affected by chemo, giving rise to a variety of symptoms including, mouth ulcers, a metallic taste in your mouth, nausea, changes in appetite, bloating, diarrhoea and constipation.

If you are having a kind of chemotherapy that is known to cause nausea and vomiting, you will most likely also be given anti-sickness medicines called anti-emetics to help control this. They are generally very effective if taken regularly.  If you do find you are feeling sick after chemo, talk to your oncologist or your cancer nurse.  There are different kinds of anti-emetics they can try if the first ones don’t work.

Some anti-emetics cause constipation which is much easier to manage if you treat it early. If high fibre foods or supplements aren’t working or aren’t suitable for you, ask your medical team to prescribe something for you to take when needed.

  1. Take your anti-sickness medicines as prescribed. It is much easier to cut down later if you find your nausea is mild, than to take more if you have a bad episode of sickness.
  2. Mention any side effects of your anti-sickness medication or your chemotherapy treatment to your team. They can often make adjustments to improve things.
  3. Trouble with needles? If you or the nurses are having a problem getting the chemo into your veins, mention this and ask if you can discuss the possibility of having a PICC line inserted for easier intravenous access
  4. Learn and practise a relaxation technique that you can use before and during your chemo if you find the sessions stressful. Listening to music, or relaxation recordings, visualising a pleasant experience, or deliberately slowing and quietening your breathing can all be useful methods.
  5. Keep doing things that matter to you through treatment. Seeing the family, staying in touch with friends, keeping up with hobbies, taking day trips to nice places, even going in to work from time to time can all be useful ways of making sure that having chemotherapy doesn’t take over your life completely. Most people find they cope better and feel “more themselves” if they maintain contact with the important things in their life.
  6. Eat little and often – several small meals can be easier on your digestion and small portions are less daunting if your appetite is reduced. If possible, have someone else prepare food for you, or freeze food in advance so you don’t have to cook in the first week after chemo, when you may be feeling worse. Some people find cooking smells bring on nausea and take away their appetite
  7. Experiment with flavours  hot, spicy food can irritate the lining of your stomach, but sometimes herbs and spices add flavours which can help If your taste buds are affected. Experiment so see which flavours work best for you. Everyone is different but aloe vera gel (as a mouthwash) or fresh pineapple can be useful for a sore mouth. A teaspoon of slippery elm powder can calm and balance digestion and may be useful for indigestion and either mild diarrhoea or mild constipation. Ginger is good for reducing nausea. Try ginger teas, ginger biscuits or a little ginger in a vegetable juice.
  8. Make sure you drink plenty of water. If you prefer hot drinks, try herb teas. A little lemon juice in a glass of warm water can help stimulate your appetite. Some people also find it reduces the metallic taste. Try having some first thing in the morning and 20 minutes before meals.
  9. Try soups, stews, juices and smoothies as they can be a good way to make sure you’re getting the nutrients your body needs even if you don’t feel like eating. Your body needs good food to help it recover, but your digestion may not be strong enough to cope with too much fibre or raw foods, so experiment with how much feels right for you. Cooking vegetables in soups and stews makes them easier to digest. There is evidence that eating colourful vegetables and fruit during treatment can help reduce side effects and may possibly make chemotherapy more effective.
  10. How you eat is as important as what you eat. Sitting at a table, taking a moment to let go of the worries of the day before starting to eat, chewing thoroughly and letting eating be your only activity can all increase your enjoyment of food and support your digestion.

Top Tips for Energy and Fatigue during Chemotherapy

Fatigue is a very common side effect of chemotherapy.  Your body is working hard to repair and rebuild cells that have been damaged.  That doesn’t always leave much energy for anything else.

