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  • Understanding Colon Cancer Chemotherapy Side Effects: A Comprehensive Guide
Visual guide to managing colon cancer chemotherapy side effects, showing medication, healthy lifestyle, and support groups.

Colon cancer chemotherapy can be a life-saving treatment, but it often comes with a myriad of side effects that can take a toll on both physical and emotional well-being. Understanding and effectively managing these colon cancer chemotherapy side effects can make the journey through treatment more manageable and improve the overall quality of life. In this comprehensive guide, we will explore various side effects of colon cancer chemotherapy, from common physical symptoms to cognitive changes and emotional challenges, and provide practical strategies to help patients cope during this difficult time.

Key Takeaways

  • Common side effects of colon cancer chemotherapy include fatigue, nausea, vomiting, and diarrhea.

  • Strategies to manage these side effects include medications, lifestyle modifications and consulting a healthcare professional.

  • Patients undergoing chemotherapy should also seek counseling services or support groups for emotional support.

Common Side Effects of Colon Cancer Chemotherapy

Patient receiving chemotherapy treatment for colon cancer

One of the primary goals of colon cancer chemotherapy is to destroy cancer cells, but this process can also affect healthy cells, leading to several common side effects. Some of the most frequently experienced side effects during colon cancer chemotherapy include:

  • Fatigue

  • Nausea

  • Vomiting

  • Diarrhea

The good news is that these side effects can often be managed with medications and lifestyle adjustments, allowing patients to maintain a relatively normal routine during treatment.


Fatigue is a frequent side effect of chemotherapy, manifesting physically, mentally, and emotionally. Anemia, which can be caused by chemotherapy’s effect on the production of red blood cells in the bone marrow, is one common cause of fatigue. Balancing rest and gentle exercise is key to managing fatigue during treatment.

Regular aerobic exercises, such as walking, jogging, or cycling, combined with strength training exercises like lifting weights, can alleviate cancer-related fatigue. Prioritizing good sleep hygiene and scheduling 30-minute rest breaks during the day may also reduce fatigue and contribute to overall well-being.

Nausea and Vomiting

Nausea and vomiting can be particularly distressing side effects of systemic chemotherapy, but they can be controlled with antiemetic medications, which are a type of chemotherapy drug, like:

  • Ondansetron

  • Granisetron

  • Dolasetron mesylate

  • Palonosetron

Studies have demonstrated that these antiemetic medications can effectively control nausea and vomiting in patients undergoing colorectal cancer treatment, helping them maintain a more comfortable experience during their colon cancer therapy.

Beyond medications, dietary modifications like more frequent smaller meals, avoidance of spicy or greasy foods, and increased fluid intake can help manage nausea and vomiting during chemotherapy.


Diarrhea is a common side effect of colon cancer chemotherapy, and it can be both uncomfortable and potentially dangerous if left untreated. Medications like loperamide (Imodium® or other brands) can be used to manage diarrhea resulting from chemotherapy for colorectal cancer, including colon and rectal cancer, bowel cancer, and colon cancer. In the case of rectal cancer, similar side effects and treatment options apply.

Beyond medication, lifestyle modifications like avoiding trigger foods, consuming sufficient fluids, and incorporating high-fiber foods into the diet can help control chemotherapy-induced diarrhea. If diarrhea becomes severe or unmanageable, consultation with a healthcare professional is advised for further guidance.

Chemotherapy-Induced Anemia

Anemia is a common side effect of chemotherapy, characterized by a reduction in hemoglobin levels and leading to feelings of fatigue and shortness of breath. Chemotherapy-induced anemia can be diagnosed through a complete blood count (CBC) test, which measures red blood cell levels, hemoglobin, and hematocrit in the blood.

To treat anemia, blood transfusions or erythropoietin stimulating agents may be recommended by healthcare professionals. Both treatment options will be examined more closely in the subsections below.

Blood Transfusions

Blood transfusions are sometimes necessary to treat chemotherapy-induced anemia and can be an effective way to increase red blood cell count, while also monitoring the white blood cell count. During a blood transfusion, donated blood is administered intravenously, with the nurse initiating the transfusion at a slow rate to monitor for potential reactions.

While blood transfusions can be associated with some risks and complications, they are generally administered to reduce the risk of severe complications due to low blood count in chemotherapy patients.

Erythropoietin Stimulating Agents

Erythropoietin Stimulating Agents (ESAs) are medications used to treat anemia by stimulating the production of red blood cells in the bone marrow. These medications, such as Epoetin alfa and darbepoetin alfa, are commonly used in the treatment of chronic kidney disease and other conditions related to low red blood cell count.

ESAs can help manage chemotherapy-induced anemia by elevating hemoglobin levels and minimizing the need for blood transfusions. However, side effects may be associated with the use of ESAs, and patients should discuss the risks and benefits with their healthcare provider.

