If you have side effects of cancer treatment

You may notice skin and nail changes if you have certain treatments.

Contact your healthcare team if you have any problems with your skin or nails.

They can tell you about creams that can help and how to protect your skin from the sun.

Chemotherapy

Side effects of chemotherapy include dry, sore or itchy skin, and changes in skin colour, nails that are brittle or have white lines across them.

To care for your nails during chemotherapy:

• moisturise your nails and cuticles
• use nail varnish to cover your nails during treatment - quick-drying varnish or false nails will not work

Immunotherapy

Rash, itchy skin or changes in skin colour are side effects of immunotherapy.

Targeted therapy

Side effects of targeted therapy include rash, itchy skin and changes in skin colour.

Radiotherapy

Dry, sore or itchy skin, changes in skin colour and skin that blisters and peels are side effects of radiotherapy.

To care for your skin during radiotherapy:

• wash your skin every day with your usual soap
• pat your skin dry instead of rubbing it
• apply your usual moisturiser every day - ask your pharmacist for advice
• use your usual deodorant, unless it irritates your skin
• avoid shaving the area if possible and do not use laser, wax or hair-removal creams
• avoid using heat or cold packs on the area
• try wearing loose-fitting clothes made from natural fibres such as cotton or silk, and avoid tight bands, ties or straps on the sore area
• use a high-factor sunscreen (SPF 50 or above) to protect your skin from the sun and continue to use it for at least a year after treatment ends
• check with your healthcare team if you should stop swimming - chlorine in the water can sometimes irritate your skin when you're having radiotherapy
• stop using any products on your skin if your skin breaks

You may feel tired while you are having any kind of cancer treatment, or for some time afterwards.

It can help to:

• get plenty of rest
• avoid doing tasks or activities that you do not feel up to
• do light exercise to boost your energy levels, such as walking or yoga
• ask your friends and family for help with everyday tasks

If tiredness affects you at work, consider asking your employer for time off or if you can work part time.

Contact your healthcare team if you suddenly feel very tired and out of breath. This can be a sign of anaemia.

You may have hair loss if you have:

• radiotherapy
• chemotherapy

Radiotherapy

Radiotherapy only causes hair loss in the area being treated.

It usually grows back a few weeks after treatment finishes. But sometimes it may be a slightly different texture or colour than it was before.

It may not grow back if you have a high dose of radiotherapy.

Chemotherapy

Not everybody who has chemotherapy has hair loss.

It's most common to lose hair from your head. You can also lose it from other parts of your body, such as your arms, legs and face.

It usually grows back a few weeks after treatment finishes. But sometimes the hair that grows back is a slightly different colour. It may be curlier or straighter than it used to be.

Coping with hair loss

Hair loss can be upsetting. Talk to your healthcare team if you find losing your hair difficult to cope with.

They understand how distressing it can be and can support you and discuss your options with you.

Options include:

• headwear such as a headscarves
• hair replacement

Help with hair replacement costs after cancer treatment

Using cold caps to reduce the chance of hair loss

It may be possible to reduce the chances of hair loss by wearing a cold cap while you're having chemotherapy.

A cold cap looks like a bicycle helmet. It cools your scalp during a treatment session. This reduces blood flow to the scalp, reducing the amount of medicine that reaches it.

Whether you can use a cold cap depends on the type of cancer you have. Cold caps also work better with certain types of chemotherapy medicine. Cold caps do not always work.

Ask your healthcare team if:

• a cold cap might help you
• you can get it as a treatment - it is only available in some hospitals

Feel sicking (nausea) or getting sick (vomiting) are side effects of most types of cancer treatment.

Your healthcare team can give you anti-sickness medicine to reduce or prevent this. The type depends on the treatment you are getting.

Tell your healthcare team if your medicine does not help or causes too many side effects. There may be a different one that works better for you.

Problems eating and drinking can be a side effect of some cancer treatments.

Loss of appetite or weight loss

If you lose your appetite try to drink plenty of fluids and eat what you can.

