Pancreatic Cancer

Side effects of chemotherapy

Doctors use various cytotoxic drugs (chemotherapy) to treat people with pancreatic cancer (see ‘Chemotherapy’). The side effects vary from one drug to another and according to the number of treatments given. Different people react in different ways.

Most people we interviewed had had gemcitabine, with or without capecitabine. Common side effects of gemcitabine include flu-like symptoms, fever, reduced resistance to infections, bruising or bleeding, tiredness sometimes due to anaemia, nausea, vomiting, poor appetite, skin rash, change in liver or kidney function, and fluid retention causing swollen ankles or breathlessness. Less common side effects include diarrhoea, hair loss, and mouth sores or ulcers. The side effects of capecitabine are similar. This drug may also cause soreness and redness or darkening of the palms of the hands and soles of the feet (sometimes known as hand-foot syndrome), abdominal pain, taste changes and angina. 

Some people said that they had tolerated gemcitabine, with or without capecitabine, remarkably well. Helen, for example, felt tired but managed to go back to work. David’s (Interview 30) wife felt a ‘bit unwell’ but otherwise the side effects ‘were not dramatic’. Many felt a little sick at times and off their food but had medicines to counter nausea. Some said their hair had thinned but had not fallen out completely. Others said they had avoided side effects altogether by following advice to take anti-emetic drugs to counter nausea, use mouthwashes and clean their teeth frequently.

However, some people felt very ill at times. Side effects typically started a few hours after each intravenous infusion and lasted two or three days, after which many people said they had been able to resume their normal activities. In some the side effects were worse with each successive treatment. One man had ‘intense shivering’ on the evening of his chemotherapy. Phil also said he got a ‘severe fever’ when he had treatment. Infections need to be treated as medical emergency usually with intravenous antibiotics. Signs of infection include:

  • A fever and high temperature 37.5C (99.5F) or over 38.0C (100.4F) depending on the hospital’s policy.
  • Feeling shivery and shaky
  • signs of a cough, sore throat, or pain or burning when passing urine, or diarrhoea
  • suddenly feeling unwell, even with a normal temperature such as headaches, aching muscles or feeling sluggish (lethargic). 

Ann started gemcitabine and managed to have six of the 18 planned treatments before stopping it because she could not tolerate the side effects. Others also had serious side effects.

Cancer can increase the risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg or arm, or breathlessness and chest pain. Blood clots can be very serious. Most can be treated with an anticoagulant (drug to thin the blood). Tony developed a thrombosis in his arm. His arm felt as though it was going to burst. He had to have anticoagulant treatment in hospital. Rory developed a thrombosis in her leg.

Some people had had other types of chemotherapy so experienced different or more severe side effects. David (Interview 09) had felt like ‘death warmed up’ after his infusions of fluorouracil. He had blisters in his mouth and terrible nausea. Theodora’s mother had various chemotherapy drugs and lost enough hair to make her buy a wig.

People coped with the side effects of chemotherapy in various ways. Some found drugs such as anti-emetics very helpful. Many different medicines can reduce nausea and vomiting, but Ann did not find medicines very helpful so she had to find other ways to cope with the side effects of gemcitabine. She said that she valued clean crisp sheets, hot water bottles at the right temperature and drinks made in just the right way. Peter (Interview 36) said that frame of mind was important too.

Last reviewed June 2015.
Last updated June 2015.

 

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