Hair Loss and Chemotherapy

Scalp cooling cap for reducing hair loss during chemotherapy

Hair loss, also known as alopecia, is a temporary side effect of some chemotherapy drugs and can be a distressing experience for many patients. The good news is that there are ways to cope with hair loss during chemotherapy treatment, such as using scalp cooling caps or turning to wigs and head coverings.

These options will be discussed more thoroughly in the subsections below.

Scalp Cooling Caps

Scalp cooling caps are a type of headwear that can help reduce hair loss during chemotherapy by constricting the blood vessels located beneath the scalp’s skin, thereby decreasing the amount of chemotherapy delivered to the hair follicles. Research has shown that scalp cooling caps are effective in reducing hair loss associated with chemotherapy. Here are some key points:

  • Scalp cooling caps have a success rate of approximately 50.5% in women.

  • They work by constricting blood vessels, reducing the amount of chemotherapy delivered to the hair follicles.

  • Scalp cooling caps are a non-invasive and safe option for patients undergoing chemotherapy.

Scalp cooling caps are available at select hospitals and infusion centers for those receiving chemotherapy treatment.

Wigs and Head Coverings

For patients who experience hair loss during chemotherapy, wigs and head coverings can provide a sense of normalcy and help them feel more comfortable and confident. Wigs, scarves, and hats can also provide protection from the sun and cold air. In addition to the practical benefits, wearing wigs or head coverings can enhance emotional well-being during the hair loss period.

Patients can obtain medical-grade wigs for hair loss due to chemotherapy from specialized boutiques and organizations that provide free wigs to cancer patients, such as Cartier’s Wigs & Wishes and EBeauty Community.

Skin and Nail Changes

Hands and feet affected by hand-foot syndrome during chemotherapy

Chemotherapy can cause various skin and nail changes, such as hand-foot syndrome and dry, itchy skin. These side effects can be quite uncomfortable and may require creams and proper care to manage.

Hand-foot syndrome and dry, itchy skin, as well as strategies to manage these side effects, are detailed in the subsections below.

Hand-Foot Syndrome

Hand-foot syndrome, also known as palmar-plantar erythrodysesthesia (PPE), is a side effect of certain chemotherapy medications that can cause redness, swelling, and discomfort on the palms of the hands and soles of the feet. Hand-foot syndrome occurs when certain chemotherapy drugs, such as pegylated liposomal doxorubicin (PLD), docetaxel, and fluoropyrimidines like capecitabine, affect the skin.

To manage hand-foot syndrome, patients can use creams, such as 10% urea cream and topical steroid creams, and apply cool compresses to affected areas.

Dry, Itchy Skin

Dry, itchy skin is another common side effect of chemotherapy and can be alleviated with moisturizers and gentle skincare routines. Patients should opt for gentle, hydrating, hypoallergenic products free of irritants such as fragrance, alcohol, or sodium lauryl sulfate (SLS).

Additionally, maintaining a gentle skincare routine, such as taking short showers or baths in cool or lukewarm water, gently patting the skin dry, and washing the body with a gentle cleanser, can help manage dry, itchy skin during chemotherapy.

Cognitive Changes: Chemo Brain

“Chemo brain,” or cognitive changes resulting from chemotherapy, can cause memory and concentration problems in some patients. While these changes can be frustrating, they can often be managed with cognitive rehabilitation and lifestyle modifications, such as regular exercise and a healthy diet.

Cognitive rehabilitation and lifestyle modifications are detailed in the subsections below.

Cognitive Rehabilitation

Cognitive rehabilitation involves programs and interventions targeted at addressing cognitive dysfunction or “chemo brain” experienced by cancer patients who have received chemotherapy. Programs such as cognitive behavioral therapy (CBT) and cognitive training (CT) aim to improve cognition and reduce cognitive symptoms in cancer survivors by providing tailored therapy guidance, in-session reflection, and homework assignments to restore or enhance cognitive abilities.

Studies have shown that cognitive rehabilitation can improve the following skills in cancer patients:

  • Attention

  • Problem-solving

  • Organization

  • Executive function

  • Word-finding

This can help them regain a sense of normalcy and control over their lives.

Lifestyle Modifications

Lifestyle modifications can also play a significant role in managing the cognitive side effects of chemotherapy. Regular exercise has been proven to improve cognitive function and reduce the severity of cancer- and treatment-related cognitive issues. Adequate sleep is also essential for maintaining cognitive health and brain function during cancer survivorship.

Lastly, following a diet rich in antioxidants, engaging in cognitive rehabilitation, and implementing cognitive strategies such as making lists and using organizers can further help manage cognitive side effects during chemotherapy.

Chemotherapy’s Impact on Fertility and Sexual Health

Couple discussing fertility preservation options before chemotherapy

Chemotherapy can have a significant impact on fertility and sexual health, which is an important aspect of overall well-being for many patients. Fertility preservation options should be discussed with a healthcare professional before starting cancer treatment, and maintaining a healthy sex life may require open communication with a partner and seeking support from healthcare professionals.

