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Ovarian Cancer

Unwanted effects of chemotherapy

Chemotherapy commonly causes unpleasant side effects, but some people have very few. Some side effects can be controlled with medicines. Almost all side effects are short-term and will gradually disappear after the treatment. 

The women we talked to often knew someone else who had had chemotherapy for cancer, or had at least heard something about it before they were diagnosed. Hair loss and sickness are common knowledge, but several women described how their preconceptions about the treatment were mistaken. 

Hair loss is a common side effect of some, but not all, of the drugs used to treat ovarian cancer. In particular, carboplatin, the most widely used of them, rarely causes hair loss. Some women we talked to lost no hair, in others the hair thinned but did not fall out completely. A woman who did not lose her hair thought that she got less sympathy from other people because they did not identify her as a cancer patient. 

Although women felt prepared that their hair might fall out, some were more upset than they expected because it changed their appearance and was a visible reminder of the illness. One young woman had thought that it would not bother her to lose her hair and was surprised to be very upset. The loss of hair from other parts of the body often took women by surprise.

 

She was upset when her hair fell out after chemotherapy.

She was upset when her hair fell out after chemotherapy.

Age at interview: 44
Sex: Female
Age at diagnosis: 41
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Anyway it was upsetting when it first happens, you know, it's, I had very, very long hair and I had it cut short, but it didn't stay short for very long, and yeah it is upsetting, there's no doubt about it. I think it's the, you can sort of keep going, keep going but when your hair falls out it's the manifestation of the whole thing is reality then, so when you find the hair on your pillow, yeah this is really real.

Because I think up to that stage you think - well I thought anyway - it's happening to someone else, it's happening to someone down the road and I was just sort of going through it like a dream and I think when you find the hair on your pillow or on the floor or in the sink or wherever, it's reality and but, you get over it.  

 

She lost her eyebrows and eyelashes after chemotherapy.

She lost her eyebrows and eyelashes after chemotherapy.

Age at interview: 48
Sex: Female
Age at diagnosis: 48
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But what I do find hard is losing my eyebrows and my eyelashes because, I look so peculiar to myself. I don't like what I look like in the mirror. I haven't, I know that there are places you can go, there's a place called 'Look Good, Feel Better', I think. There's one that's not too far away and I've considered going there but I'm slightly resistant to painting my face.  

I wear very light makeup normally and but I don't know, I don't want to paint on eyebrows and things. So yes, I find it quite hard. I feel a little bit reclusive, I feel, you know, I know that everybody, everybody's just been overwhelmingly loving to me since I was diagnosed. In my work, in my family and my friends and everyone, and I know that, you know, there's, nothing to be ashamed of to, or anything but I, I just I'm keeping myself to myself a little bit since I've lost my eyebrows.

Women coped with hair loss in different ways. Some cut their hair short before treatment, others had their remaining hair cut or shaved off after it started to fall out because they didn't like it coming out unevenly. A few women tried a 'cold cap' treatment during chemotherapy which sometimes prevents hair loss. Wigs were offered to those treated on the NHS and many found them satisfactory although they could be hot in summer and cold in winter.

 

Cut the rest of her hair off when it started falling out after chemotherapy.

Cut the rest of her hair off when it started falling out after chemotherapy.

Age at interview: 41
Sex: Female
Age at diagnosis: 40
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The first dose I think must've been in the November and my hair started falling out just, I think it was a week after, I can't remember if was a week or two weeks now. And initially it just, there were just one or two strands of hair that came out, by the second day there were a few more, by the third day it was coming out in handfuls. And on the fourth day I'd got quite a few bald patches so I asked my husband to cut it as short as he could, and I said maybe we'll leave it at that. But it was still coming out quite a lot so he just got the clippers and clipped it off. But strangely enough we had quite a laugh about it because as he was cutting it he kept saying "Oh, you know, you're so and so now," and then he'd cut a bit more and "Oh, you know, definitely Sinead O'Connor," and this sort of thing.  

