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Cancer Treatment Side Effects: Chemotherapy, Radiation, Surgery

Cancer treatments save lives, but they also come with side effects. Hear straight from patients who’ve been treated for cancer – what they experienced and what helped them get through it.

Side Effects of Cancer Treatment

Everyone tracks differently when it comes to side effects. Explore below to hear directly from patients who shared what side effects they experienced after undergoing treatments like chemotherapy, radiation therapy, surgery, hormone therapy, targeted therapy, and immunotherapy. We’ve organized the stories by cancer and treatment type.

BACKGROUND: Side effects happen after cancer treatments start to affect healthy organs and tissues. Remember to report these to your medical care team so they can help reduce or prevent these side effects. Some of the most common reported side effects include1:

  • Anemia
  • Appetite Loss
  • Bleeding and Bruising (Thrombocytopenia)
  • Constipation
  • Delirium
  • Diarrhea
  • Edema (Swelling)
  • Fatigue
  • Fertility Issues
  • Flu-Like Symptoms
  • Hair Loss (Alopecia)
  • Infection and Neutropenia
  • Lymphedema
  • Memory or Concentration Problems (“Chemo Brain”)
  • Mouth and Throat Problems
  • Nausea and Vomiting
  • Nerve Problems (Peripheral Neuropathy)
  • Immunotherapy and Organ-Related Inflammation
  • Pain
  • Sexual Health Issues
  • Skin and Nail Changes
  • Sleep Problems and Insomnia
  • Urinary and Bladder Problems


Side Effects by Treatment

Chemotherapy

For chemotherapy side effects, Dr. Doug Blayney of Stanford explains the drugs damage fast-growing cells, which means you may be able to predict to some degree what the side effects may be.

“The other fast growing cells are in the hair so many chemotherapies cause temporary hair loss because we damage those cells,” says Dr. Blayney.

“The other fast growing cells are in our GI tract, mouth, so sometimes mucositis or sores in the mouth, or nausea and vomiting can occur. Other fast growing cells is in our bone marrow so white blood cells or platelets can temporarily be damaged with chemotherapy.”

Less Common Chemo Side Effects

He also describes less common side effects, including temporary nerve damage, energy loss, and chemo brain.

“You won’t be able to do as much as you did before. But it’s important to push yourself through and not fall off your exercise program during this time because one of the ways we prevent side effects is with exercise.

It makes people feel better. It helps with the brain, thinking, and it also helps to not gain weight so exercise is good for all these side effects of chemotherapy.”

Dr. Doug Blayney

Radiation Therapy

Radiation Therapy General Information

Dr. Kenneth Biehl works as a radiation oncologist for cancer patients. He says the feeling of radiation therapy is similar to getting an X-ray.

During the  treatment you don’t ever feel anything. The treatments are very brief. They only take a minute or two to give the treatment.

Dr. Biehl adds there are some rare cases where patients undergo very high doses of radiation, and that type of treatment can take up to 10 to 12 minutes or so.

When radiation side effects start to hit

“If there’s a longer course of radiation where you’re getting radiation treatment over five to eight weeks or something like that, then the radiation treatment side effects will begin usually in the third or fourth week of treatment,” says Dr. Biehl.

Examples of radiation side effects for different cancers

What side effects occur can depend on where the radiation treatment is targeted on the body. He talks specifically about breast and prostate cancers as examples.

“If you have radiation treatment given for breast cancer or prostate cancer, those are in totally different positions on the body. The breast cancer’s often close to the surface of the skin so you’re much more likely to have some skin side effects. Those are usually just little darkening of the skin first then a little pinkness in the skin,” Dr. Biehl adds. 

He also says location matters in terms of where organs are. If you have radiation on the left breast area, there’s quite a bit of attention because the heart and lungs sit behind it. On the right breast, the heart is usually out of the range. Any of those side effects wouldn’t be felt during the actual radiation therapy treatment; they are long term.

