More about the risks and side effects of chemotherapy

Average rating:

Mouth problems

The cells which line the mouth are affected by some cytotoxic drugs. This may lead to a sore mouth, a dry mouth or other mouth problems. Routine good mouth care will help to prevent mouth problems from developing or from becoming more serious. If possible, do the following either yourself or with the help of a carer:

* Brush your teeth twice a day with a soft toothbrush and fluoride-containing toothpaste.
* Rinse your mouth after meals and at night. Use water or 0.9% sodium chloride solution (saline or salt water). You can make a fresh sodium chloride solution for each rinse by dissolving half a teaspoon of salt in 250 ml fresh water. Use cool or warm water, whatever your prefer.
* Remove any debris that you can see in your mouth or on your tongue by gentle brushing with a soft toothbrush. If possible, do this regularly but mainly after meals and at bedtime. Foam sticks are an alternative if brushing with a soft toothbrush causes pain or bleeding.
* Chewing pineapple may also help to clean your mouth. Pineapple contains ananase which is an enzyme (chemical) that can help to break down debris in the mouth. You can use fresh pineapple or unsweetened tinned pineapple.
* Remove dentures at night. Clean dentures with a soft toothbrush and toothpaste. Soak overnight in a denture solution. Rinse before use the next day.

If you develop a dry mouth then simple measures such as frequent sips of water and chewing sugar-free gum will often help and be all that is needed in many cases. Artificial saliva or medication to stimulate the salivary glands are sometimes used, which your doctor can prescribe for you. (See separate leaflets called 'Mouth Care' and 'Dry Mouth' for more details.)

Hair loss
Some cytotoxic drugs damage the hair making cells. Some or all of your hair may fall out. This usually occurs 2-3 weeks after a course of treatment starts. Body hair and eyelashes may also fall out in addition to scalp hair. After the course of treatment has finished the hair will usually regrow within 4-12 months.

Hair loss does not bother some people. You may wish to cut your hair short before starting chemotherapy so that any changes are not so dramatic. Some people like to wear a wig. Other people prefer to wear a hat or scarf. In particular, remember to cover your head or wear high protection sun screen when out in the sun. If your eyelashes fall out, you can wear glasses or sunglasses to protect your eyes on windy days.

Constipation
This may be helped by eating plenty of foods high in fibre and having lots to drink. A laxative may be needed in some cases.

Diarrhoea
This is a side-effect from some drugs. You should increase the amount that you drink if you develop diarrhoea. If it persists or becomes severe, you should tell your doctor. Anti-diarrhoea medicines may be needed and you may even need to be admitted to hospital for a 'drip of fluid' if you become dehydrated due to severe diarrhoea.

Nerve problems
Some drugs can affect nerves. This may lead to a lack of sensation in parts of the body such as the fingers or toes, pins and needles or weakness of muscles. Tell your doctor if any of these symptoms occur.

Fertility
Some chemotherapy drugs can affect fertility in both men and women. Sometimes this is temporary and sometimes it is permanent. If this is a concern, one option may be for men to store sperm or women to store ova (eggs) before chemotherapy treatment begins. These can be 'frozen' and may be able to be used in the future if you wish to have a pregnancy. Some women develop an early menopause when taking some cytotoxic drugs.