 

Tried using the cold cap to prevent hair loss after chemotherapy.

Tried using the cold cap to prevent hair loss after chemotherapy.

Age at interview: 58
Sex: Female
Age at diagnosis: 49
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I had six chemo first and I decided to use the icecap to try and save my hair, you know, they said I could try it and I thought 'well I am a swimmer, I swim every day and I wear a cap, surely, you know, I can wear, it's like a swimming cap with ice, I'd give it a go.' I used it twice, it was quite claustrophobic but I'm used to cold water so it didn't really affect me that much, the only thing was it was three quarters of an hour before and three quarters of an hour afterwards, so it added an extra hour and a half to a long long day, but more tedium than anything. 

But after twice they said 'if you start losing it you may as well give up". Well after the second time, about the third week, just before the chemo started, lumps, I had brushed my hair and it was all coming out so I thought 'well there's no point anymore', so it made it a lot easier. But people have had results with it apparently but I haven't met anyone who has yet so, try it by all means if you want a go but I can't recommend it because it didn't do any good to me but I wouldn't, I needed to try it just to '.

 

Describes getting used to wearing a wig.

Describes getting used to wearing a wig.

Age at interview: 41
Sex: Female
Age at diagnosis: 40
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And the morning after he'd sort of clipped my hair I met my mum and we went shopping. I put my, I did put my wig on that evening because I thought I'd better used to it quickly and then the next morning I just put it on, went out and went shopping. Felt a bit strange initially because if you frown and you've got your own hair you hair goes with you, but when you're wearing a wig and you frown it feels like it's either going to fall off or it does just feel very strange. But I mean they're amazingly resilient and even in the windiest of places I never once felt it was going to fall off. And because they're so realistic, even if it blows your hair out of the way all you can see is your scalp, so.  

And I'd grown my hair a bit longer so that it more or less matched my wig. My wig was just a bit of a different colour, it had sort of like red highlights in it, so I think most people just thought I'd had a colour put on it. But, you know, I was quite happy to wear it. Although I did find in the winter I needed to wear a hat more because the wind seemed to sort of cut through it and it definitely isn't as warm as having your natural hair.  

Some women bought their own wigs, others preferred to wear hats or scarves. Some covered their heads all the time, some went bareheaded all the time and others wore their wigs or scarves only when out.  

 

Was given a nice wig but preferred to wear a scarf or hat.

Was given a nice wig but preferred to wear a scarf or hat.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
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And then, the wig lady came round to fit me with a wig, and, and there was lots of choice' Because I, you know, I hadn't realised. I thought a wig was a thing that you put on your head and it was all hot and horrible. But there was lots of choice and she was brilliant, and she cut it and styled it to suit me. But whatever happened, however good that wig was, I didn't feel comfortable in the wig. 

You said you weren't comfortable with your wig. Did you go and get yourself a wig from somewhere else or did you wear hats ? What did you do?

No. I gave the' funnily enough I gave the wig away to a friend about three months ago who admired it at the time so I said 'okay if you like it you can have it'. I wore scarves. Well often I wore nothing. I tended to wear scarves because I thought people might be more comfortable with me in a scarf rather than as a bald head. 

So what I had was scarves. I had lots of scarves, probably about half a dozen scarves and sort of cover the top, and tie them round and have them hanging. And then in the winter I had - I've still got it - a really nice velvet, bright purple hat that just perched on the top of my head. It kept it warm. So yeah, and I managed with that.

 

The second time her hair fell out she left her head uncovered with close friends and family.

The second time her hair fell out she left her head uncovered with close friends and family.

Age at interview: 61
Sex: Female
Age at diagnosis: 58
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I was quite lucky, actually, because each time I've had the hair loss it's started, the way the drugs are formed, in about the September so it's been the winter that I've been wearing the wig, so that has helped, because they are very hot in the summer. As soon as the sun gets on them they are very hot. But no, I've coped with it and the first time I wore the wig the whole time even in the house, apart from perhaps in the evenings. Second time I wore it every time I went out of the door, but my grandchildren and everybody came in the house and I wasn't wearing it. You know, I'd got used to not wearing it sort of around the house, and if very close friends came, I wouldn't bother putting it on. I'd have it by the front door that I could just plonk on, you know.  

