Lung Cancer

Side effects of chemotherapy for lung cancer

Chemotherapy is often used to treat people with lung cancer. The drugs have side effects which vary from one drug to another and according to the number of treatments given. 

Treatment has changed over the years and may not be as bad as expected. One man said that individual side effects can usually be dealt with, but it is difficult when there are many side effects at the same time.

Some people have chemotherapy as an out-patient while others have to stay in hospital (see 'Lung cancer - chemotherapy'). Some people manage to work between treatments. One person said that it was helpful to go back to work because it stopped her thinking about the next lot of chemotherapy. 

Chemotherapy drugs are usually given into a vein. After many treatments these veins may collapse or may become hard and uncomfortable. Occasionally, if chemotherapy has to be given repeatedly it is delivered via a Hickman line, tube going into a bigger vein in the chest which is left in place. One woman described how her Hickman line was inserted. She said that it had made treatment much easier.

Recalls that her veins became hard and uncomfortable during chemotherapy.

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Recalls that her veins became hard and uncomfortable during chemotherapy.

Age at interview: 55
Sex: Female
Age at diagnosis: 55
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I was sick, and more depressed, and there came a point when I was almost phobic about it because my veins all started to go hard and things and it was horrible. However not so horrible that I would have stopped it, you know I was happy, I was going to continue to do it because I felt it was such a dramatic thing that was happening to me it must be doing something. And in fact when I sort of bounced back each time physically and everything everybody was saying "You look fantastic, you look better than you've ever looked', and you know you, and I did I felt, I felt good when I was good in the good bits.

So there were positive things but it was the physical sticking the needles in that got to me in the end and these hard, hard veins. But I wouldn't put anybody off doing it if, I mean I think you just know yourself; some people couldn't continue it. Other people that were there with exactly the same thing it didn't seem to bother them at all, just completely sailed through it. So I think it's, it is to do with your body and yeah it must be that.

Talks about the Hickman line that she had put into a vein in her chest.

Talks about the Hickman line that she had put into a vein in her chest.

Age at interview: 62
Sex: Female
Age at diagnosis: 55
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I've had 104 infusions of chemo of various types and having been told by the first consultant that I only had four months to live I'm now seven years on.  

I have no surface veins left to take the chemo so I've been given this year a Hickman line. And this I fought to the bitter end until in the end the doctor said "I am sorry Maureen you just do not have any veins left," we'd got down to using the small ones in my feet. He said "We have got to give you a Hickman line, there's no other way." I strongly objected to this, being the vain creature that I am I didn't want plastic tubes hanging from my boob. But I could see that it was the right course to take so I agreed.

Could you explain for other people what a Hickman line is?

Yes, when they have used all your surface veins they tap into a deeper vein within the body and they bring, it's very difficult, it's quite embarrassing, they tap into a deeper vein nearer the heart and they bring it out and you have two sort of plastic tubes hanging down from the incision that they've made.

And they can use that?

And they can use that as often as they like. And I hate to own up to it but it is so much easier. It's not uncomfortable, it's just unsightly, but then I don't walk around with my top off. When they inserted the Hickman line I was awake for the whole procedure. They put a screen in front of my face so I couldn't see what they were doing and it was just no problem whatsoever, it really, really wasn't. So if there is anyone that has been, they have suggested they have a Hickman line it's not as frightening as it sounds and it makes life so much easier, especially now that I have to have blood transfusions which take up to nine hours, they can just plug in straight away and there's no problems.

Most people felt nausea or were sick at some stage, but this was often controlled with medication. It is common practice to have anti-sickness drugs before chemotherapy and in the majority of patients this is successful.

Recalls the medication he was given to control his nausea.

Recalls the medication he was given to control his nausea.

Age at interview: 57
Sex: Male
Age at diagnosis: 57
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And they actually gave me anti sickness pills, eighteen of which I was supposed to take and a nurse said, 'If you can do without some of those try your best to because they're steroids and they're not very good for you.' But she didn't tell me until the second time round so the first time, the first chemo I'd taken them all, the second one I only took half of them and fared very well.  