Other side effects breast cancer patients might notice around the third or fourth week of treatment include:

  • Fatigue
  • Skin changes, redness/pinkness in the skin, darkening of the skin
  • Reduced size due to decreased inflammation

On the other hand, the prostate is deep within the pelvis so there aren’t really any skin side effects. Instead, the problems may pop up because the prostate is right between the rectum and the bladder.

“So you can have side effects in both the bladder and the rectum. In the rectum you can have some diarrhea, some urgency with your bowel movements,” says Dr. Biehl. “With the bladder you can have some urgency with your bladder, feeling like you have to get to the bathroom right away. Sometimes you can have some burning with urination.”

Most of those side effects of radiation are gone within a month or two with the radiation finishing up. Some are gone very quickly after radiation treatment.

Side Effects by Cancer Type

Breast Cancer

Margaret A.
Invasive Ductal Carcinoma (IDC) + Ductal Carcinoma in Situ (DCIS), Stage 2

Double Mastectomy Side Effects
Waking up to severe pain
*Solution: pain meds

Chemotherapy: AC-T Side Effects
(AC) Fuzziness in head, queasiness in stomach, fatigue
Solution: Anti-nausea medications
(Taxol) Excruciating pain in knees, feet, joints
Solution: Doctor lowered chemo dosage

Genoa M.
HER2, Stage 3

Neoadjuvant Chemotherapy: Taxotere, Carboplatin, Herceptin Side Effects
Nausea, fatigue, constipation, diarrhea
Solutions: (Overall) Moving around by swimming & walking, drinking a lot of fluids to flush out the chemo, (nausea) avoiding hunger

I’m not an athlete by any means, but I could swim and I could walk. As long as I moved and tried to do those things, even though I felt crappy, I would always feel better afterwards.

Doreen D.
Invasive Ductal Carcinoma (IDC), Stage III

Neoadjuvant chemotherapy: TCHP Side Effects
Nausea, fatigue, diarrhea, sore throat, memory loss, loss of focus, loss of taste
Solution: (Sore throat) Biotene mouthwash, (fatigue) exercise

Lumpectomy: No significant side effects

Radiation Side Effects
Sore, constant burning of skin, exhaustion

Tina C.
Ductal & Lobular, Stage 3A, ER+

Double Mastectomy Side Effects
Limited mobility
Solution: Exercises to stretch, like “Itsy Bitsy little spider exercises” to run fingers and stretch mobility

Chemotherapy: AC-T Side Effects
(AC) “Hangover” feeling, heightened smells, nausea, loss of appetite
Solutions (Nausea) Emend medication
(Taxol) Brittle, dry nails, constipation, occasional diarrhea
Solution: (Constipation) MiraLAX and prunes

When I talked with other survivors that had been through chemo, they describe this “Emend” which is a stronger anti-nausea. I talked to my oncologist about it and he prescribed that for me  rounds two, three, four and that made a huge, huge difference for me. 

Cervical Cancer

Mila L.
Squamous Cell Carcinoma, Stage 1B1

Neoadjuvant Chemotherapy: Cisplatin Side Effects
Fatigue, extreme nausea, heightened sense of smell, loss of taste, ringing in ears, neuropathy
Solutions: (Overall) Dr. lowered # of chemo sessions from 6 to 4, (Nausea) marijuana edibles

Radiation Side Effects
Skin lesions, itchy skin, pelvic tightness
Solutions: (Tightness & soreness) physical therapy for pelvis & vagina

Adjuvant Chemotherapy Side Effects
No significant side effects, some pain prevented by steroids
Solution: (Prevent pain) Steroids

Brittany W.

Squamous Cell, Stage 4B

Radiation Side Effects
Burning in pelvic region and neck areas (radiation targets), weight loss, fatigue
Solution: (Overall) Blood tranfusions, (burns) prescription burn medication

2nd-line Chemotherapy: Carboplatin and Paclitaxel
Fatigue, nausea, bone pain, hair loss (all got better as cycles went on)

(Blood transfusions are) like a chemo infusion except there are no side effects of it. You just sit there over the course of a couple of hours and they slowly provide you with red blood cells or white blood cells or just blood, whatever it is that you need.

