Other side effects of chemotherapy include mouth ulcers, diarrhoea, conjunctivitis, weight loss or weight gain. Bleeding, infection and cystitis can occur, but they are rare. Some people having chemotherapy also develop an intense fear of attending for treatment. You should discuss these problems with your doctors and carers. They should be able to help.
Women having anthracyclines have a small risk of developing heart failure.
In the longer term, women who have unusually high cumulative doses of cyclophosphamide have a slight risk of developing leukaemia. There is good evidence that chemotherapy is more effective if it is given over several months, but no evidence that courses of 12 to 18 are more effective than those lasting a few months. There is good evidence to show that doses of chemotherapy that are as high as can be tolerated are more effective than lower doses, which would give fewer side-effects. In theory, very high doses of chemotherapy should kill off more cancer cells than normal doses of chemotherapy. However treatment with high doses of chemotherapy is very toxic, and sometimes fatal.