The next few chemos I only took the odd one now and again and fared very well. The last two chemos on purpose I didn't take a single tablet and that was the only time, I was never sick but I felt nausea and I just said to myself, 'You will not be sick, ignore it, you will not be sick ignore it, you will be not be sick ignore it'. And when I felt nauseous which may have been for three hours a day for about ten days it wasn't too nice a feeling. But that was my own choice, did I want the tablets which were bad for me or did I want the nausea, I chose to have the nausea. And I chose to ignore it in terms of being sick, it wasn't quite so easy, you can't ignore feeling sick, you just feel sick all the time, that was awful. But I chose to have that instead of the tablets.

Hair loss is common during chemotherapy. One man said that he was surprised to find that he had lost his hair from his ears, arms and legs as well as well as his head. Some people were upset when they lost their hair, but most people said that they soon got used to their new image. Some wore wigs, hats or bandanas to conceal their lack of hair.

Discusses his feelings about losing his hair during chemotherapy.

Discusses his feelings about losing his hair during chemotherapy.

Age at interview: 62
Sex: Male
Age at diagnosis: 61
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Had your hair fallen out by this stage?

It started after about five treatments. Suddenly, I was seeing a lot of hair on my coat collar. I didn't realise I was losing it (laughs), but it was' The whole structure of the hair changed, so it was more prone to breaking. So I was seeing short hair on the back of the collar, and I could clean it off in the morning and go home in the evening, and it would be back. So it was fairly dramatic once it started. I suppose hair loss is one of the best-known side effects of chemotherapy, because most people associate that. What I didn't realise, because I also knew hair loss could happen - and in fact it did, it had started - Pardon me. But what I didn't realise is that you also lose the hair from inside the nose, and the ears, and on your arms and your legs. I'd just assumed it was on top of your head! (Laughs). And I couldn't really afford to lose a lot, I was already fairly thin on top, but '.

And how did it make you feel, losing hair?

I didn't particularly like it. I'm a bit vain, so I would have preferred to have kept what I thought were my good looks, but I didn't like the look of me as I began to go bald.  But it doesn't seem to bother anybody else, so I discussed it with my wife, and she said she'd still love me even if I had no hair!  I remember saying to her, 'What if I have no hair on my body either?' and she said, 'Oh that's okay, I'll still love you'. And I said, 'Well, what if I've got no money?' She said, 'Well that's different!' (Laughs) She 's a bit of a shopaholic, is my wife.

(Laughs)

So once I knew it didn't bother other people, then I didn't bother about it. It hasn't worried me, losing hair.

She was very upset at first when she lost her hair during chemotherapy.

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She was very upset at first when she lost her hair during chemotherapy.

Age at interview: 68
Sex: Female
Age at diagnosis: 66
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How do you feel about losing your hair?

Oh I'm not bothered now, I was at first, oh I wouldn't speak to nobody, I wouldn't open the door to my daughter. I was in a right state. Anyway I've got over that.

You have a very smart turban?

Now I've got some nice hats.

Have you?

Yes, I got this one from hospital. It's a black cap really but this is just the thing that goes on the top.

It's lovely. They give you those do they?

Yes.

Many people said that chemotherapy made them feel physically tired and sometimes depressed. One man said that he felt as though he had influenza. He also mentioned, like many others, that his sense of taste had been affected. Someone else mentioned a temporary loss of smell.

Describes some side effects of chemotherapy, including symptoms similar to influenza and loss of taste.

Describes some side effects of chemotherapy, including symptoms similar to influenza and loss of taste.

Age at interview: 57
Sex: Male
Age at diagnosis: 56
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It tends to, the symptoms basically are one of a very, very bad dose of influenza, a very bad dose of influenza and it is horrible. It not only affects, but the thing is not only does it affect you like that it also affects your taste buds. Our taste completely changes. Now I like, I used to like, you notice I say used to like red wine, even, excuse me, even to-date I'm still not drinking red wine like I used to drink red wine. I have to drink white wine which I don't mind but I'd prefer red wine but it still doesn't taste the same. Now that's because of the chemotherapy. Other things; blackcurrant jam which I love; no taste at all.  Now you know how sweet blackcurrant jam is, absolutely no taste.

So it's had a permanent effect on your taste buds?