Colorectal Cancer

Hugo T.
Colon Cancer, Stage 1

Immnotherapy: Vedolizumab Side Effects
Fatigue

Mainly it’s just the fatigue. I’ve been through chemo, surgeries, recoveries, and so this could be a lot worse.

It does knock me around a bit with the fatigue, but apart from that it’s ten times better than what I experienced with chemo and surgeries.

Barbara M.
Colon Cancer, Stage 3

Chemotherapies: FOLFOX & CAPOX Side Effects
Neuropathy in fingers, aversion to drinking cold liquids, chemo brain/fog, intense nausea
Solutions:(Overall) Walking, moving around

I could walk. I did a lot of walking through my chemo. There’s no bad weather, only bad clothing. I walked in the snow. It was my healing. It was my therapy. It was my everything.

Hodgkin Lymphoma

Stephanie O.
Classical Hodgkin Lymphoma, Stage 2BX (Bulky)

Chemotherapy: Stanford V Side Effects
Fatigue, slight nausea, constipation, mouth sores, food aversions
Solutions: (Nausea) Zofran, (constipation) stool softeners, Colace, (mouth sores) special mouthwash and toothpaste

I remember my nurse practitioner telling me it’s a lot easier to stay ahead of the nausea than to feel nauseous and then try to take medication to combat it. I took that to heart and I really religiously took the anti-nausea medications.

Mara T.
Classical Hodgkin Lymphoma, Stage 2BX

Chemotherapy: ABVD Side Effects
Nausea, body aches, constipation (from anti-nausea meds)
Solutions: (Nausea) Zofran and Phernergan, keeping ahead of nausea, drinking a lot of fluids (body aches) baths, (constipation) MiraLAX

I just listened to my body. I didn’t move when I didn’t feel like it because it didn’t make any difference in my outcome. It was living second by second for me at the time.

Tylere P.
Classical Hodgkin Lymphoma, Stage 3

Chemotherapy: ABVD Side Effects
Change in taste (metallic), fatigue
Solution: (Taste) drinking fruity drinks

Other than that, I was just really tired for a day or so after chemo. I didn’t really get nauseous or anything like that. My mom would drive about three hours to come stay with me after infusions.

Erica H.
Classical Hodgkin Lymphoma, Stage 3B

Chemotherapy: ABVD Side Effects
Fatigue, burst of energy → insomnia, constipation, acid reflux
Solutions: (Overall) Drinking a lot of fluids to flush out chemo, (constipation) flax seed, fruit, veggie shakes

Make sure all the waste is out of my body from the constipation – am I drinking enough water to make me feel strong and my veins available? 

Ava O.
Classical Hodgkin Lymphoma, Stage 4B

Chemotherapy: ABVD Chemo Side Effects
Fatigue, weird tastes (chemicals), bloating, weight gain
Solutions: (Overall) Running, drinking a lot of fluids, especially water

Drinking two liters of water every day was one of the toughest things I did, but every morning, I’d chug 16 ounces and that was the start of my day. I made it a rule,  I couldn’t do anything else unless I did that.

Leukemia

Evan L.
Acute Lymphoblastic Leukemia (ALL)

Chemotherapy Side Effects
Neuropathy, muscle cramps, heartburn, fatigue, nausea, mouth sores (mucositis)
Solution: (Nausea) Zofran, keep full stomach, avoid hunger, (mouth sores) magic mouthwash

I think it’s important to eat. When I wasn’t eating enough I would start to get nauseous so even if it doesn’t taste good it’s good to eat food and just have food in your body.

Lauren J.
Acute Lymphoblastic Leukemia (ALL)

Chemotherapy Side Effects
Nausea, joint pain, constipation (from joint pain meds) and hemorrhoids
Solutions: (Nausea) Ginger chews, ginger drinks, (constipation) creams, donut seats for comfort, sitz baths, magnesium drinks

They had given me pain medicine. Occasionally, I’d get some joint pain or bad headaches. The pain medicine they were giving me caused constipation.

