
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.
- Sex:
- Background:
- Age at interview:
- 73
- Sex:
- Female
- Age at diagnosis:
- 69
- Background:
- Audrey is a teacher, now retired. She is married and has 3 children. Ethnic background/nationality: White British.
- Age at interview:
- 65
- Sex:
- Male
- Age at diagnosis:
- 63
- Background:
- Michael is a retired wine merchant. He is married with one adult child. Ethnic background: White, half Polish half British.
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.
- Age at interview:
- 62
- Sex:
- Female
- Age at diagnosis:
- 62
- Background:
- Ann is married with 3 children. She was a GP for over 35 years til her retirement when she developed pancreatic cancer, co-founder of the charity that runs healthtalk.org inspired by her own experience of breast cancer, and Medical Director of the Oxford University Health Experiences Research Group. Ethnic background/Nationality: White British.
- Age at interview:
- 64
- Sex:
- Female
- Age at diagnosis:
- 63
- Background:
- Maureen is a retired therapeutic counsellor; she is married with 3 adult children. Ethnic background: White British.
- Age at interview:
- 59
- Sex:
- Male
- Age at diagnosis:
- 58
- Background:
- Richard was a finance director for a multi-national company. He is now retired. He is divorced and has three children. Nationality/ethnic background: White British.
- Age at interview:
- 45
- Sex:
- Female
- Age at diagnosis:
- 65
- Background:
- Saba is a designer. She is single and has no children. Ethnic background: Asian.
Anyway, they started the chemo treatment and, you know, it was at our local hospital and it, and it was fine actually. She didn’t, I think the first couple of sessions that she had, I think the first session she had had quite an impact on her physically. She kept getting a fever. She would get a fever for the first day or second day after and they, they said they could do that because the immune system drops as her, she could be prone to catching infections. We couldn’t let any children like, she couldn’t see her grandchildren during that time because, you know, young children often pick up colds and flus and we didn’t want her to sort of catch that. She did have nausea the first time but that was as a result to; they’d given her some antibiotics because I think she had got a bladder infection, a slight bladder infection. They’d given her antibiotics and I think that was a reaction to the antibiotics and not actually to the chemo. Because I gave her anti, anti-nausea tablets with the chemo as well and I think that, that really did help. But I think the first two sessions of chemo she was quite ill. And one thing we noticed that she’d got one of her eyes became completely bloodshot. So I think what they did was, I think the second time I think they put the dosage of chemo a little bit lower, because they felt that her body just was a bit too frail actually to sort of deal with it.
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.
- Age at interview:
- 66
- Sex:
- Female
- Age at diagnosis:
- 65
- Background:
- Rory is a retired teacher. She is married and has three adult children. Ethnic background/nationality: White British.
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.
- Age at interview:
- 44
- Sex:
- Female
- Age at diagnosis:
- 41
- Background:
- Alison is married and has 2 children. She is a PhD student. Ethnic background/Nationality: White British.
- Age at interview:
- 59
- Sex:
- Male
- Age at diagnosis:
- 49
- Background:
- Peter is a journalist. He is married and has two children. Ethnic background/nationality: White British.
- Age at interview:
- 57
- Sex:
- Male
- Age at diagnosis:
- 52
- Background:
- John was a shipwright before he retired in 2007 due to ill health. He is married and has two adult children. Ethnic background/Nationality: White Scottish.
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.
- Age at interview:
- 59
- Sex:
- Male
- Age at diagnosis:
- 49
- Background:
- Peter is a journalist. He is married and has two children. Ethnic background/nationality: White British.

Last reviewed June 2015.
Last updated June 2015.