Center For Survivorship
Oncology Rehabilitation and Research

Side Effects of Cancer Treatment

Are you suffering from one of these common side effects from cancer treatment such as surgery, chemotherapy, radiation, hormonal and biological therapy?

Cancer Related Fatigue (CRF)

CRF is the most common side effect caused from treatments for cancer including chemotherapy, radiation, hormonal and biological therapies.  CRF is diagnosed as a generalized weakness with exhaustion with decreased motivation to engage in usual activities; resting or napping during the day doesn’t help and difficulty in completing daily tasks due to fatigue.

Other issues that can contribute to fatigue include: pain, emotional distress, insomnia, anemia, poor nutrition (nausea, mouth sores, taste changes) a sedentary lifestyle (lack of exercise or physical activity), depression, anxiety, thyroid deficiency, dehydration, respiratory disorders, heart disease, chronic pain, reduction in blood counts from chemotherapy and drug or alcohol dependence.

What can you do?

  1. Consult a physical therapist for exercise and education. Research shows that exercise decreases fatigue, increases red blood cell count and improves overall conditioning. A physical therapist can provide an exercise prescription and energy conservation techniques.
  2. Consult with your physician to determine if you have other health problems that are contributing to fatigue


Chemotherapy induced peripheral neuropathy, also called CIPN, is an injury to the peripheral nerves affecting the feet, hands, nerves that control balance in the ear and some nerves that affect bowel control. It may result in pain, numbness, tingling or aburning sensation.  As a result there can be problems with walking, balance, and using hands for picking up and holding items or problems with bowel control.

What can you do?

  1. Consult with your physical therapist for education and exercise.  Strategies to increase sensation and strength, decrease pain, and improve safety are important to manage neuropathy.
  2. Consult with your physician regarding medication that may help to manage the neuropathy.
  3. Consult with your local Integrative health clinic as acupuncture and reflexology have been shown to increase sensation and decrease pain.

Decreased Strength, Flexibility & Endurance

Treatments for cancer can cause weakness, decreased movement in joints and decreased endurance. These issues need to be worked on immediately. Exercise programs can prevent some of the problems while being treated for cancer.  Other exercise programs can be started after cancer treatment to build up strength, flexibility and endurance again. Research has demonstrated that all cancer survivors, no matter the diagnosis can benefit from an exercise program.  No matter where you are starting from, there is an exercise program for all survivors. The time to start is today.  Exercise prescriptions can be created to complete at home or in groups.

What you can do?

  1. Consult your physical therapist for an evaluation to determine your exercise prescription to increase your strength, flexibility, balance and/or endurance


Pain can be a side effect from the treatments for cancer, including surgery, chemotherapy, radiation, hormonal and biological treatments, as well as accompany numbness, swelling, decreased joint motion and weakness.  Pain may be constant or intermittent and at all levels of intensity. There is help.  Don’t think that you have to live with it. 

What can you do?

  1. Immediately tell your medical practitioner. Consult with your physician to determine if medications or cancer treatment is contributing to pain.
  2. Consult with your physical therapist to determine if muscles, bones, connective tissue, nerves or other functional problems are contributing to pain. They can complete manual therapy as needed and prescribe the appropriate exercise program to help decrease pain.

Swelling of arms, legs, trunk or head and neck may be a side effect of cancer treatment. Removal of lymph nodes or radiation can cause swelling and prevent the lymph system from working properly. If diagnosed early, lymphdedema can be reversed and swelling eliminated.  If not diagnosed early, swelling can be decreased and maintained at a low level to prevent functional deficits.

What can you do?

  1. Consult a physical or occupational therapist who treats patients with lymphedema.  If possible, discuss the potential for preventing lymphedema prior to having surgery or radiation.  If unable to consult prior to treatment, schedule a consult after surgery and before, during or after radiation to learn strategies to prevent or decrease the intensity of lymphedema


Also called cognitive impairment and chemobrain and defined as changes in mental sharpness and abilities experienced during and after cancer treatment.  Mental fogginess may last for a short period of time or a lifetime. Common symptoms include difficulty with concentration, multitasking, recalling words, learning new information or new tasks, remembering planned events, losing one’s train of thought midsentence, processing information.  There can also be problems with increased irritability, and decreased mental flexibility so that unanticipated changes seem overwhelming. Chemotherapy, radiation, hormonal therapies, medications, lack of sleep, fatigue, depression and stress can all contribute to cognitive impairment.

What can you do?

  1. Consult with your local physical therapist to help prescribe an exercise program.  Research has demonstrated that increase exercise including aerobic activity protects and helps heal the brain.
  2. Consult with your physician to determine if there are medications or other health problems that may be contributing to the mental fogginess
  3. Consult with a social worker or psychologist that works with patients having cognitive impairment

Mental Fogginess

Treatments for cancer, including surgery, chemotherapy, radiation, and medications may all contribute to balance issues by creating muscle weakness and nerve damages that can increase your risk of balance problems and potential falls.  Falls are dangerous as they can lead to fractures and lack of mobility decreasing your independence.  Don’t wait for falls to happen.  Get screened for falls now.  If you are already feeling unsteady, get help immediately.

What can you do?

  1. Consult your physical therapist about screening for falls and setting up a falls prevention program.  They will give you exercises to strengthen your balance and strategies to prevent falls.
  2. Consult your physician regarding medications that may be contributing to balance issues.
  3. Join a local support group or community exercise program that focuses on balance programs.

Balance Concerns

Many cancer therapies including chemotherapy have a direct negative effect on bone health.  Bones can have decreased bone density thus leading to fragile and brittle bones. Certain cancers, such as prostate or breast cancer, are treated by hormonal removal which can cause bone loss.  As a result osteoporosis and/or osteopenia in cancer patients can be a serious problem for both men and women.  Drugs help stop the destruction of bone but exercise is needed to help form new bone. 

What can you do?

  1. Consult with your physical therapist for the most effective exercises to help strengthen bone and prevent osteoporosis.
  2. Consult with your physician to determine what risk factors you may have that can be controlled by medication.
  3. Consult the National Osteoporosis website for information:

Osteoporosis & Osteopenia

Research shows that up to 50% of cancer survivors will have difficulty sleeping during and after treatment for cancer.  Difficulty going to sleep, waking up in the middle of the night or waking up too early, may be a result of treatment for cancer.  This lack of sleep can contribute to a decrease in the immune system, increased fatigue and depression.

What can you do?

  1. Consult your physical therapist to educate and prescribe exercise that can assist in helping improve sleep.
  2. Consult with you physician regarding treatments, medications or other healthcare issues that may contribute to insomnia.


Most cancer survivors worry about cancer returning.  The fear of recurrence rarely leaves but diminishes over time.  Some situations that may trigger fear include: a relative or friend diagnosed with cancer, aches and pains previously associated with cancer treatment, media coverage of cancer and before or during follow up appointments with physician.

This fear can immobilize a person and prevent them from living their life.  The good news is…there is hope.  There are coping strategies that can be implemented immediately to help during those moments when this fear takes over.

What can you do?

  1. Consult your physical therapist for coping strategies to deal with the fear of recurrence
  2. Join a cancer support group (check with your local hospital or join an online cancer support group)
  3. Consult a social worker or psychotherapist for assistance in coping with this fear.

Fear of Cancer Recurrence