Advice about wigs, scarves and make up is often offered through 'Look good, feel better' sessions (see 'Resources' section).

Hair that grew back after chemotherapy was sometimes a different colour, or was thicker, softer or curlier than it had been before.

 

Her hair grew back differently after chemotherapy.

Her hair grew back differently after chemotherapy.

Age at interview: 51
Sex: Female
Age at diagnosis: 48
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And the other thing that's happened is it's gone very dark. I was quite grey before this, and I've gone about three shades darker, which is quite nice actually! 

But when it grows back it grows back differently. It's beautiful, it's like baby hair, but it was much curlier when it grew back the second time, so' I don't know if that's just the effect the drugs have on it, but it was quite nice having it curly and really nice condition. 

Some of the drugs used may cause nausea and vomiting but nowadays women are given anti-sickness medication (anti-emetics) to prevent or reduce this. This prevented some women from having any sickness, but others had varying amounts of nausea and vomiting. For some it was worse after the first chemotherapy treatment than after later ones, for others it got worse with each treatment. Various forms of ginger seemed to help the nausea; a nurse had advised one woman to drink American dry ginger ale (see 'Complementary approaches').

 

She felt sick after her early chemotherapy treatments but felt fine in later ones.

She felt sick after her early chemotherapy treatments but felt fine in later ones.

Age at interview: 47
Sex: Female
Age at diagnosis: 35
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But the surprising thing is I felt great. I felt great during the chemotherapy. The first one, I was very sick for the first day or so but then after that I was fine. The second one, I was I think sick on the first day but then fine after that. The third one I wasn't even sick at all. The fourth one, nothing. And between the third and the fourth or just after the fourth, yes I think it was between the third and the fourth I went on a walking holiday in Yugoslavia, that's how well I felt. So chemotherapy, people get really uptight about the word 'chemotherapy' and they think 'oh it's going to be an awful life, I won't be able to live it and I won't be able to carry on doing the things I do', but I did.  

 

She felt more sick with each chemotherapy treatment she had.

She felt more sick with each chemotherapy treatment she had.

Age at interview: 65
Sex: Female
Age at diagnosis: 59
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I was very, very fortunate; I did not lose any hair, it just made me very, very sick. At 2 days, I could almost time it, 2 days after I'd had the treatment I was very ill for about a week.  

The first two sessions were not bad. The third session knocked me for six. It really would, it made me very, very sick. Days it made me sick, lethargic and it probably lasted about a week. And that went on each month thereafter, for the next 4 months, getting progressively worse.  

Which effect is associated with which medicine can be hard to know. Some women had constipation, which, especially in the first couple of days after treatment, can be caused by the anti-sickness medication rather than by the chemotherapy itself. Drinking lots of water and continuing to eat were seen as important in combating the constipation. A few felt very cold, had diarrhoea, mouth soreness, or weight changes. Several noted the tinny or metallic taste in their mouth which ruined the flavour of tea, coffee and wine.

The nervous system was sometimes affected, with numbness or tingling in the feet or hands, double vision, loss of high frequency hearing, headaches, dizziness or restlessness. A woman found that she could not do up her small child's buttons. Some noticed finding it hard to remember things or concentrate, which was particularly annoying if they wanted to read to distract themselves. In some the skin became dry and itchy and nails discoloured. One of the side effects of paclitaxel (Taxol) is an aching of the muscles or joints, typically three days after treatment, which several women reported. Often a steroid was given to help women cope with chemotherapy; some said that these made them feel energetic immediately after treatment or interfered with sleep. Steroids also sometimes caused puffiness or weight gain.

 

Describes the pains in her legs in addition to other side effects of chemotherapy.