  1. Keep physically active. Some days it may not be possible, but keeping active at the right level for you actually reduces fatigue, supports your energy and helps you sleep.  See the Physical Activity section for ideas.
  2. Invest the energy you do have in yourself.  Taking a walk in the park, meditating, seeing friends, going to a therapist for a treatment – all these things take energy to do, but they might also help you feel better, lift your spirits and boost your energy.  Spending your energy on things that give you energy back starts a positive spiral and boosts your wellbeing.  Avoid the temptation to do too much on days when you are feeling better
  3. Separate activity and rest  when we’re not feeling well we can get into a state of never actually doing anything, but never properly resting either. Notice when you have more energy and use that time to do something for yourself.  Then have make sure you have a proper rest, in bed if necessary.  You might have energy for another activity afterwards.
  4. Make relaxation into an activity  Deep relaxation is vital for healing. You can make relaxation into something that you do deliberately as part of an active programme to support your health.  For instance, make a time to lie down and listen to a relaxation or imagery exercise each day.  There are some on the Penny Brohn website or you can find relaxation CDs in our shop.  There are many resources available on YouTube or free on the internet. Finding something that you enjoy and practising regularly is the key
  5. Have a routine – Getting up, being active, eating and resting at similar times each day can help even out peaks and troughs in your energy.
  6. Eat well  keeping your blood sugar well balanced helps your energy. Reducing refined carbohydrates, limiting caffeine, eating sweet things with foods that contain some fat and protein to prevent a rapid rise in blood glucose, and increasing whole foods and fibre in your diet, can all help.   Your body needs good food to rebuild itself.  See our Healthy eating guidelines and recipe pages for ideas
  7. Ask for and accept help – take as many of the burdens of daily living off your shoulders as possible. Get groceries delivered.  Get help with the cleaning.  See if friends can pick up the kids, or bring food round on chemo days.  That will leave you free to invest your energy in yourself.
  8. Put yourself first  your energy may be very variable. Give yourself permission to change your mind and do what your body needs. That might mean asking friends to leave so you can rest, or turning back before you’ve hardly started a walk.
  9. Try complementary therapies  there is evidence that therapies like acupuncture can sometimes help with chemo related fatigue. You may also like to try Reflexology, Healing or Shiatsu, which all involve gentle touch and can help support your energy.
  10. Practise mindfulness  this means paying attention to what you are doing when you are doing it. Keeping your attention on one thing at a time can reduce stress and help you conserve your energy.

In the Chemo Day Unit

Chemotherapy can be delivered in many different settings, including sometimes in your own home.  It usually takes at least 2 hours for chemotherapy to be given, and can take much longer.  This can be a boring and stressful time – it’s worth thinking about ways of making it easier!

  1. Take a friend – ideally someone who can drive you there, pick you up and worry about parking, so you don’t have to.
  2. Take a healthy snack – you may not feel like eating, but if you do, there might be nothing suitable in the hospital. Try taking a juice or a herb tea in a flask.
  3. Wear something comfortable  shoes you can easily slip off, slippers, loose waistbands, ear buds to block out noise, and eye masks so you can sleep. Chemo can be very stressful. But the more relaxed you are the easier everything will be. Take in anything that helps you relax and calm down – a lucky charm, a special scarf, a pet rock, a cuddly toy….Whatever works for you!
  4. Take headphones – listening to gentle music or following a relaxation or imagery exercise is another good way to stay calm and relaxed – and pass the time.
  5. Take a colouring book – or some knitting, sewing, Sudoku, crosswords, solitaire….. Anything that will absorb your attention without requiring too much concentration.
  6. Take something beautiful – photographs, pictures, magazines, and articles of clothing – anything that will help take you somewhere beautiful and peaceful in your mind.
  7. Learn some imagery techniques  our minds have power over our bodies. Seeing chemotherapy as a powerful ally can actually help it work better and reduce side effects for some people.  See our Self Help Techniques pages for more ideas
  8. Learn some meditation techniques – counting the breath, doing a body scan, focusing the attention into the lower belly, repeating a mantra. Any of these can help you stay focussed and centred when you are feeling stressed or panicky. 
  9. Learn some self massage techniques  touch is deeply soothing. You can learn simple ways to massage your own hands, head and face that can help you stay calm.
  10. Talk to your nurses! Let them know if these is anything that is troubling you or that you are not sure about. They can often make adjustments to appointments or medication that make things easier for you or get someone to see you if you have ongoing concerns

We hope these ideas are useful – let us know what works for you and send in your own Top Tips for Coping with Chemo to share with others.