High blood sugar 

(May be severe)

What to look for?

• You may feel thirsty.
• You may pee more often than usual.
• You may feel tired or sleepy.
   

What to do?

• Your health care team may do a blood test to check your blood sugar level.
• You may be told to change your diet or given medication to lower your blood sugar.
• If you have diabetes, check your blood sugar regularly. Your health care team may ask you to check it more often than usual.

Diarrhea

(May be severe)

What to look for?

• Loose, watery, unformed stool (poo) that may happen days to weeks after you get your treatment.
   

What to do?

If you have diarrhea:

• Take anti-diarrhea medication if your health care team prescribed it or told you to take it.
• Do not eat foods or drinks with artificial sweetener (like chewing gum or ‘diet’ drinks), coffee and alcohol, until your diarrhea has stopped.
• Eat many small meals and snacks instead of 2 or 3 large meals.
• Drink at least 6 to 8 cups of liquids each day, unless your health care team has told you to drink more or less.
• Talk to your health care team if you can’t drink 6 to 8 cups of liquids each day when you have diarrhea. You may need to drink special liquids with salt and sugar, called Oral Rehydration Therapy.
• Talk to your health care team if your diarrhea does not improve after 24 hours of taking diarrhea medication or if you have diarrhea more than 7 times in one day.

Ask your health care team for the Diarrhea pamphlet for more information.

Rash; dry, itchy skin

(May be severe)

What to look for?

• You may have cracked, rough, flaking or peeling areas of the skin.
• Your skin may look red and feel warm, like a sunburn.
• Your skin may itch, burn, sting or feel very tender when touched.
   

What to do?

To prevent and treat dry skin:

• Use fragrance-free skin moisturizer.
• Protect your skin from the sun and the cold.
• Use sunscreen with UVA and UVB protection and a SPF of at least 30.
• Avoid perfumed products and lotions that contain alcohol.
• Drink 6 to 8 cups of non-alcoholic, non-caffeinated liquids each day, unless your health care team has told you to drink more or less.

Rash may be severe in some rare cases and cause your skin to blister or peel, more marks may appear as "bulls-eyes". If this happens, get emergency medical help right away.

Nausea and vomiting

(Generally mild)

What to look for?

• Nausea is feeling like you need to throw up. You may also feel light-headed.
• You may feel nausea within hours to days after your treatment.
   

What to do?

To help prevent nausea:

• It is easier to prevent nausea than to treat it once it happens.
• If you were given anti-nausea medication(s), take them as prescribed, even if you do not feel like throwing up.
• 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 (like coffee, tea) and avoid alcohol.

If you have nausea or vomiting:

• Take your rescue (as-needed) anti-nausea medication(s) as prescribed.
• Ask your health care team for the Nausea & Vomiting pamphlet for more information.
• Talk to your health care team if:
  • nausea lasts more than 48 hours
  • vomiting lasts more than 24 hours or if it is severe

Fatigue 

What to look for?

• Feeling of tiredness or low energy that lasts a long time and does not go away with rest or sleep.
   

What to do?

• Be active. Aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days.
• Check with your health care team before starting any new exercise.
• Pace yourself, do not rush. Put off less important activities. Rest when you need to.
• Ask family or friends to help you with things like housework, shopping, and child or pet care.
• Eat well and drink at least 6 to 8 glasses of water or other liquids every day (unless your health care team has told you to drink more or less).
• Avoid driving or using machinery if you are feeling tired.

Ask your health care team for the Fatigue pamphlet for more information. 

Low appetite, weight Loss

What to look for?

• Loss of interest in food or not feeling hungry.
• Weight loss.

What to do?

• Try to eat your favourite foods.
• 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 no appetite.

Ask your health care team for the Loss of Appetite pamphlet for more information.

Mouth sores

What to look for?

• Round, painful, white or gray sores inside your mouth that can occur on the tongue, lips, gums, or inside your cheeks.
• In more severe cases they may make it hard to swallow, eat or brush your teeth.
• They may last for 3 days or longer.

What to do?

To help prevent mouth sores: 

• Take care of your mouth by gently brushing and flossing regularly.
• Rinse your mouth often with a homemade mouthwash.
• To make a homemade mouthwash, mix 1 teaspoonful of baking soda and 1 teaspoonful of salt in 4 cups (1L) of water.
• Do not use store-bought mouthwashes, especially those with alcohol, because they may irritate your mouth.

If you have mouth sores:

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

Ask your health care team for the Oral Care (Mouth Care) pamphlet for more information.
 

Hair thinning or loss 

What to look for?

• Your hair may begin to become thin or fall out during or after treatment.
• In most cases, your hair will grow back after treatment, but the texture or colour may change.
• In very rare cases, hair loss may be permanent.
   

What to do?

• Use a gentle soft brush.
• Do not use hair sprays, bleaches, dyes and perms.

Dry mouth

What to look for?

• You may have a dry or sticky feeling in your mouth or throat,
• Your saliva may be thick and stringy.
• You may have cracks in your lips or at the corners of your mouth
• You may have difficulty chewing, tasting, swallowing or talking
   

What to do?