It may help to:

• eat smaller meals more often instead of 3 large meals a day
• eat healthy snacks regularly
• eat light meals on the day of your treatment
• sip drinks slowly through a straw, instead of drinking them straight from a glass

Talk to your healthcare team if you're worried about your diet or lack of appetite. They may refer you to a dietitian.

Sore mouth

Radiotherapy or chemotherapy can make the lining of the mouth sore and irritated. This is known as mucositis.

Symptoms include:

• the inside of your mouth is sore - as if you've burnt it by eating very hot food
• mouth ulcers, which can become infected
• discomfort when eating, drinking or talking
• a dry mouth
• reduced sense of taste
• bad breath

Tell your healthcare team if you have any of these problems.

They may recommend:

• painkillers
• special mouthwashes that can help
• you avoid spicy, salty or sharp foods

Problems swallowing

Radiotherapy to your chest, head, neck or oesophagus (gullet or food pipe) can make swallowing uncomfortable.

Tell your healthcare team if this affects you. They may recommend:

• you eat soft or liquid foods
• medicine to reduce the discomfort
• in some cases, a temporary feeding tube

Diarrhoea and constipation are side effects of most types of cancer treatment.

Tell your healthcare team if you have these side effects.

They may recommend:

• medicine to reduce or prevent these side effects
• changes to what you eat

Some cancer treatments can cause aches, pain, swelling or stiffness.

If you have these side effects tell your healthcare team.

They may refer you to a physiotherapist, who can recommend exercises for you to try.

Being active and stretching regularly can help to prevent stiffness.

Many people find that they lose interest in sex during cancer treatment. Your sex drive usually returns gradually after your treatment has finished.

Radiotherapy and chemotherapy can reduce your fertility. If there's a risk this could happen, it may be possible to store some of your eggs or sperm, or part of your ovaries before treatment.

Some medicine types can cause harm to an unborn child. Avoid getting pregnant or getting someone pregnant if you are having cancer treatment. You can talk with your healthcare team about this.

Side effects of radiotherapy can include:

• stiffening and narrowing of the vagina - using vaginal dilators (devices you insert into your vagina) or having sex regularly may help with this
• vaginal dryness - lubricants, vaginal moisturisers and medicated creams can help with this
• menopause - this can cause symptoms such as hot flushes and night sweats, but treatment with hormone replacement therapy (HRT) if your team recommends it may help
• difficulty getting an erection (erectile dysfunction) - this tends to improve with time and there are several erectile dysfunction treatments available
• pain when ejaculating - this should pass a few weeks after the treatment ends

One of the side effects of radiotherapy is lymphoedema.

You may have pain and swelling in your:

• arms or legs
• the part of your body that was treated

It may be possible to reduce your risk of lymphoedema by looking after your skin and doing regular exercises.

Ask your healthcare team if you're at risk and what you can do to:

• help avoid it
• keep the symptoms under control.

Contact your healthcare team as soon as possible if you have any of these symptoms:

• severe tiredness and lack of energy
• shortness of breath
• noticeable heartbeats (heart palpitations)
• a pale complexion

Many cancer medicines lower the amount of red blood cells, which carry oxygen around the body.

If your red blood cell count drops too low, you'll develop anaemia.

You may need treatment to increase your number of red blood cells.

Cancer medicines can reduce the number of cells called platelets in your blood. These help stop severe bleeding when you cut or injure yourself.

If you have a low number of platelets, you may:

• bruise easily
• have severe nosebleeds
• have bleeding gums

Tell your healthcare team if you have these problems. You may need treatment to increase the number of platelets in your blood.

Some people have problems with short-term memory, concentration and attention span during cancer treatment. It is also known as chemo brain or brain fog. You may find that routine tasks take much longer than usual.

It's unclear why this happens. But the symptoms usually improve when treatment finishes.

Things such as using lists, calendars and your mobile phone for reminders can help. Doing some mental exercises, eating well, and getting enough rest may also be useful.

You may have difficulty falling asleep, or wake up during the night and cannot get back to sleep.

There are things you can do to help improve your sleep.

Contact your healthcare team if this advice does not work, as you may need medicine.