No, no, no just temporary while you're on the chemo. It's only the wine that's had the longer effect. Now what I think with the wine is, I know it's a silly thing to talk about (laughs) but I think it's the tannin in the wine that does it, in red wine, I think it's the tannin that does it in the red wine and that's what's caused it.  But now my taste is nearly back to normal again.
 

Pins and needles in fingers or toes are quite common with some types of chemotherapy. One woman said that her nails had gone a funny colour. Sense of touch, balance and hearing may also be affected. One man described his cold feet, muscle pains and a strange feeling that made him want to move his legs all the time, sometimes described by doctors as “restless legs”.

During chemotherapy he was very sick and developed pins and needles in the fingers and toes.

During chemotherapy he was very sick and developed pins and needles in the fingers and toes.

Age at interview: 55
Sex: Male
Age at diagnosis: 50
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When I came home after having the chemotherapy I was very, very sick with the chemo and my local doctor came up because I was very violently sick. I moved to upstairs, constantly in bed. When the doctor came in he gave us a wee box here [points to chest] and fed it into my chest with an anti sickness and morphine. And the nurses came in every day and changed, put more morphine in and it helped greatly.

That's good and what other side effects did you have apart from the feelings of sickness and hair loss?

I started getting like pins and needles in my fingers and my feet and my toes and once I started getting the right medication like the morphine and anti sickness and that it cleared away itself, it was no problem and it worked for me and it could work for you.

Some people recalled that they had suffered from oral thrush, sore throat, sore gums, or mouth ulcers when they were being treated. One woman said she lived on ice cream and gruel like porridge. Another woman, who had high doses of chemotherapy as part of a trial in 1995, still has a dry mouth today. She remembered her terrible mouth ulcers and lack of control over bodily functions. Others said that they had constipation as well as diarrhoea.

Recalls that during chemotherapy she developed thrush.

Recalls that during chemotherapy she developed thrush.

Age at interview: 53
Sex: Female
Age at diagnosis: 52
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How many cycles of chemotherapy did you have?

I had six. Six session of chemo, every three weeks yes.

Did you have any side effects with the chemo?

I had one, once I think it was the fourth session and I got what they call thrush. Uh, its just all white in your mouth and it you know, you just, you lose all your taste-buds and everything but they gave me the right medication and within four days it was gone and that's the only thing I suffered from. I didn't have no sickness, obviously my hair fell out. I got very tired towards the end of the first week which, but I knew all this because they'd explained to me right from the beginning I knew exactly what was happening to me so I wasn't frightened, you know there was no need to be frightened or anything like that.

What were your feelings when your hair fell out?

It didn't really bother me because I thought it was a small price to pay. You know, if this was going to save me so no it didn't bother me.

Describes the side effects of chemotherapy that she experienced, particularly the mouth ulcers, tiredness and diarrhoea.

Describes the side effects of chemotherapy that she experienced, particularly the mouth ulcers, tiredness and diarrhoea.

Age at interview: 64
Sex: Female
Age at diagnosis: 57
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Well as I say I think the worst side effects are the tiredness and the fatigue and the mouth ulcers. It's so painful, there's nothing that eases the pain and it has still left me, I mean alright I'm very grateful that I'm still alive and everything you know but it does come at a price. I still do have effects, sort of side effects with my mouth, I have a dry mouth and I have problems still with my insides and that you know.  

But I think it's just the sheer tiredness and not being able to do anything and it's so frustrating because you want to get out of bed and it isn't as though you just want to lay there but you just can't do it, it's just a physical impossibility because you are so weary. I mean alright I lost my hair within the first couple of weeks but there again may be if I'd have been younger it would've bothered me more but that was never really a concern to me because I thought well you know we're trying to save my life here, if the worst comes to the worst I can wear a wig if it never grows back you know. So that was never a particular issue although I didn't like wearing wigs actually I did try and, they do supply you with them but I never found it comfy so I didn't bother, I just used to wear a turban.

