Side effects & management

Most side effects are managed effectively when reported early. We start with what matters most: when not to wait.

When to call straight away

We start with what matters most. The following do not wait for the next scheduled appointment — call the same day:

A temperature of 38°C or above, or shivering — even with no other symptoms. This is the most important one of all.
Severe or persistent diarrhoea, or being unable to keep fluids down.
Breathlessness or chest pain that comes on suddenly.
Bleeding that does not stop, or extensive bruising without cause.
Pain that is not controlled by the medication you were given.

There is no such thing as an unnecessary call. A symptom reported early is nearly always dealt with more simply — and most of the time the answer is reassuring. Keep the contact number somewhere you can find it easily.

The most common side effects

These depend entirely on the treatment you are receiving — you will not get all of them, and many people get very few.

Fatigue — the most common. It is not ordinary tiredness and does not always lift with sleep. Pacing helps, and so, counterintuitively, does gentle activity.
Nausea — now prevented in the great majority of cases with medication before each cycle. If it happens anyway, the medication is adjusted.
Susceptibility to infection — which is why fever is treated as a priority.
Mouth soreness — largely prevented with careful mouth care from day one.
Neuropathy — tingling or numbness in hands and feet. Report it early; timely adjustment prevents it becoming permanent.
Skin reactions — more common with certain targeted therapies, and manageable.

Keep a note

A simple diary — what appeared, when, how badly, how long it lasted — is worth more than it seems. At the next visit it turns “I felt a bit rough” into information precise enough to adjust treatment.

Immune-related side effects are different

If you are receiving immunotherapy, possible side effects come from an immune system that has become more active and may affect healthy tissue. They can appear weeks after a dose, and even after treatment has finished.

So report new symptoms, and always mention that you are on immunotherapy to any doctor you see.

Frequently asked questions

If I have no side effects, does that mean the treatment is not working?

No. There is no relationship between the severity of side effects and how well treatment works. Feeling well is simply good news.

Can I take a painkiller or something for fever on my own?

Ask first. Some common medicines can mask a fever that needs to be noticed, or interact with treatment. You will be given clear guidance on what is allowed.