Doctor Sanjeev Sewak

Chemotherapy side effects

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss: can occur (uncommon). See the nurses about a wig if you so desire.
-Infertility/birth defects: Please use barrier methods of contraception during chemo cycles as birth defects can also occur

-Hot flushes are common.
-Vaginal dryness: You can use lubricants. Contact your doctor if this is a problem.
-Joint and muscle pains occurs in about 30% of patients.
-Osteoporosis: (thinning of the bone) Take osteolin to prevent this.
-Fatigue.
-Nausea (uncommon).
-May increase your cholesterol slightly.

-Infection: (in 5% of patients) Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients) You may feel fatigued or short of breath. You may require a blood transfusion.
-Fatigue/tiredness
-Nausea or vomiting: (uncommon) Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Diarrhoea: can be common. Drink lots of water and take gastrostop. If does not settle ring nurses or if worse go to Emergency Dept.
-Sunsensitive: More likely to burn. Put on sunscreen.
-Birth defects: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Hand-foot syndrome: Occurs only if you have 5-FU given continuously over many days. Manifest as painful blisters/cracking on palms and soles of your feet.

-Infection: (in 5% of patients) Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients) You may feel fatigued or short of breath. You may require a blood transfusion.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Infertility/Birth defects. Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Skin rash. Can be prevented by taking Dexamethasone 1 tablet twice a day for 3 days, starting the day before chemo.
-Conjunctivitis or irritation in the eye occurs rarely.
-Side effects are made considerably less if vitamin B12 injections are given every 9 weeks and folic acid tablets are taken daily.

-High blood pressure: (can commonly occur). May require tablets to treat this. Get you GP to check your BP.
-Protein in the urine: (uncommon). Checked by urine tests.
-Bleeding internally: (rare) eg from lungs, in urine or bowel motions.
-Blood clots: (rare). Manifest as leg swelling or chest pain or shortness of breath.
-Bowel perforation: (very rare but can be fatal).
-Allergic reactions: Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.

-Fever is common: Prevented by taking panadol 2 tabs four times a day for 24 hours after chemo.
-Raynaud’s Phenomenon: (uncommon). Manifest as very cold hands and feet due to decreased circulation. Can be permanent.
-Pneumonitis: (rare). Inflammation of the lungs. This is rare and manifest with shortness of breath, cough and fever. Can be permanent.
-Allergic reactions: (rare). Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss: can occur (uncommon). See the nurses about a wig if you so desire.
-Hearing loss/or ringing in the ears: (5-20% of patients). Can be permanent.
-Neuropathy: (5-20% of patients). Numbness in hands and feet. Can be permanent.
-Kidney damage: (2-15% of patients). Picked on blood tests. Prevented by keeping up water intake in the first five days after chemo. Can be partially reversible.
-Fluid overload: (10% of patients). Occurs in the first few days after chemo and cause shortness of breath.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.

-Allergic reactions: (rare). Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.
-Acne-type rash: Is common. Can be itchy, scabby and painful. Use oatmeal wash/cream. Take regular minocycline tablets to prevent the rash.
-Diarrhoea: can occur and can be severe. Take gastrostop 2 tablets every 4 hours for 12 hours (take for whole 12 hours). Repeat for the second 12 hours if diarrhoea has not settled. If you still have diarrhoea go to the Emergency Dept.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia:(in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low Platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss: can occur (very common). See the nurses about a wig if you so desire.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Neuropathy: (5-20% of patients). Numbness in hands and feet. Can be permanent.
-Allergic reactions and oedema (fluid retention in the legs etc): Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion. This can be prevented but you must take dexamethasone. Take 2 tablets twice a day, starting the day before chemo, same on day of chemo and day after chemo. VERY IMPORTANT, WRITE ON CALENDER TO TAKE DEXAMETHASONE.
-Nail changes, such as black discolouration or splitting.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss can occur: (common). See the nurses about a wig if you so desire.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Drug extravasation: Very rarely occurs when the drug is given through the IV and leaks into the tissues. This can cause severe pain and tissue breakdown. Report this to the nurses ASAP.
-Heart damage; (1% of patients). Shows up as shortness of breath. Can be permanent but can be helped with medications.
-Leukemia: (0.1% of patients). Can occur 2 to 10 years after receiving the drug.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: (uncommon). Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: (uncommon). Can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss can occur (uncommon). See the nurses about a wig if you so desire.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Pneumonitis: Inflammation of the lungs. This is rare and manifest with shortness of breath, cough and fever.

