Chemotherapy

Feeling queasy or sick in your stomach is called nausea. Vomiting is another word for ‘throwing up’. These are common side effects of cancer treatment, but they can usually be managed well with anti-nausea medicine.

Helpful tips

Don’t go for long periods without eating, as this may make your nausea worse

• Take anti-nausea medication as instructed by your treatment team.
• Tell your doctors or nurses if you’re not able to eat or drink much. They can help with managing your nausea.
• Eat small, frequent meals and snacks.
• The smell of hot food can make nausea worse, so try to stay out of the kitchen while meals are being cooked.
• Try cold foods if you feel sick, they often smell less and are easier to eat when you’re feeling unwell.
• Try eating with a fan or open window, as the fresh air may help with your nausea.
• Try dry salty foods such as crackers or toast.
• Food and fluids with ginger may help, like ginger ale, ginger biscuits, and candied ginger.
• Sip on cold clear fluids, like cordial, lemonade, and apple juice.
• Try to limit fatty and fried foods because they take longer to digest, which can make nausea worse.

After treatment, some people notice that food tastes or smells different. It might take a while for things to go back to normal.

Helpful tips

To improve your sense of taste and smell:

• Keep your mouth clean and fresh.
• Rinse your mouth with water before meals.
• Make your food tastier by adding sauces, herbs, and spices.
• Avoid smells you find unpleasant.
• Use soft, moist or wet food options if your mouth is dry or sore.
• Cold foods like sandwiches, salads, or yoghurt might be easier to eat than hot foods.
• Try using plastic utensils if some foods taste metallic.
• Try lemon drops or mints if you have a metallic taste in your mouth.
• Try citrus fruits

Some cancer treatments can cause cramping, gas, bloating, and diarrhoea (loose stools). Make sure to tell your nurse or doctor if you have any of these symptoms, or if you notice blood in your stool.

Helpful tips

If you have diarrhoea you must seek medical advice. It is important to make sure you drink plenty of fluids to replace fluids and electrolytes lost from your body.

• Stay hydrated with water, diluted juices, weak tea, clear soups, or oral rehydration drinks from the pharmacy.
• Watch for signs of dehydration such as dry mouth, thirst, or dark urine, and seek medical advice if these occur.
• Only take anti-diarrhoea medication if prescribed by your treatment team.
• Home remedies like ginger-infused water, or salt and honey water may help soothe symptoms.

If the diarrhoea continues, your treatment team may recommend:

• Changing to lactose-free milk and yoghurt or plant milk alternatives (soy or oat milk).
• Limit high fibre foods.
• Limit fruit juice, alcohol, caffeinated drinks like coffee and strong tea, and spicy food.

If you get a sore bottom:

• Try using a wet washer or unperfumed baby wipes.
• Use a protective barrier cream around your bottom

Constipation can be caused by some cancer treatments, certain medications (such as pain relievers and anti-nausea drugs), reduced food and fluid intake, and lack of physical activity.

Helpful tips

Tell your treatment team if your bowels are not working regularly.

• A gentle laxative can help soften the bowel motion.
• Eating more fibre, drinking plenty of fluids, and staying active can help prevent constipation.

It is important to slowly increase fibre in your diet, to avoid discomfort. Foods that contain fibre include:

• Wholemeal and wholegrain breads, cereals, pasta, oats and brown rice.
• Fruit and vegetables.
• Legumes or pulses.
• Dried fruit, unsalted nuts, ground seed and nut mixes.

Chemotherapy causes fatigue because it affects healthy cells and disrupts the body’s energy production. Your body works harder to repair itself, leaving you feeling drained and exhausted.

Helpful tips

Listen to your body and ensure you have a balance of rest, exercise and nutritious food.

• Doing gentle exercise or being active every day can give you more energy, help with tiredness, and keep your muscles strong.
• Talk to a physiotherapist or exercise physiologist who work with people recovering from illness or injury. They can help find the activities that are suited to you.
• Eating meals and snacks can give you more energy through the day.

For support managing your fatigue and energy levels, try using the Energy Coach in the Leukaemia Foundation’s Online Support Service.

Some treatments can cause mouth sores (ulcers) and sore gums. This makes eating and drinking painful and hard to do.

Helpful tips

This is a common and uncomfortable side-effect of some cancer treatments. It can start about a week after treatment and usually goes away after a couple of weeks.

• Talk with your treatment team about pain medication including gels that can numb the sore spots before mealtimes.
• Remove poor fitting dentures when you feel your mouth becoming sensitive.
• Avoid foods that might sting your mouth such as citrus fruits, spicy, salty or dry crunchy food and alcohol.
• Choose soft, moist foods that are easier to chew and swallow.

Some cancer treatments affect the production of saliva, which can cause a dry mouth.

Helpful tips

Increase the amount of fluids you drink each day to help moisten your mouth.

