Ovarian Cancer

Chemotherapy commonly causes unpleasant side effects, but some people have very few. Some side effects can be controlled with medicines. Almost all side effects are short-term and will gradually disappear after the treatment. The side effects from chemotherapy depend on the type, how much, and your reaction to the drug(s) being given. Some general side effects with chemotherapy for ovarian cancer include: 

• hair loss or thinning 
• feeling sick (nausea) 
• diarrhoea and constipation 
• higher risk of infection  
• increased bruising and bleeding 
• feeling tired (fatigue) 
• effects on the nervous system (including anxiety, restlessness, dizziness, and headaches) 
• numb or tingling in the hands or feet (peripheral neuropathy) 

Other side effects beyond this list may be experienced: refer to the resources and information page for further resources and information about chemotherapy. 

The women we talked to often knew someone else who had had chemotherapy for cancer or had at least heard something about it before they were diagnosed. Hair loss and sickness are commonly known side effects, but several women described how their preconceptions about the treatment were mistaken.  

Hair Loss

Hair loss is a common side effect of some, but not all, of the drugs used to treat ovarian cancer. For instance, Carboplatin, the most widely used of them, rarely causes hair loss. Some women we talked to lost no hair while in others, the hair thinned but did not fall out completely. A woman who did not lose her hair thought that she got less sympathy from other people because they did not identify her as a cancer patient. 

Although women felt prepared with the knowledge that their hair might fall out, some were more upset than they expected because it changed their appearance and was a visible reminder of the illness. One young woman had thought that it would not bother her to lose her hair and was surprised to be very upset. The loss of hair from other parts of the body often took women by surprise.

Women coped with hair loss in different ways. Some cut their hair short before treatment, others had their remaining hair cut or shaved off after it started to fall out because they didn't like it coming out unevenly. A few women tried a 'cold cap' treatment during chemotherapy which sometimes prevents hair loss. Wigs were offered to those treated on the NHS and many found them satisfactory although they could be hot in summer and cold in winter.

Some women bought their own wigs, others preferred to wear hats or scarves. Some covered their heads all the time, some went bareheaded all the time and others wore their wigs or scarves only when out.  

Advice about wigs, scarves and make up is often offered through 'Look good, feel better' sessions (see 'Resources and Information').

Hair that grew back after chemotherapy was sometimes a different colour, or was thicker, softer or curlier than it had been before.

Feeling sick and nausea 

Some of the drugs used may cause nausea and vomiting, but anti-sickness medication (anti-emetics) are given to prevent or reduce this side effect. Anti-sickness medication prevented some women from having any sickness, but others had varying amounts of nausea and vomiting. For some it was worse after the first chemotherapy treatment than after later ones, for others it got worse with each treatment. Some complementary approaches such as various forms of ginger seemed to help the nausea; a nurse had advised one woman to drink American dry ginger ale (see 'Complementary approaches').

Changes in bowel habit

It can be hard to know which effect is associated with which medicine. Some women had constipation, which can be caused by the anti-sickness medication rather than by the chemotherapy itself, especially in the first couple of days after treatment. Drinking lots of water and continuing to eat were seen as important in combating constipation.  

A few women felt very cold, had diarrhoea, mouth soreness, or weight changes. Several noted a tinny or metallic taste in their mouth which ruined the flavour of tea, coffee and wine.

Other side effects

The nervous system was sometimes affected, with numbness or tingling in the feet or hands, double vision, loss of high frequency hearing, headaches, dizziness or restlessness. A woman found that she could not do up her small child's buttons. Some noticed finding it hard to remember things or concentrate, which was particularly annoying if they wanted to read to distract themselves. In some, the skin became dry and itchy and nails discoloured. One of the side effects of paclitaxel (Taxol) is an aching of the muscles or joints, typically three days after treatment, which several women reported. Often a steroid was given to help women cope with chemotherapy; some said that these made them feel energetic immediately after treatment or interfered with sleep. Steroids also sometimes caused side effects such as puffiness or weight gain.

Many women became extremely tired and lethargic so that they slept a lot or just sat around doing very little. Because chemotherapy affects normal blood cells as well as cancer cells patients can be vulnerable to infections or become anaemic, some requiring blood transfusions. Chemotherapy can lower the number of platelets in your blood, and you may bruise very easily, have nosebleeds or bleed more heavily than usual from minor cuts or grazes. If you do have any of these problems, you may have to be admitted to hospital for a platelet transfusion. 

A few women had moments when they could understand why some people decide not to continue with chemotherapy or said that they would really not want to go through it again. Some found that complementary approaches, physical activity, buying tempting foods (such as chocolate and fruit) and continuing to eat well helped them to recuperate. A woman who felt cold during her chemotherapy said that the warmth in Majorca, where she had a holiday afterwards, helped her feel better.