The worst part of being in the hospital was hemorrhoids. That was worse than pain I felt from any infusion during treatment. I had never had anything like that.

Sasha T.
Acute Myeloid Leukemia (AML)

Chemotherapy Side Effects
Nausea, vomiting, diarrhea
Solutions: (Nausea) Zofran and compazine

(My first) round was probably the worst of the side effects. When I did the other rounds, it wasn’t the same chemo, so it wasn’t as intense, it was a bit more mellow. And those things were just the normal side effects, which is just the nausea and vomiting.

Mary Clare B.
Acute Myeloid Leukemia

Induction Chemotherapy Side Effects
Poor appetite, change of taste, fatigue, constipation, diarrhea, body pain
Solutions: (Overall) Prescribed medications, (nausea) ginger ale, (upset stomach) ginger chews, (body pain) heating pads, (digestion and fatigue) being active

I think still being active, trying to get out of the room trying to walk around was helpful for digestion, for appetite for overall fatigue.

Non-Hodgkin Lymphoma

Brianna B.
Anaplastic Large Cell Lymphoma (ALCL)

Chemotherapy: CHOEP Side Effects
Fatigue, hair loss, nausea, vomiting, low blood cell counts, constipation, diarrhea
Solution: (Nausea) Ativan, some Zofran

Follow the directions your doctor gives you. If they tell you your white blood cell count is going to be low, and they tell you to keep yourself safe from infection, do it. Wash your hands, keep yourself away from crowds and be careful.

Sean R.
Chronic Lymphocytic Leukemia (CLL) – Clinical Trial

Venetoclax and Ibrutinib Side Effects
(Ibrutinib) High levels of phosphorus, high blood pressure, (Venetoclax) blurry vision
Solutions: (High phosphorus levels) allopurinol, enagel and phoslo, avoid high-phosphorus foods like almonds, milk, and oatmeal, (high blood pressure) blood pressure medication (blurry vision) switched off Venetoclax

They seemed to have come to the conclusion that my healthy diet, which certainly might’ve been healthy in other circumstances, was packed with phosphorus and not healthy for that situation.

Lacey B.
Chronic Lymphocytic Leukemia (CLL)

Chemotherapy: Fludarabine, Cyclophosphamide, Rituximab Side Effects
(Overall) Nausea, taste changes, (Rituximab) Allergic reaction: heart rate drop, itchy skin

I had some nausea, but that was pretty well maintained. I had to have really strong flavors though. Anything that was mild tasting tasted horrible.

Emily G.
Diffuse Large B-Cell Lymphoma (DLBCL), Stage 4

Chemotherapy: R-CHOP Side Effects
Nausea, appetite loss, fatigue, “chemo brain,” irritability, neuropathy in fingers, mouth sores
Solution: (Overall) Fluids, (nausea) Zofran and compazine, (appetite loss) ginger, (mouth sores) Biotene mouthwash

Chemo brain you hear about, I felt I was totally in a fog. I do remember losing my train of thought which I didn’t connect to chemo for awhile. I couldn’t spell anything for a while even after I was done. I would be typing on my computer and trying to spell out words and I couldn’t do it. I felt like I was in a fog the whole treatment.

Arielle R.
Primary Mediastinal (PMBCL)

Chemotherapy: Dose-Adjusted R-EPOCH Side Effects
Nausea, fatigue, mouth sores, loss of appetite, stomach/digestive pain
*The biggest side effect: constipation
Solutions: (Nausea) Zofran, (constipation) Phillips “Milk of Magnesia” pill, (digestive pain) antacid, taken in morning on empty stomach for best results

I’m not a big TV watcher but man, I needed TV. I needed something to fixate on so that I could stop thinking about my body and TV really helped. And I could do a show, something small, take a break because my brain couldn’t really follow for that long, and then go back to it.

So that was really key for me with nausea to try and distract or pace around the house. Just something to change the moment.