• Avoid dry foods – try adding extra sauce or gravy to dishes.
• Rinse out your mouth with an alcohol-free mouthwash, salty water or sodium bicarbonate in water after meals.
• Try sucking on lollies or soft jellies if your mouth is sore.
• Chewing gum can help make more saliva.

Loss of appetite is when you do not want to eat or do not feel like eating very much. Many things can affect your appetite, like the physical and emotional effects of treatment. Many people find that although their appetite improves after treatment, it can be some time before it returns to normal.

Helpful tips

• Eat small, healthy meals and snacks.
• Include protein-rich foods with meals (see page 9).
• Drink protein-rich fluids like milkshakes, smoothies, protein soups, or special high-energy drinks.

How food looks and smells influences appetite:

• Choose colourful fruits and vegetables and try to make food look and smell good.
• Keep meals fun and tasty.

Hair cells are one of the cells that is affected by chemo. It is very common for people with blood cancer having chemo to loose their hair.

Helpful tips

• Prepare your family and friends.
• Use a soft hairbrush and a mild baby shampoo.
• Pat your hair dry gently with a towel.
• Cut your hair shorter or have it shaved when you start chemo. Use an electric shaver.
• Avoid using heat or chemicals – don’t dye or blow dry your hair.
• Use sunscreen on your scalp.

Chemo brain happens when cancer treatment temporarily affects how your brain works, making it harder to think or remember things. It’s a common and usually short-term side effect.

Helpful tips

• Keep a notebook or use your phone to track reminders, appointments, and ideas.
• Sticking to a routine and doing things in the same order each day helps reduce confusion.
• Prioritise good sleep. Fatigue makes memory and focus worse.
• Eat well and stay hydrated to support brain health.
• Light exercise like walking can boost energy and focus.
• Puzzles, reading, or memory games can help keep your mind sharp.
• Let friends, family, or coworkers know if you need reminders or support.
• Talk to your doctor. They can check for other causes and suggest strategies or therapies.

Sun sensitivity happens when your skin reacts more strongly to sunlight, often from medications or treatments.

Helpful tips

• Cover up with long sleeves and long pants
• Wear sunglasses and a hat or a beanie to protect your scalp
• Talk to your nurse about which sunscreens are best to use
• Avoid sun exposure at high UV times of the day.

Chemotherapy can lower your red blood cell count, which means your blood carries less oxygen. This can make you feel tired, weak, or breathless. A blood test will confirm if your red blood cells are lower than normal.

Helpful tips

• Tell your treatment team if you are feeling tired, dizzy, weak, or breathless. They can do a blood test to check your red blood cell count
• Take supplements if prescribed. Only use iron or vitamins your doctor recommends.
• You may be given a blood transfusion in the hospital

If you are experiencing any chest pain, go to the closest emergency department or call 000 for assistance.

Chemotherapy can lower your platelet count, which are the cells that help your blood clot. This can make you bruise or bleed more easily. A blood test can check your platelet count.

Helpful tips

• Tell your treatment team if you have had any unexpected bleeding or easy bruising. Such as a bloody nose, heavier than usual period, bruising without knocking yourself
• Avoid sharp objects in your mouth like chop bones or potato chips
• Be careful not to cut or injure yourself
• Use a soft toothbrush
• Use an electric razor
• Wear closed toe shoes outside and slippers around the house
• You may be given a platelet transfusion in the hospital

Chemotherapy can reduce your white blood cells, called neutrophils, which help fight infections. This makes it easier to get sick and harder for your body to fight germs. A blood test can check your white blood cell count.

Helpful tips

• Check your temperature regularly, if it is 38 degrees or more, go to the closest emergency department or call 000 for assistance
• Tell your treatment team if you are experiencing any signs of infection
• Avoid crowds; keep away from people who are sick and might be contagious (colds, flu, chicken pox)
• Eat food that has been properly prepared and freshly cooked
• Don’t clean up pet faeces
• Avoid swimming in public pools, lakes, or rivers.
• Wear gloves and a face mask in the garden
• You may be given an injection under the skin to help boost your neutrophil count.
• Talk to your treatment team about vaccinations. Generally, live vaccines are not recommended for people undergoing blood cancer treatment

Some blood cancer treatments can cause peripheral neuropathy. It happens when treatment affects the nerves that carry messages between your brain, spinal cord, and the rest of your body. It can cause numbness, tingling, burning or ‘pins and needles’ in your hands and/or feet. You may also feel some weaknesses, sensitivity to touch, or have trouble with balance. Symptoms gradually worsen over time.

Helpful tips

• Tell your healthcare team early if you are experiencing any symptoms.
• Keep track of any changes in sensation.
• Protect your hands and feet from injury and cold. Wear well-fitting shoes and slippers at home. Wear gloves when you’re out in the cold or gardening.
• Take extra care with hot and cold as neuropathy can make it harder to feel the temperature.
• Keep your skin moisturised.
• Regular light exercise may lower your risk of developing neuropathy.

Helpful resource: https://www.cancer.org.au/assets/pdf/understanding-peripheral-neuropathy