Chemotherapy is very important in the armamentarium of cancer treatments (also including surgery, radiation). Even with the introduction of newer agents like targeted therapies, immunotherapy etc, chemotherapy still forms the basis of treatment. Most chemotherapies can cause side effects which are immediate or delayed or can be long lasting. While looking at side effects, basic side effects are the ones that are looked for primarily.

Basic Side Effects:

During chemotherapy, good and bad cells are killed, including blood cells; which causes the blood count to drop. Additionally, the mucosal lining is affected as well, which results in mucositis, diarrhea, and constipation. Hair follicles are affected too, which results in hair loss, and may cause loss of eyebrows and eyelashes. These kinds of immediate side effects of chemotherapy are not very lasting. Generally, these aspects will see recovery once the chemotherapy is over.

Other Serious Side Effects:

However, other side effects can be serious. These include change of taste, anorexia (not liking to eat), nausea (feeling of distaste for food), and vomiting. These are some of the most important side effects because these cause people to not consume food. If a person stops eating, they can become dehydrated, weak and this can also hinder their recovery and trouble to continue further treatment. Nowadays, doctors individually explain to the patients the side effects of particular drugs which will be used for the treatment. For example,

• If a patient is on a drug which is going to cause them to vomit, doctors are required to explain to them the specifics of what to eat.
• If a patient has nausea with vomiting as a side effect, they are advised to change their diet. Since their taste is gone, they are asked to eat fried food and sweets during the first five days of chemotherapy. They can be asked to eat chocolates, coffee, eat cold foodstuffs like ice cream, and nuts. They are also advised to not eat regular food but eat soft food instead like custards and pudding.
• If the patients are going to have neuropathy, they are explained how to hydrate themselves and to inform the doctors in case they experience side effects like buttoning - unbuttoning, losing belongings, so that their dosage can be adjusted accordingly.
• If a patient has their blood count going low as myelosuppression, then they are given either growth factors or are asked to inform the doctors if they suffer from fever, loose motion or any fatigue and weakness. The doctors then test their blood count, give them growth factors and antibiotics.
• If the patient's hemoglobin is dropping, they are given erythropoietin, nutrition, and appropriate support.
• If the platelets of a patient are going low, they are given drugs like romiplostim among others to push them.

Rare Side Effects:

Certain side effects are extremely rare but need to be mentioned nonetheless.

• A few patients who receive chemotherapy, get ‘chemo-brain’. This refers to the mental fogging caused rarely in some patients as an after effect of the treatment.
• Patients can have depression or suffer from anxiety. Hence doctors sometimes have to make use of antidepressants and involve psychiatry in management.
• Individualised side effects also need to be explained to patients, though they can be managed with the help of current advanced medications.

Growth factors can help in increasing blood count, while hydration and nutrition can make patients eat well. Having psychologists and doctors explain to the patient can help in reducing their side effects significantly. Additionally, antibiotics can help in taking care of infections. With all this armamentarium, a major percentage of patients would manage their chemotherapy very well. Most importantly, the patient should get involved in their treatment. If they are involved with their treatment, eating well, hydrating enough and are exercising regularly, most of these side effects can be managed by the patients on their own. Very few side effects require hospitalisation or support.