Nausea and vomiting
Most chemotherapy drugs cause feelings of sickness and vomiting. Children and adolescents are given anti-sickness medicines (anti-emetics) before, during and after their chemotherapy to reduce or prevent this side-effect.
Loss of appetite
Children and adolescents may lose their appetite during their treatment. They may also experience a strange taste in their mouth, which can alter the type of food they want to eat. A close eye will be kept on their weight and a referral to a dietitian will be made if required.
Nutrition: further information
Sore mouth
Children and adolescent’s mouths may become sore and they may get ulcers, which can lead to infection. Adequate mouthcare including brushing teeth and using products such as mouth wash and oral gel to coat the lining of the mouth can help to prevent mucositis. Some centres also use low-level laser therapy.
Diarrhoea and constipation
Chemotherapy drugs are likely to change bowel habits. Some cause diarrhoea and others constipation. Medicines and dietary advice will be given.
Constipation: further information
Hair loss (alopecia)
The vast majority of patients will lose some or all of their hair. All body hair can be affected. This is temporary and it will grow back.
Skin changes
Skin may be affected. It may become dry and extra sensitive. Ensure sun block is used if patients are in the sun, as some chemotherapy agents can increase the risk of skin cancer. There may be other changes specific to individual drugs.
Bone marrow depression
There will be a temporary reduction in how well the child or young person’s bone marrow is working to produce their blood, leading to lower blood counts than normal:
- a low number of red blood cells causing tiredness, tachycardia (fast heart rate) / tachypnoea (fast breathing)
- a low number of white blood cells resulting in the child or adolescent being immunocompromised (at risk of infection due to lowered immunity)
- a low number of platelets causing bruising, petechial spots (a type of rash) and potentially bleeding
Blood counts are checked regularly and blood and platelet transfusions given as required.
Kidneys and liver function
The kidneys and liver may be temporarily affected by some of the drugs resulting in a disturbance in electrolytes and enzymes. Kidney and liver functions are checked regularly by monitoring biochemistry levels. The chemotherapy drugs that affect your kidneys are given with extra intravenous fluids, however, it is important to ensure the child or adolescent drinks well even after these fluids are finished to assist normal liver and kidney function. It is also important to report any change in urinary output or pattern.
Fertility
Fertility can be affected in the short and long-term, which may result in difficulty in becoming pregnant or fathering a child. However, effective barrier contraception must still be used (where applicable) during treatment and for a few months after this is to prevent pregnancy, limit infection risk and prevent the partner being exposed to chemotherapy via body fluids. The subject of fertility should be discussed by the consultant before treatment.
Periods (menstruation)
Periods may lessen or stop during treatment.
Tiredness, exercise and fatigue
Most children and young people undergoing chemotherapy and radiotherapy will be tired and some may experience fatigue – fatigue is an extreme form of tiredness that sleep does not relieve. Despite this we advocate that, with the exception of contact sports (such as rugby, if the child has a central line or potential for low platelet count), the patient should exercise and be as active as possible.
Allergic reaction
Any medicine may cause an allergic reaction. These reactions can range from mild to severe. A mild allergic reaction may include skin rashes and itching, high temperature, shivering, redness of the face, a feeling of dizziness or a headache. If you see any of these signs, please report them to the patients Clinical Nurse Specialist/Key Worker) or PTC or POSCU for further advice.
Signs of a severe allergic reaction include any of the above and shortness of breath and chest pain. A 999 call for immediate medical help is necessary.
Last review date: February 2026