Cough; Feeling short of breath

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

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.

While you are getting chemotherapy treatments:

• 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.
• Check with your doctor before getting any vaccines, surgeries 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.

Diarrhea

• May occur days to weeks after the drug is given / after treatment starts.
• Drink plenty of clear fluids. Limit hot, spicy, fried foods, foods/drinks with caffeine (coffee, tea or cola), orange or prune juice. Try a low-fiber BRAT diet (Bananas, white Rice, Apple sauce, Toast made with white bread).
• Take anti-diarrhea drug(s) if given to you by your doctor.
• Also see Diarrhea pamphlet.*

Tiredness

• Rest often; take naps if needed. Move slowly when getting up.
• Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
• If you are feeling tired, avoid driving or operating machinery

Infections that happen when the immune system is impaired (usually by viruses, bacteria or fungi that would not normally result in infections in patients with normal immunity)

Nausea and vomiting (generally mild)

• May occur in hours to days after the dose is given/ after treatment starts.
• Drink clear fluids and avoid large meals. Get fresh air and rest.
• Limit spicy, fried foods or foods with a strong smell.
• Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
• Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
• Also see Nausea & Vomiting pamphlet.*

Rash; dry, itchy skin (may be severe)

• Stay out of the sun; wear sunblock, a hat and cover exposed skin.
• Use daily moisturizer.
• Severe rash may occur on the body/limbs with blistering or peeling of skin:  Get emergency medical help right away if this occurs.

Mild swelling in arms and legs; puffiness

• Keep your feet up when sitting. Eat a low-salt diet.
• Avoid tight fitting clothing.

Headache; mild joint, muscle pain or cramps 

• Take painkiller(s) as directed, if given to you by your doctor.
• Otherwise, take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
• Rest often, but may try light exercise.

Heart problems
(irregular heartbeat, chest pain, fainting, swelling in legs/ankles/belly, shortness of breath)

Drug reaction (fever, severe rash, itchiness, flushing, dizziness, shortness of breath, chest or throat tightness)

• You may be given medicines to prevent or treat this reaction
• May occur during or shortly after the drug is given.

Blood clot (limb pain or swelling, hardened vein in limb), may occur in lungs (sudden start of coughing, breathing problems, chest pain, coughing blood)

Blockage of an artery (blood vessel) in your heart, brain, chest, belly, or limbs; this may result in stroke (sudden loss of vision, speech, or the use of your limb(s)) or heart attack (chest pain, shortness of breath), or pain in chest, belly or limb

Blocked intestines
(severe belly pain, bloating, severe constipation)

Effects on the brain (confusion, difficulty with thinking, speaking, movement or balance, blurred and/or loss of vision, weakness on one side of the body)

Rapid killing of cancer cells when you start treatment may lead to build up of cell waste products

• If mild, this may cause gout, with joint pains, but if severe, may cause fevers, kidney failure, confusion and be life-threatening.
• You MUST take the preventive medicines given by your doctor AND
• Drink plenty of fluids (6-8 glasses per day) and void (urinate) frequently.