Chemotherapy's Effects on Organs and Body Systems

The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help you keep them to a minimum. It can also help give you the best possible experience.

Chemotherapy's effects on organs

Your medical profile and diagnosis is different from those of other people. So is your reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team possible side effects of treatment before the treatment begins.

Because anticancer medicines are made to kill growing cells, they also affect normal, fast-growing cells elsewhere. These include:

• Blood cells forming in the bone marrow

• Cells in the digestive tract. For example, mouth, stomach, intestines, and esophagus).

• Cells in the reproductive system, such as in the sexual organs

• Hair follicles

Some anticancer medicines may affect cells of vital organs, such as the heart, kidney, bladder, lungs, and nervous system.

Chemotherapy causes no serious long-term problems for most people. But in some cases, chemotherapy can cause permanent changes or damage to the heart, lungs, nerves, kidneys, and reproductive or other organs. Certain types of chemotherapy may also have delayed effects. For example, a second cancer may develop many years later. Discuss any long-term effects that may result from your treatment with your doctor.

Chemotherapy's potential effects on the kidneys and bladder

Some anticancer medicines cause bladder irritation or result in temporary or permanent damage to the bladder or kidneys. You may need to collect a 24-hour urine sample to be looked at in a lab. Your doctor may ask for a blood sample to see how well your kidneys are working before you begin chemotherapy. Some anticancer medicines cause the urine to change color (orange, red, green, or yellow) or take on a strong or medicine-like odor for 24 to 72 hours. Talk with your doctor to find out if the chemotherapy medicines you are getting will cause any of these side effects.

Drinking plenty of fluids will help you have good urine flow and help to prevent problems. This is especially true if you are taking medicines that affect the kidney and bladder. In addition to water, juice, soft drinks, broth, and soup, you may include ice cream, Popsicles, and gelatin to get more fluids. Caffeine can act as a mild diuretic, but even coffee is better than no fluids. 

Because medicines can affect your kidney and bladder, be sure to let your doctor know right away if you have any of the following symptoms:

• Pain or burning during urination

• Frequent urination

• Inability to urinate

• A feeling that you must rush to urinate (urination urgency)

• Reddish or bloody urine

• Fever

• Chills, especially chills that cause your body to shake

Chemotherapy's potential effects on the nerves and muscles

The following are the most common symptoms of nerve and muscle problems because of chemotherapy. But each person has slightly different symptoms. Symptoms may include:

• Weak, sore, tired, or achy muscles

• Walking problems, pain when walking, or both

• Loss of balance

• Clumsiness, difficulty picking up objects, or both

• Shaking or trembling

• Hearing loss

• Jaw pain

• Stomach pain

• Constipation

• Tingling or pain in the feet

Most of the time, these symptoms will get better with time. But this may take up to a year after treatment. These symptoms may look like other health conditions. Always see your doctor for a diagnosis.

How can I cope with nerve and muscle problems?

The National Cancer Institute (NCI) recommends the following strategies for reducing nerve and muscle problems related to chemotherapy:

• If your fingers are numb, they will not react correctly when you touch something sharp or hot. Handle objects with care.

• To prevent falls or accidents, move slowly and use handrails. This is especially true if you have weak muscles or if you have problems with balance. Use bath mats in the tub or shower to lower your risk of slipping. Also think about wearing shoes with rubber soles for better traction.

• Ask your doctor about taking pain medicine, if needed.

Chemotherapy's potential effects on the sexual organs

Many people, both men and women, find that chemotherapy affects their sex organs, as well as their ability to have sex. Your age and general health will influence how the medicines will affect your sexual function. The NCI provides the following advice for coping with sexual problems linked with cancer and chemotherapy.

Men

Chemotherapy medicines can cause temporary or permanent infertility. They reduce the number of sperm cells and their ability to move. This doesn't always affect a man's ability to have intercourse, but it could create difficulty in getting or keeping an erection. Chemotherapy can also damage the chromosomes in the sperm, which could lead to birth defects.

Discuss with your doctor the use of birth control during treatment, including using a condom for the first 48 hours after the last dose of chemotherapy. This is because some chemotherapy medicines can be found in the semen. Your doctor can advise you regarding how long to use birth control. If you wish to father a child, you should talk with your doctor to find out whether the treatment will affect your fertility. Also discuss the possibility of sperm-banking before you begin your treatment.

Women

Chemotherapy can affect a woman's menstrual periods, fertility, and menopause. Consider the following:

• Effects on the ovaries. Anticancer medicines can affect the ovaries and reduce their ability to make hormones. Some women find that their menstrual periods become irregular or stop completely during chemotherapy. Related side effects that affect the ovaries may be temporary or permanent.

• Infertility. Damage to the ovaries may result in infertility that can be either temporary or permanent. Whether infertility occurs, and how long it lasts, depends on many things. These include the type of medicine, the dose, and tour age. Egg harvesting and embryo cryopreservation are options. But these may be expensive and time-consuming. 

• Menopause. Your age and the chemotherapy medicines and dosages will determine whether you have menopause while on chemotherapy. Chemotherapy may also cause menopause-like symptoms such as hot flashes and dry vaginal tissues. These tissue changes can make intercourse uncomfortable and can make you more likely to have bladder or vaginal infections, or both. Any infection should be treated right away.
  Discuss with your doctor and cancer care team the best ways to ease symptoms such as hot flashes and vaginal symptoms. Also ask about ways to prevent infections. Dressing in layered clothing, and passing up caffeine and alcohol, can help reduce hot flashes. The right kind of clothing also makes a difference in reducing vaginal infections. Don't wear tight slacks or shorts. Choose cotton underwear and pantyhose with a ventilated lining.
  Take care when using vaginal lubricants to decrease vaginal dryness. Use a water- or mineral oil-based lubricant instead of petroleum jelly. Your doctor may prescribe a vaginal cream or suppository.

Research has also shown that chemotherapy can affect how you think and remember things. This is called "chemo-brain." People seem to recover from these changes over time, but these vague "thinking problems" can be very disturbing to both you and your family. Talk with your doctor if you believe you or your loved one is having trouble thinking or remembering things after getting chemotherapy.