Side effects of chemotherapy

Side effects can affect everyone differently, and you may not get all the side effects mentioned here. Your chemotherapy team should tell you about possible side effects and how they are managed. Ask them any questions you have and tell them about anything unusual. Side effects normally get better once your chemotherapy finishes.

As well as the side effects on this page, chemotherapy can also affect the blood cells, causing cause side effects, such as an infection and anaemia.

Keeping a diary of any side effects you have can help you talk about these with your chemotherapy team. It can also help you keep track of how you feel during each cycle, and help you prepare for the next cycle.

The common side effects of chemotherapy for pancreatic cancer are:

• Extreme tiredness (fatigue)
• Runny poo (diarrhoea)
• Feeling and being sick (nausea and vomiting)
• Loss of appetite, taste changes or a sore mouth
• Losing your hair
• Tingling or numbness in your fingers or toes
• Blood clots in a vein

Fatigue (extreme tiredness)

Fatigue is a common side effect of chemotherapy. It isn’t the same as just feeling tired. Fatigue can be physically, mentally and emotionally draining.

Some people find that the fatigue starts a few hours to a few days after having chemotherapy and starts to improve after a few days. It can take a few months after treatment for fatigue to fully improve.

There are things that can help. See how the chemotherapy affects you and how much activity you can manage. For example, you may want to do very little on the days after chemotherapy when you may have fatigue.

Runny poo (diarrhoea)

Some chemotherapy drugs can cause diarrhoea. If this happens, try to drink as much as you can manage so you don’t get dehydrated. Dehydration is when the body loses more water than it takes in.

If you have diarrhoea more than four times a day, call the emergency number. Diarrhoea can be treated with medicine. Your chemotherapy may be delayed until the diarrhoea is better, or the dose of your chemotherapy may be lowered.

Read our tips for coping with diarrhoea.

Feeling and being sick (nausea and vomiting)

Chemotherapy can make some people feel or be sick. This usually happens a few hours after treatment and can last for a few days. You may be given anti-sickness medicines before you start certain types of chemotherapy. You will also be given anti-sickness medicines to take home. If you are taking the anti-sickness medicines and still feeling or being sick, call the emergency number. Read our tips on coping with feeling and being sick.

Loss of appetite, taste changes or a sore mouth

During chemotherapy you may not feel like eating much. Try eating small meals more often – for example three small meals and three snacks a day. If your appetite doesn’t get better after a few days, tell your doctor, nurse or dietitian.

Chemotherapy can also cause a funny taste in your mouth. Some people say this tastes like metal or cardboard. Sucking boiled sweets and using herbs and spices in your food can help.

Chemotherapy can make your mouth sore and cause mouth ulcers. This can make eating and drinking uncomfortable. Clean your teeth regularly with a soft toothbrush and avoid foods that sting your mouth. Rinsing your mouth with cool water after eating can help. Using an alcohol free mouthwash regularly can help prevent ulcers.

Tell your chemotherapy team about any problems you have with your mouth. They can give you mouthwashes, medicines and gels to help. They can also check that you don’t have an infection, such as oral thrush. This can cause taste changes but is normally easy to treat with anti-fungal tablets.

Read more about dealing with a poor appetite and taste changes, including tips on things that can help.

Losing your hair

Chemotherapy may cause your hair to thin or even fall out altogether. This is more common with FOLFIRINOX or nab-paclitaxel. Your hair should grow back after treatment. Using a gentle shampoo (such as baby shampoo) and leaving your hair to dry naturally helps.

Ask your nurse about things that can help you cope with hair loss, including ways to cover it up or referring you for a wig if you wish. You could also ask if scalp-cooling is available and suitable for you. This can help to protect the hair on your head during chemotherapy and reduce hair loss. You wear the cap for a period before, during and after your treatment.

Macmillan Cancer Support and Cancer Hair Care have more information about hair loss.

Tingling or numbness in your fingers or toes

Some chemotherapy drugs can affect the nerves in your hands and feet, which can cause tingling or numbness. This is called peripheral neuropathy. It is most common for people having FOLFIRINOX, FOLFOX or nab-paclitaxel.

It may be worse when it is cold. Wearing gloves and warm socks and avoiding cold food and drinks may help. Peripheral neuropathy normally gets better after treatment. But for some people it can get worse in the first few months after treatment.

It’s important to tell your chemotherapy team about any tingling or numbness, so it does not become a long term problem. They can change the dose of the chemotherapy drug that causes this, or you may stop the drug until it gets better. You may also be given medicines for any pain.

Blood clots in a vein

A blood clot in a vein can block the flow of blood. This is called deep vein thrombosis (DVT). You are more at risk of a blood clot if you have pancreatic cancer and are having chemotherapy.

Symptoms of a blood clot in a vein can include:

• pain, swelling or tenderness in an arm or leg
• your skin may look red or a different colour to normal in the affected area
• a sudden pain in your chest
• feeling short of breath, which can start suddenly or gradually

Call the emergency number straight away if you have any of these symptoms or go to A&E.

Blood clots can be serious and need treating straight away. Your chemotherapy team should tell you how to reduce the risk of blood clots and may give you blood thinning medicine. Move around as much as possible, and drink as much fluid as you can manage.

Updated May 2024

Review date October 2026