But I would say the side effects, the worst one is the mouth ulcers. And of course you've no control over bodily functions, you know I mean you're going to the loo, it just pours out of you, you know diarrhoea and what have you. I can always remember on occasion, which was about the only time that I ever really felt like giving up, and someone had given me some money for the Christmas and so my husband had been and bought me a new dressing gown and slippers and I was wearing it and I just couldn't get to the loo in time and it just poured out of me. And oh it was, I was in a right state. When my husband walked in and I just, I was just sort of crying and saying "Oh this is it, I've had enough, I can't carry on like this," you know. And he was very, very calm and collected and just cleaned me up and sorted me out and I was fine again then you know. That's about the only time really that I ever felt that I couldn't carry on with it. But yes, some people do, I have heard people say that you know it is too much, that they would never, ever go through it again.  
 

Chemotherapy can have serious side effects and may have to be stopped before the course is finished. It may reduce the number of normal cells in the blood to dangerous levels. Sometimes platelets (which help blood clotting) are badly affected. If this happens people can bruise very easily. One woman described the “purply red spots” that developed under her skin.

Explains how chemotherapy badly affected her blood.

Explains how chemotherapy badly affected her blood.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
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When it got after the fourth lot of chemotherapy I had another really bad reaction, well I didn't actually I felt absolutely fine but I'd been and had the last lot of chemo and then two weeks later I went, you had to go back for a blood test you know because it does really badly affect your blood. And they said that I'd no platelets, I'd no red cells, my white cells weren't performing, if I had, you know if I had a nosebleed I could probably bleed to death because it were just like water running through my veins but I felt fine. And I'd been and had another blood transfusion that day and they said "We want to bring you in, just to be on the safe side you know and give you some antibiotics." In other words they were preventing an infection starting.  

Explains that her platelet count dropped dangerously low during chemotherapy.

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Explains that her platelet count dropped dangerously low during chemotherapy.

Age at interview: 62
Sex: Female
Age at diagnosis: 62
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And this went on from July till September. I was to have four lots of treatment so it took in about twelve weeks.

Four lots of three weeks cycle?

Yes. During that time I did have a very low platelet count.  I had some purply red spots come up which were just a few but I rang the unit and they said they would ring me back. And they contacted the chest consultant who asked if I could go in and they did a blood test there and then and my platelets had dropped right down to five. I'd been shopping the day before, I didn't think much to it and they, they asked the other patients there if they would mind if I was treated first because I needed urgent treatment which to me again I was thinking, “Oh do I?” Not knowing much about platelets, perhaps I should have done. And I had the treatment on the Friday and I had to go in each day over the weekend and have the treatment and my platelets went up. But again they had a bed available for me should I need to be hospitalized.

The red blood cells that contain haemoglobin and carry oxygen may also be affected. Abnormally low levels may lead to breathlessness. The white cell count (those that fight infection) can drop to dangerous levels too. One man said that he had developed pneumonia while on chemotherapy because he hadn't been warned that his white blood count and immune system would be badly affected by the treatment.

Explains that he developed pneumonia because he wasn't warned that his immune system had been affected by the chemotherapy.

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Explains that he developed pneumonia because he wasn't warned that his immune system had been affected by the chemotherapy.

Age at interview: 53
Sex: Male
Age at diagnosis: 51
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It didn't go according to plan because one of the things they omitted to say to me was that when I started getting the chemotherapy it would really impact my immune system, it would impact my ability to fight off germs. And although I'd been falsely diagnosed previously as having pneumonia, about, within ten days of me getting the first dose of chemo I had a very severe dose of pneumonia, it almost developed over the course of a weekend. And what was happening was that a lot of my employees and friends and colleagues were coming around to the house to see me because they knew that I was dying and knew that we had an open outlook towards this so they were all coming around to say hi and you know we're rooting for you etc. and it was really appreciated, but because they had omitted to warn me about my immune system I was being hugged and kissed, by all sorts of people, men as well as women. And as a result of that I caught every germ that they had. So I ended up actually being, seeing my new GP because I had changed GPs within the practice and switched to the GP that my wife uses. And that GP came round to see me and immediately got me admitted to the hospital and I was put into a ward where I was barrier nursed.
 

Sometimes the drugs used to treat or prevent the side effects of chemotherapy drugs themselves cause side effects.

 

Last reviewed May 2016.
Last updated May 2012.

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