Describes the pains in her legs in addition to other side effects of chemotherapy.

Age at interview: 48
Sex: Female
Age at diagnosis: 48
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And then the next day it hit, actually. When I say hit, it wasn't dramatic, it was sort of insidious pain that went into my legs which was really, it got quite bad. Over the next 3 days I was in a lot of pain in my legs, I just couldn't get them comfortable, I couldn't bear things to be on them, I couldn't, I couldn't fold them, I couldn't sit with my legs tucked under me. I just had to be straight out, lying, I had no painkillers either that could combat the pain of it, though the angels on the other end of the phone faxed me a prescription for some heavy duty drugs which I then got from, which helped a little bit. But it wore off of it's own accord after 3 days.

The leg problem always happens and that's really the worst of chemotherapy for me, apart from the tiredness, which is overwhelming. I can't stay awake, I can, I think I can probably fall asleep on one leg now. And that lasts for about 10 days, but the leg pain is the worst, and then the numbness in the feet. I, after the fourth chemo I got it in the fingers which I think doesn't happen to everyone. They, they get fingers and feet simultaneously but me, I just got it in the feet and my toes have been kind of numb for about 3 months now. Which is not, it's not painful in any way it's just mildly inconvenient. I kind of occasionally trip on the pavement but I haven't fallen over.

 

Describes side effects and explains how the steroids she was given to help with chemotherapy...

Describes side effects and explains how the steroids she was given to help with chemotherapy...

Age at interview: 59
Sex: Female
Age at diagnosis: 58
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The side effects were very strange. The actual day to day process when the chemo went in was nothing that you couldn't cope with, it just made you feel that you were on another planet. But I felt that if you just sat quietly, just watched the television then you could overcome it. The amazing thing was though, the first day that you had it done, you went on a high. I couldn't sleep that night so I used to come downstairs and I used to watch television all night. Because they put steroids in you, you see, and they make you quite high, don't they? And I just couldn't sleep so rather than keep my husband awake all night I just used to come down here with a sleeping bag and watch the television and then sleep during the day.  

But when I'd actually finished all the chemotherapy then some of the after effects start to come out. Like you notice your nails are not so strong, the toe nails are very ridged, I'm told, with the different sessions that you take. And you get these sorts of aches and these pains which feels like a flu. But I used to take painkillers and it just used to go. I mean it takes about 6 months for that to pass and I mean, now I don't have that any more, I'm more or less back to normal, apart from the weight and a little bit of tingling in the toes and the hands. I must admit I feel quite good and I'm back to normal.

Many women became extremely tired and lethargic so that they slept a lot or just sat around doing very little. Because chemotherapy affects normal blood cells as well as cancer cells patients can be vulnerable to infections or become anaemic, some requiring blood transfusions. Chemotherapy can lower the number of platelets in your blood and you may bruise very easily, have nosebleeds or bleed more heavily than usual from minor cuts or grazes. If you do have any of these problems you may have to be admitted to hospital for a platelet transfusion.

 

Chemotherapy made her feel extremely tired and lethargic.

Chemotherapy made her feel extremely tired and lethargic.

Age at interview: 59
Sex: Female
Age at diagnosis: 59
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I found that the tiredness was very, very debilitating, and also lethargy. I had actually, because I paint and I draw, I had actually got various sketchbooks that I was going to do during the autumn but I really, I couldn't even read very much, I read a couple of books and I looked at a lot television. But I found that the lethargy was a real problem. I normally have tremendous energy and, you know, I'm very enthusiastic about a lot of things and, but I found all of that left me, which was something I had to deal with.

A few women had had moments when they could understand why some people decide not to continue with chemotherapy, or said that they would really not want to go through it again. Some found that complementary approaches, physical activity, buying tempting foods (such as chocolate and fruit) and continuing to eat well helped them to recuperate. A woman who felt cold during her chemotherapy said that the warmth in Majorca, where she had a holiday afterwards, helped her feel better.


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Last reviewed June 2016.

Last updated January 2010.

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