Hair thinning or loss 

• Use a gentle soft brush and avoid hair sprays, bleaches, dyes and perms.
• In most cases, your hair will grow back after treatment, but the texture or colour may change. 

Unusual bruising or bleeding 

(May be severe)

• Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
• Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Fever, chills, infection

(May be severe)

You have a fever if your temperature taken in your mouth (oral temperature) is:

• 38.3°C (100.9°F) or higher at any time OR
• 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

• Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
• Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
• Do not eat or drink anything hot or cold right before taking your temperature.
• Wash your hands often to prevent infection.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room.
 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Nausea and vomiting

(May be severe)

May occur in hours to days after your treatment. It is easier to prevent nausea than to treat it if it happens. 

To help prevent nausea:

• Take anti-nausea medication(s) as prescribed to you by your doctor.
• Drink clear liquids and have small meals. Get fresh air and rest.
• Do not eat spicy, fried foods or foods with a strong smell.
• Limit caffeine (e.g. coffee, tea) and alcohol.

If you have nausea or vomiting:

• Take anti-nausea medication(s) as prescribed to you by your doctor. 
• Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Mouth sores

(May be severe)

You may have round, painful, white or gray sores inside your mouth. They can occur on the tongue, lips, gums, or inside your cheeks. In more severe cases they may make it hard swallow, eat or to brush your teeth. They usually last 1 to 2 weeks.

To help prevent mouth sores: 

• Take care of your mouth by gently brushing and flossing regularly.
• Rinse your mouth often. Do not use mouthwashes with alcohol.
• Instead, try a homemade mouthwash:
• Mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.

If you have mouth sores:

• Check with your health care team as soon as you notice mouth or lip sores or if it hurts to swallow.
• Avoid hot, spicy, acidic, hard or crunchy foods.  Your doctor may prescribe a mouthwash to relieve mouth sores and prevent infection.

See the Mouth Care pamphlet for more information.

Low appetite

• You may not feel like eating or you may lose weight.
• Try to eat foods that you like and eat small meals throughout the day. 
• You may need to take meal supplements to help keep your weight up.
• Talk to your health care team if you have a low appetite.
• See our Loss of appetite pamphlet for more information.

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

• Take anti-diarrhea medication if your health care team prescribed it.
• Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
• Eat many small meals and snacks instead of 2 or 3 large meals.
• Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Reactions at the injection site 

What to look for?

• Your skin may become red, itchy, bruised, and/or swollen where the injection was given.
• Site reactions are usually mild and go away within one to three days.

What to do?

• Tell your nurse right away if there is any burning, stinging or other pain while doxorubicin is being injected into your vein.
• You may need to apply hot compresses or ice/cold compresses if you have mild redness or discomfort. This depends on which medication caused the reaction in your treatment.
• Talk to your health care team to find out which treatment is right for you.