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Side Effects of Chemotherapy and Radiation

What Is Cancer?


What Are Side Effects?


Side effects can range from tiredness and flu-like symptoms to hair loss and blood clotting problems. Because it's hard for doctors to predict how the body will react, anyone who is being treated for cancer is closely monitored. Doctors weigh the amount and severity of side effects against the benefits of treatments.


Side effects vary:

  • Some teens have just a few, while others have many over the course of treatment.

What Are Common Side Effects of Chemo and Radiation?

Chemo and radiation cause similar side effects. Chemo's side effects depend on the type of drug used, the dosage, and a person's overall health. These effects are more likely to affect the whole body.




Tiredness (or fatigue) is the most common side effect of both chemotherapy and radiation. Even the most active teens are likely to find themselves exhausted and perhaps even a little "foggy-headed" during treatment — and possibly for a while afterward. This is normal. Scale back on activities and rest as much as possible. Once treatment is over, your energy should return.

Flu-like Symptoms

Some cancer medicines appear to trigger the body's normal inflammatory response, causing flu- or cold-like symptoms, such as a runny nose, chills, and cough. Drinking plenty of fluids can help clear excess mucus. Also ask your doctor which, if any, over-the-counter medicines might help.



Mouth, Gum, and Throat Sores


Gastrointestinal Problems

Many types of chemo drugs are known to cause nausea, vomiting, loss of appetite, constipation, or diarrhea. Medicines can prevent or ease a lot of these symptoms. It's also common for teens to find that their taste preferences change while on chemo (like being unable to tolerate some smells or textures, for example).

If your appetite wanes, try eating several small servings of something rather than three large meals. Also concentrate on keeping yourself hydrated with water, juices, and broths.

Gastrointestinal symptoms related to radiation tend not to be as severe as those brought on by chemo, except in those who receive radiation to the pelvis or abdomen.

Skin Changes

Chemo drugs can cause rashes, redness, and other types of skin irritation — especially if you had radiation before the chemo (this is called "radiation recall"). Radiation alone can cause similar symptoms, along with blisters, peeling, and swelling, in the area of treatment.

Wearing loose, soft cotton clothing may help with the discomfort. Your doctor might also recommend or prescribe creams or ointments. Because the affected area can be more sensitive to the sun for a while after treatment, always wear sunscreen with an SPF of at least 30 whenever going outdoors.

Weight Changes

Some people might have weight loss or weight gain. It's common for those taking steroids to have an increased appetite and gain weight in unusual places, like the cheeks or back of the neck. Others might have decreased appetites or trouble keeping food down (especially if they're feeling nauseated after chemo).

If you're concerned about your weight, talk to the doctor about how to maintain a healthy weight based on your medical needs.

Hair Loss

During chemo, hair thinning and hair loss may happen all over the body. Radiation therapy to the head and neck may cause hair loss in that area, but radiation anywhere else will not cause the hair on the head to fall out.

Though some teens take hair loss in stride, others find it upsetting. Know that your hair will grow back — though it might be a slightly different color or texture. In the meantime, many teens choose to wear baseball hats, bandanas, scarves, or wigs.

Before treatment, some teens get shorter haircuts, as it can be easier to watch shorter strands of hair fall rather than long ones.

Kidney and Bladder Problems

Some chemo drugs can affect the kidneys. Frequent blood tests will help doctors monitor kidney function. Staying well hydrated can help. Tell the doctor if you have blood in your pee or any problems urinating.



Frequent blood draws throughout treatment will monitor the levels of these cells. If they get too low, you might get donor cells through a blood transfusion.

Blood Clotting Problems




White blood cells (WBCs) also can be depleted during or after cancer treatment. WBCs called neutrophils help fight infection. Having too few can put someone at increased risk of serious infection, a condition called neutropenia. A fever can be a sign of serious infection, so tell your doctor right away if you get one.

Teens with neutropenia need to take special precautions against germs. They should wash their hands well and often, especially before eating, after using the bathroom, and after touching animals. But they also need to avoid crowded indoor places or visiting with friends or family members who have contagious illnesses (such as a cold, the flu, or chickenpox).

People who have recently received live-virus vaccines, such as measles or oral polio, can pass these viruses to those with low blood cell counts, so it's also important to avoid contact with them. To prevent food-borne infection, teens with neutropenia shouldn't eat raw seafood, undercooked meat, or eggs.


Because their immune systems are compromised, teens with cancer (especially those with neutropenia) can't fight off bacteria and other germs that enter the body. So a seasonal virus or cold can quickly turn into a life-threatening infection.


If you get any of these symptoms, especially a fever, contact your doctor right away.

How Long Do Side Effects Last?

Most side effects start to go away after cancer treatment ends and the healthy cells have a chance to grow again. How long this takes typically on a person's overall health and the types and amounts of drugs and/or radiation he or she had.


Before treatment, the doctor will talk to you about your risk of late effects and what precautions can be taken before treatment, if any. For example, some teens who undergo treatments with fertility risks can take preventive measures like egg or sperm preservation.

What Else Should I Know?

Cancer treatment has come a long way. But it can be hard to cope with the sometimes painful or uncomfortable side effects of treatment. Fortunately, doctors have many ways to make treatments easier to manage.

You also might feel the emotional effects of having a serious illness. Talk with your parents and your care team. A hospital support group, life specialist, social worker, or psychologist from the care team can help you before, during, and after your cancer treatment.

Reviewed by: Robin E. Miller, MD
Date reviewed: October 2016