Sonia S.
Primary Mediastinal B-Cell Lymphoma (PMBCL), Relapsed

Chemotherapy: R-ICE Side Effects
Nausea, fatigue, constipation, appetite loss
Solutions: (Overall) Drinking a lot of fluids, (constipation) OTC meds like MiraLAX, (appetite loss) finding one or two palatable items, like fruit smoothies

In general, just stay hydrated. That’s sometimes not a problem because your body’s just begging for water. They tell you to try to drink more to flush everything out because you don’t want all that staying in there. 

Also, try to eat. I know that my appetite was not great. I think the worst was when I had the conditioning chemo right before CAR T. That was when I had literally zero appetite.

Mags B.
Primary Mediastinal B-Cell Lymphoma (PMBCL), Stage 4

Chemotherapy: R-CHOP Side Effects
Nausea, sensitive to smells, headaches, numbness (neuropathy), acid reflux, mouth sores
Solutions: (Nausea) ginger pills, ginger tea, snacking on foods in small portions, (headaches) cold or hot baths, essential oils, naps, (mouth sores) prescription medication, (mouth sores) chewing ice

For the headaches, I tried a million different things. I really didn’t want to take strong drugs because I was already on too many drugs. I didn’t want to take anymore unless it’s absolutely necessary.

I would do cold or hot baths, depending on how I was feeling. I would have a wet towel on my head. I even tried using essential oils to help with the headaches. Just being quiet, taking lots of naps.

Rachel P.
Marginal Zone Lymphoma (MZL)

Chemotherapy: R-EPOCH Side Effects
Itchiness, bone pain (from Neupogen shots), nausea, fatigue

Neupogen gives you that bone pain that’s so incredibly painful it’s hard to describe. It’s a deep aching that comes from inside your bones all over and even your scalp hurts.

During the bad days, I would literally just lay down in my room all day. It was not enjoyable.

Ovarian Cancer

Heather M.
Epithelial, Stage 2

Chemotherapy: Paclitaxel and Carboplatin
Runny nose, nail and teeth changes, loss and change in taste, mouth sores, sore throat, constipation, and anal fissures, foot pain, nerve issues

Solutions: (Taste change) use plastic spoon to avoid metal taste, (mouth sores) coconut oil on lips to help with external dryness, drink Carafate, gargle with warm water and baking soda, (constipation) miraLAX, (anal fissues) numbing ointment applied before bowel movement, (nerve pain in leg) compression socks

If you’re having problems like that, please tell your nurse. They’re there to work with you. They’re your team. They’re going to try to help even embarrassing parts of you. And no one is going to laugh or snicker or anything because they have seen it all and it’s all natural parts of your body that are just injured from this life-giving poison that you’re having to take.

Maurissa M.
Low-Grade Serous, Stage 3

Chemotherapy: Carboplatin and Avastin Side Effects
Bloating, fatigue, pain in joints, legs, neuropathy, itching, appetite loss, nausea (especially 3rd cycle), diarrhea, constipation, indigestion
Solutions: (Diarrhea) Chicken noodle soup, avoid fried foods, (constipation) miraLAX and Senna, (indigestion) Tums, Imodium AD, Pepto-Bismol

After my third chemo is when I started to lose my appetite. That was really bad. I was weak, I was losing my appetite, and I was still dealing with the itching and the pain. But by that time I knew the pain was going to be here for a couple of days, the world is not going to end, you’ll be okay.

Prostate Cancer

Bruce M.
Gleason Score 8/9

Radiation side effects (long-term)
Blood in the urine and incontinence. Started to feel small mass start to bleed inside the bladder.
Solutions: (Mass) Medical staff performed local procedure, cauterizing it so it didn’t bleed anymore. Doctor said likely caused by damage from radiation.

In terms of incontinence, the key message is do your Kegel exercises religiously, both before and after treatment. I’ve found that I have minimal incontinence issues when I regularly do the exercises but when I slack off, it becomes more impactful


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References

1. “Side Effects of Cancer Treatment.” About Cancer, National Cancer Institute, Accessed 15 Jan 2021,https://www.cancer.gov/about-cancer/treatment/side-effects.

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