• Use sugar-free gum or lozenges (e.g. those that contain xylitol) to help keep your mouth moist.
• Suck on ice chips or sugarless popsicles to help relieve dry mouth.
• Rinse your mouth often (every 1 to 2 hours) with a homemade mouthwash.
• To make a homemade mouthwash, mix 1 teaspoon of baking soda and 1 teaspoon of salt in 4 cups (1L) of water
• Do not use store-bought mouthwashes, especially those with alcohol because they may irritate dry your mouth
• Spray your mouth with water or artificial saliva products (e.g., Moi-Stir Spray®, Biotene® products) as needed to keep it moist.
• Apply mouth lubricant (like Biotene Oral balance gel®) after you brush your teeth, at bedtime, and as needed.
• Use a steam vaporizer at night to relieve nighttime dry mouth
• Speak to your health care team about the right product for you.

See our Mouth Care pamphlet for more information.

Talk to your health care team if your dry mouth does not improve or if it is severe. 

Taste changes

What to look for?

• Food and drinks may taste different than usual.

What to do?

• Eat foods that are easy to chew, such as scrambled eggs, pasta, soups, cooked vegetables.
• Taste foods at different temperatures, since the flavour may change.
• Try different forms of foods, like fresh, frozen or canned.
• Experiment with non-spicy foods, spices and seasonings.

Headache, mild joint, muscle pain or cramps 

What to look for?

• New pain in your muscles or joints, muscle cramps, or feeling achy.
   

What to do?

• Take pain medication (acetaminophen or opioids such as codeine, morphine, hydromorphone, oxycodone) as prescribed.
• Read the above section: "What should I do if I feel unwell, have pain, a headache or a fever?" before taking acetaminophen (Tylenol®), ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or Aspirin. These medications may hide an infection that needs treatment or they may increase your risk of bleeding.
• Rest often and try light exercise (such as walking) as it may help.

Ask your health care team for the Pain pamphlet for more information.

Mild swelling

What to look for?

• You may have mild swelling or puffiness in your arms and/or legs. Rarely, this may be severe.
   

What to do?

To help prevent swelling:

• Eat a low-salt diet.

If you have swelling:

• Wear loose-fitting clothing.
• For swollen legs or feet, keep your feet up when sitting.

Liver problems

Your health care team may check your liver function with a blood test. The liver changes do not usually cause any symptoms.

What to look for?

• Rarely, you may develop yellowish skin or eyes, unusually dark pee or pain on the right side of your belly. This may be severe.

What to do?

If you have any symptoms of liver problems, get emergency medical help right away.

Heartburn; stomach upset; bloating

What to look for?

• Pain or burning in the middle or top part of your chest. It may get worse when you are lying down or bending over or when you swallow.
• A bitter or acidic taste in your mouth.
   

What to do?

• Drink clear liquids and eat small meals.
• Do not eat acidic, fatty or spicy foods.
• Limit caffeine (like coffee, tea) and avoid alcohol.
• Avoid smoking or being around tobacco.
• Sit up or stand after eating. Do not lie down.
• Raise the head of your bed six to eight inches. You may need to use extra pillows to do this.
   

Anemia (low red blood cells)

What to look for?

• You may feel more tired or weaker than normal.
• Pale skin and cold hands and feet.
• You may feel short of breath, dizzy or lightheaded.
• This may occur in days to weeks after your treatment starts.
   

What to do?

If your health care team has told you that you have anemia (low red blood cells):

• Rest often and eat well.
• Light exercise, such as walking may help.
• You may need medication or a blood transfusion.
• If it is very bad, your doctor may need to make changes to your treatment regimen.

Kidney problems

Your health care team may check for proteins in your urine (pee) and your kidney function regularly with a blood test. You may have blood in your urine.
 

What to look for?

• Swelling in your hands, ankles, feet or other areas of your body.
• Weight gain that is not normal for you.
• Pain in your lower back.
• Muscle twitches and cramps or itchiness that won't go away.
• Nausea (feeling like you need to throw up) and vomiting.
• Changes in urination (peeing) such as less urine than usual.
   

What to do?

• If you have any of these signs, talk to your health care team or go to your closest emergency department.
   

To prevent kidney infections:

• Drink at least 6 to 8 cups (2 litres) of water or other liquids per day unless your health care team has told you to drink more or less.
• When you feel the need to pee, go as soon as possible. Do not wait or hold in the pee.

Low neutrophils (white blood cells) in the blood (neutropenia)

When neutrophils are low, you are at risk of getting an infection more easily. Ask your health care team for the Neutropenia (Low white blood cell count) pamphlet for more information.
 

What to look for?

• If you feel hot or unwell (for example if you have chills or a new cough), you must check your temperature to see if you have a fever.
• Do not take medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen).
• Do not eat or drink anything hot or cold right before taking your temperature.

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 (100.4°F) or higher for at least one hour.
   

What to do?

If your health care team has told you that you have low neutrophils:

• Wash your hands often to prevent infection.
• Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.
• Keep a digital thermometer at home so you can easily check for a fever.
   

If you have a fever:

If you have a fever, try to contact your health care team. If you are unable to talk to the team for advice, you must get emergency medical help right away.