Side-effects

Coping with side-effects

Chemotherapy is associated with many different side-effects. This section talks about coping with these side-effects. Please note that the side effects below are temporary and usually stop after treatment.

Most side-effects of chemotherapy are connected with the digestive system, mouth, skin and hair. This is because chemotherapy drugs works on  fast growing cells, so it not only affects cancer cell but rapidly dividing healthy cells that are present in the stomach lining, mouth, hair, skin and bone marrow. 

A member of your child’s care team can explain what the side effects of certain drugs are likely to be. They can also prescribe medicines (such as anti-sickness ones) to help.

Please note that medical advice (from your child’s care team) should always be sought if you are concerned about the severity of side-effects, if your child has been exposed to an infection such as chicken pox or measles, or if your child is showing signs of the following:

• Temperature above 38°C and ‘the chills’ or muscle aches. These could be signs of an infection.
• Weakness, dizziness or shortness of breath. These could be signs of anaemia.
• Bruises or small red spots on the skin, bleeding gums, blood in urine or stools. These could be signs that the blood is not clotting properly.

The above can be signs that the child’s bone marrow is affected – a common side-effect of chemotherapy. Please see our about childhood cancer-chemotherapy section for further information about the bone marrow or contact your child’s Consultant.

Below are a few suggestions about how you can help your child get through the more common side-effects associated with cancer treatment.

Chemotherapy (and radiotherapy) can make your child feel, or be, sick. This does not happen to all children.

If your child feels sick try offering them liquids to drink. Sometimes not drinking can make them feel worse. They may tolerate liquids better than solid food.

Offer small meals three to four hours before treatment and let your child rest for a long time after eating.

Offer cold, bland food such as sandwiches. Dry toast and plain biscuits are best if the child feels very sick. Avoid greasy, fatty or spicy food.

Try distraction. Reading a book together or listening to music can take your child’s mind off the way they feel.

You can also offer small amounts (a tablespoon at a time) of clear fluid if your child is being sick, once the vomiting has stopped. Gradually work up to solid foods again when your child is better.

Some chemotherapy drugs and painkilling drugs can cause constipation. Lack of fluids and inactivity can also cause constipation.

Offer high-fibre foods such as wholegrain bread, dried fruit such as raisins, fresh raw vegetables or wholemeal pasta. 

Offer as much fluids as the child will drink. Apple juice (if the child’s mouth is not sore) can help, as can warm water.

You can also encourage your child to walk around if they are able, to help the muscles in the stomach and bowels to move and start working again.

You should inform a member of your child’s care team if your child has diarrhoea.

Offer plenty of fluids, but avoid chilled drinks from the fridge.

Avoid fizzy drinks and fruit juices.

Offer foods that are high in protein and calories but lower in fibre such as hard cheese, eggs, meat or white bread.

Small frequent meals may help.

A warm bath may relieve any soreness around your child’s bottom and their nurse can also offer creams to help. It is important to keep the area clean.

You should also wash your child’s hands thoroughly.

Small mouth ulcers or sores can lead to bigger infections when a child is undergoing chemotherapy. Parents should inform their child’s Consultant if ulcers or sores develop and check for them every day. 

Teeth should be cleaned gently after each meal with a soft toothbrush. Nurses can also offer a sponge mouth care stick to clean the mouth if it is sore.

The child’s dentist should be told of the situation and may wish to postpone any planned dental treatment.

Offer plenty of fluids to keep the mouth moist and avoid offering dry food which may be hard to swallow.

Spicy foods may irritate a sensitive mouth and are best avoided.

A member of your child’s care team may be able to offer painkillers if your child’s mouth is very sore.
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Radiotherapy and chemotherapy can cause skin problems such as sun sensitivity, rashes, redness and itching. If these occur it is best to check with a member of your child’s care team about the best things to do, but in general:

Avoid using heavily scented creams or moisturisers and check with your child’s Consultant about which creams (if any) are best to use.

Keep your child out of the sun as much as possible and use a high factor (30+) sunscreen.

Keep the skin clean and pat dry thoroughly.

Watch for signs of infection in any cuts or grazes, or for any sore red spots which could indicate the beginnings of an infection.

Hair loss is a common side-effect of chemotherapy. It may be helpful to discuss with your child how they may like to handle this – for example by cutting their hair short or by buying headscarves or hats. You may want to order a wig, especially if your child is older and very sensitive to the way they look. It is best to do this before the hair has fallen out.

Whilst the child is undergoing treatment use a mild shampoo and avoid hairdryers. Also use a wide-toothed comb.

Protect the head from sunburn or from the cold with sunscreens or a hat.