The subsections below detail fertility preservation options and strategies for maintaining a healthy sex life during chemotherapy.

Fertility Preservation Options

Fertility preservation options, such as sperm banking or egg freezing, should be discussed with a doctor before starting cancer treatment. It is essential to be well-informed of the potential impacts of chemotherapy on fertility and the available options to preserve fertility, as this can influence treatment decisions and overall quality of life.

Healthcare professionals can provide guidance on the best fertility preservation options for each patient, taking into account factors such as age, overall health, and the specific chemotherapy drugs being used.

Maintaining a Healthy Sex Life

Maintaining a healthy sex life during chemotherapy may require open communication with a partner and seeking support from healthcare professionals. It is important to discuss any concerns or changes in sexual function with a healthcare provider, who can offer guidance on how to manage these issues and maintain a satisfying sex life during treatment.

Additionally, support groups and counseling services can provide a safe space for patients to share their experiences and connect with others going through similar challenges, helping them navigate the emotional aspects of cancer treatment and maintain a healthy sex life.

Emotional Side Effects and Support

Support group meeting for cancer patients undergoing chemotherapy

Emotional side effects, such as anxiety and sadness, are common during chemotherapy and can significantly impact a patient’s quality of life. It is essential to recognize these emotional side effects and seek support through counseling, therapy, and support groups if needed.

Counseling and therapy options, as well as the benefits of support groups for patients undergoing adjuvant chemotherapy and other chemotherapy treatments, are discussed in the subsections below.

Counseling and Therapy

Counseling and therapy can provide valuable support to patients coping with the emotional side effects of chemotherapy. Professional counselors and therapists with expertise in cancer care can help patients navigate their emotions, develop coping strategies, and address any concerns related to their cancer diagnosis and treatment.

Various forms of therapy and counseling are available, such as:

  • Individual counseling

  • Group therapy

  • Family therapy

  • Cognitive-behavioral therapy (CBT)

  • Mindfulness-based therapy

These therapeutic modalities, including targeted therapy drugs, can improve emotional well-being and enhance overall quality of life during cancer treatment.

Support Groups

Support groups provide a safe space for patients to share their experiences, learn from others, and connect with people who are going through similar challenges during cancer treatment. These groups can offer emotional support, practical advice, and a sense of community that can help patients cope with the emotional side effects of chemotherapy.

Many hospitals, cancer treatment centers, and online platforms offer cancer support groups, making it easy for patients to find a group that suits their needs and preferences.

Managing Side Effects at Home

Managing chemotherapy side effects at home is an essential aspect of maintaining overall well-being during cancer treatment. Proper nutrition, hydration, and communication with healthcare professionals can help patients manage side effects and prevent complications.

The subsections below provide nutritional guidance and hydration tips for managing side effects at home.

Nutritional Guidance

Proper nutrition is crucial during chemotherapy, as it can help alleviate some side effects and ensure patients receive the nutrients they need to maintain their strength. Nutritional guidance from healthcare professionals can help patients maintain a healthy diet during chemotherapy, which can alleviate side effects such as nausea, vomiting, and diarrhea, and support their digestive system.

Eating small, frequent meals and consuming foods high in calories and easy to eat can help manage these side effects.

Hydration Tips

Staying hydrated is crucial during chemotherapy, as it can help flush toxins from the body, reduce treatment side effects, and ensure proper bodily functions. Healthcare professionals often recommend consuming 8 to 10 glasses of liquids daily, with a focus on water, to maintain adequate hydration levels during chemotherapy.

It is essential to follow healthcare professionals’ advice on fluid intake and monitor hydration levels throughout treatment to prevent complications.


In conclusion, understanding and managing the side effects of colon cancer chemotherapy can greatly improve a patient’s quality of life during treatment. From physical side effects such as fatigue, nausea, and hair loss to emotional challenges and cognitive changes, there are various strategies and resources available to help patients cope. By seeking support from healthcare professionals, engaging in self-care practices, and making necessary lifestyle modifications, patients can navigate their cancer treatment journey with greater confidence and resilience.

Frequently Asked Questions

How many rounds of chemo for colon cancer?

Colon cancer patients typically receive between 6 and 12 cycles of chemo alone, followed by 2 cycles in conjunction with radiation and potentially another 4-8 afterwards.

Is chemo worth it for stage 4 colon cancer?

Chemotherapy for stage 4 colon cancer may provide symptom relief and improve quality of life, but it cannot offer a cure. It can be used in combination with surgery to remove tumors from the liver.

Has anyone ever beaten stage 4 colon cancer?

It is possible to beat stage 4 colon cancer, as demonstrated by a patient who credits his health to Michigan Medicine doctors and a woman who defied the odds.

What are some common side effects of colon cancer chemotherapy?

Common side effects of colon cancer chemotherapy include fatigue, nausea, vomiting, and diarrhea.

How can I manage fatigue during chemotherapy?

To manage fatigue during chemotherapy, get a good night’s sleep and balance rest with gentle exercise.

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