Chemotherapy and early breast cancer

Hair loss (alopecia) can be one of the most upsetting side effects of chemotherapy. Whether or not you lose your hair depends on the type of chemotherapy drugs prescribed for you.  

As well as losing hair from your head you may also lose hair from other parts of the body, such as eyebrows and eye lashes. 

To help prevent hair loss from your head, some oncology centres offer the use of scalp cooling machines. Scalp cooling works by chilling the scalp and reducing blood flow to the scalp to prevent chemotherapy from getting to the hair follicles. This means the hair is less likely to be damaged and fall out.  

Your treating team will be able to tell you how chemotherapy treatment may affect your hair and the options available to help manage this. Read more on the hair loss page.

Nausea and vomiting are common side effects of chemotherapy, but can be managed with medication. You may be given anti-nausea medication before your chemotherapy and to take home with you in case you need it later. Let your doctor know if you have nausea and/or vomiting that lasts for more than 24 hours. It’s easy to become dehydrated quickly, and your doctor can help with this.

Some chemotherapy drugs cause mouth ulcers and changes in taste. Rinsing your mouth regularly with bicarbonate of soda, even before you begin chemotherapy, can help to prevent ulcers. Eating soft mints can help get rid of the metallic taste that you may experience as a result from the chemotherapy. 

Talk to your treating team about what mouth care is required for the treatment you are having.

Some chemotherapy drugs and drugs taken to prevent nausea can cause diarrhoea or constipation. Uncontrolled diarrhoea can cause dehydration.  

It is important to talk to your GP or treating team for advice and management if you are experiencing these side effects.

Chemotherapy can affect the ovaries reducing your oestrogen levels and cause periods to stop, either temporarily or altogether. This is called early menopause. You may experience some of the symptoms of menopause, such as hot flushes, aches and pains in the joints and night sweats.

Learn more about menopause and its impact on people with breast cancer in our video Ask the Expert: Menopause – It’s more than a hot flush!

As chemotherapy reduces the level of oestrogen in your body, it can also reduce your bone density and increase your risk of osteoporosis and bone fractures. Read more about this on the bone health  page of this website.

Nail changes are a common side effect of some chemotherapy treatments. The nail changes page provides more information on the changes that may occur to your nails, including what you can do manage nail changes.

Fatigue is very common during chemotherapy. Many people describe it as being quite different from normal tiredness.

The fatigue  page contains more information on how to manage fatigue. You can also find more information in our section on physical wellbeing.

Some people who have chemotherapy say that they experience a side effect known as 'chemo brain' or 'chemo fog'. It is best described as feeling vague. Some people say they have trouble remembering things and find they aren't as organised as usual. The cognitive impairment  page includes suggestions on how to manage its effects.

Some treatments, especially chemotherapy, are known to reduce fertility. 

If preserving your fertility is important to you, there are options that may be available to you. It is important to discuss your wish to preserve your fertility with your breast cancer specialist before starting treatment, especially chemotherapy treatment. 

For more information see the Breast cancer in young women page.

Peripheral neuropathy is the general term for pain or discomfort caused by damage to the nerves of the peripheral nervous system. The damage affects the way the nerves send signals between your brain and other parts of your body, such as your hands and feet. 

Some breast cancer treatments, especially some chemotherapy drugs (e.g. taxanes), can cause peripheral neuropathy. It can result in pain, tingling, numbness, loss of sensation and hot/cold sensitivity. It can affect your balance, sleep and overall wellbeing.

It’s important to tell your medical oncologist or nurse straight away if you have any of the above symptoms of peripheral neuropathy. This will enable management of symptoms before they can progress or worsen. Your treatment plan may need to be changed or adjusted to prevent further nerve damage.

Peripheral neuropathy may be prevented from getting worse if it is picked up early, and it may go away over time once treatment has finished. However, recovery is often slow as it can take time for nerves to repair.