-Heart damage: (1% of patients). Shows up as shortness of breath. Usually improves when Herceptin is stopped and can be helped with medications.
-Allergic reactions:(rare). Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets:(in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is uncommon and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Diarrhoea :can occur and can be severe. Take gastrostop 2 tablets every 4 hours for 12 hours (take for whole 12 hours). Repeat for the second 12 hours if diarrhoea has not settled. If you still have diarrhoea go to the Emergency Dept.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss: can occur (uncommon). See the nurses about a wig if you so desire.
-Infertility:. Please use barrier methods of contraception during chemo cycles as birth defects can also occur.

-Diarrhoea: can occur and can be severe. Take gastrostop 2 tablets every 4 hours for 12 hours (take for whole 12 hours). Repeat for the second 12 hours if diarrhoea has not settled. If you still have diarrhoea go to the Emergency Dept.
-Rash.
-Heart damage: (1% of patients). Shows up as shortness of breath. Can be permanent but can be helped with medications.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 10% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Birth defects: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Heart damage: (0.5% of patients). Shows up as shortness of breath. Can be permanent but can be helped with medication.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Infertility/birth defects: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Allergic reactions: Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.
-Neuropathy: (5-20% of patients). Numbness in hands and feet. Can be permanent.

-Allergic reactions (rare). Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.
-Tumour Lysis: Fevers, chills and kidney failure can rarely occur after the first infusion.
-Low white blood cells and infection can rarely occur.

-Acne-type rash: Is common. Can be itchy, scabby and painful. Use oatmeal wash/cream. Take regular minocycline tablets to prevent the rash.
-Diarrhoea: can occur and can be severe. Take gastrostop 2 tablets every 4 hours for 12 hours (take for whole 12 hours). Repeat for the second 12 hours if diarrhoea has not settled. If you still have diarrhoea go to the Emergency Dept.
-Loss of appetite.
-Mouth ulcers (rare).
-Eye problems: (with the cornea).
-Pneumonitis: Inflammation of the lungs. This is very rare. You could get shortness of breath, a cough, and a fever. Report this to your doctor immediately.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Constipation: is common and can be prevented with laxatives such as coloxyl with senna, lactulose or movicol. Usually occurs in the first week after chemo.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
Hair loss can occur (very common). See the nurses about a wig if you so desire.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Neuropathy: (5-20% of patients). Numbness in hands and feet. Can be permanent.
-Allergic reactions: Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion. This can be prevented but you must take dexamethasone. Take 5 tablets starting the night (10pm) before chemo, and on the day of chemo (8am). VERY IMPORTANT, WRITE THIS IN YOUR CALENDER TO TAKE DEXAMETHASONE.

-Pneumonitis: Inflammation of the lungs. This is very rare. You could get shortness of breath, a cough, and/or a fever. Report this to your doctor immediately.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Low platelets: (in 1% of patients). This can lead to spontaneous bleeding from the nose, mouth, bowels, vagina, skin (bruising) or internally. If there is bleeding that does not settle go to the EMERGENCY DEPT IMMEDIATELY.
-Fatigue/tiredness
-Nausea or vomiting: Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Hair loss can occur: (common). See the nurses about a wig if you so desire.
-Infertility: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Allergic reactions: (rare). Allergies are manifest as low blood pressure, wheezing or swelling of the tongue/lips during the chemo infusion.

-Infection: (in 5% of patients). Very serious . Known as blood poisoning or septicemia. You would feel very ill and have a fever. Temp would be greater than or equal to 38 degrees. Must go to the EMERGENCY DEPT IMMEDIATELY. Infections get better on appropriate antibiotics but can be fatal if left untreated.
-Anaemia: (in 20% of patients). You may feel fatigued or short of breath. You may require a blood transfusion.
-Fatigue/tiredness
-Nausea or vomiting: (uncommon). Take anti-nausea medications as instructed after chemo. Includes pramin/maxalon, granisetron (kytril), dexamethasone, emend. Please call nurses for advice if not settling.
-Mouth ulcers: can be painful but usually last for only a few days. You should gargle with salt water/baking soda and water or mouthwash without alcohol.
-Diarrhoea: can be common. Drink lots of water and take gastrostop. Stop taking xeloda if diarrhoea not settling. If does not settle also ring nurses/doctor or if worse go to Emergency Dept.
-Sunsensitive: More likely to burn. Put on sunscreen.
-Birth defects: Please use barrier methods of contraception during chemo cycles as birth defects can also occur.
-Hand-foot syndrome: (common). Manifest as painful blisters/cracking on palms and soles of your feet. Use sorbelene cream to prevent this. Report this to your doctor. Stop taking xeloda tablets if this occurs.

Other drugs

There are other less common chemotherapy drugs. Your doctor will give you a printed copy of their side effects.