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Side effects of EOF

Find out about the side effects of the chemotherapy drug combination EOF. 

Tell your doctor or nurse if you have any side effects so they can help you manage them. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.

Contact your doctor or nurse immediately if any of your side effects get severe or if you have signs of infection, including a temperature above 37.5C.

The side effects may be different if you are having EOF with other cancer treatments. 

Common side effects

Each of these effects happens in more than 1 in 10 people (10%). You might have one or more of them.

Signs of an infection include headaches, aching muscles, a cough, a sore throat, pain passing urine, or feeling cold and shivery.

Contact your advice line or doctor straight away if you have any of these signs, or your temperature goes above 37.5C or below 36C. Severe infections can be life threatening.

Chemotherapy reduces the number of white blood cells in the blood. This increases your risk of infections. White blood cells help fight infections.

When the level is very low it is called neutropenia (pronounced new-troh-pee-nee-ah).

You have antibiotics if you develop an infection. You might have them as tablets or as injections into the bloodstream (intravenously). To have them into your bloodstream you need to go into hospital.

Chemotherapy makes the level of red blood cells fall (anaemia). Red blood cells contain haemoglobin, which carries oxygen around the body. When the level of red blood cells is low you have less oxygen going to your cells. This can make you breathless and look pale. Tell your doctor or nurse if you feel breathless.

You have regular blood tests to check your red blood cell levels. You might need a blood transfusion if the level is very low. After a transfusion, you will be less breathless and less pale.

You can also feel tired and depressed when your blood count is low and feel better once it is back to normal. The levels can rise and fall during your treatment. So it can feel like you are on an emotional and physical roller coaster.

You might notice you:

  • bruise more easily
  • have nosebleeds
  • have bleeding gums when you brush your teeth

This is due to a drop in the number of platelets that help clot your blood.

If your platelets get very low you may have lots of tiny red spots or bruises on your arms or legs called petechiae.

Tell your doctor or nurse straight away if you have petechiae.

You'll have a platelet transfusion if your platelet count is very low. It is a drip of a clear fluid containing platelets. It takes about 15 to 30 minutes. The new platelets start to work right away. 

This won't harm you. It’s due to the colour of the chemotherapy and lasts for one or two days.

Numbness or tingling in fingers and toes can make it difficult to do fiddly things such as doing up buttons. This starts within a few days or weeks and can last for a few months. Rarely, the numbness may be permanent.

Tips

  • Keep your hands and feet warm.
  • Wear well fitting, protective shoes.
  • Take care when using hot water as you may not be able to feel how hot it is and could burn yourself.
  • Use oven gloves when cooking and protective gloves when gardening.
  • Moisturise your skin at least a couple of times a day.
  • Take care when cutting your nails.

You might feel very tired during your treatment. It might take 6 months to a year for your energy levels to get back to normal after the treatment ends. A low red blood cell count will also make you feel tired.

You can do things to help yourself, including some gentle exercise. It’s important not to push yourself too hard. Try to eat a well balanced diet.

Talk to your doctor or nurse if you are finding the tiredness difficult to manage.

Tell your doctor or nurse if you have diarrhoea. They can prescribe medicine to help you. 

Drink at least 2.5 litres of fluid a day. This helps to keep you hydrated.

Ask your nurse about soothing creams to apply around your back passage (rectum). The skin in that area can get very sore and even break if you have severe diarrhoea.

Contact your doctor or nurse immediately if you have diarrhoea 4 or more times a day, or any diarrhoea at night.

Feeling or being sick can be severe. It can start a few hours after treatment and last for a few days. Anti-sickness injections and tablets can control it. Tell your doctor or nurse if you feel sick. You might need to try different anti-sickness medicines to find one that works.

Contact your doctor or nurse straight away if you’ve been sick more than once in a day.

Tips

  • Avoid eating or preparing food when you feel sick.
  • Avoid fried foods, fatty foods or foods with a strong smell.
  • Drink plenty of liquid to stop you from getting dehydrated.
  • Relaxation techniques help control sickness for some people.
  • Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.
  • Fizzy drinks help some people when they are feeling sick.

The skin on your hands and feet can become sore, red, and peel. You might also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.

Tell your doctor or nurse straight away if you have pain, swelling, redness or tingling of your hands or feet.

Tips

  • Take medicines that your doctor or nurse can prescribe.
  • Keep your hands and feet cool.
  • Avoid very hot water.
  • Don’t wear tight fitting gloves or socks.
  • Moisturise your skin with non perfumed creams.

Your mouth might get sore. You will have mouth washes to keep your mouth healthy.

You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.

Tell your doctor or nurse if your mouth is sore.

Women might stop having periods (amenorrhoea) but this may be temporary.

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. It usually starts gradually within 2 to 3 weeks after treatment begins.

Your hair will grow back once your chemotherapy treatment has finished. This can take several months and your hair is likely to be softer. It can also grow back a different colour or be curlier than before.

Tips

  • Ask about getting a wig before you start treatment so you can match the colour and texture of your real hair.
  • You could choose a wig for a whole new look.
  • Think about having your hair cut short before your treatment starts.
  • Some people shave their hair off completely so they don't have to cope with their hair falling out.
  • Wear a hairnet at night so you won't wake up with hair all over your pillow.

Food may taste metallic.

Tips

  • Choose foods that have strong flavours, such as herbs, spices, marinades and sauces if all your food tastes the same.
  • Season your food with spices or herbs, such as rosemary, basil and mint.
  • Garnish cold meat or cheese with pickle or chutney.
  • Try lemon or green tea if tea or coffee taste strange.
  • Sharp tasting fizzy drinks such as lemonade or ginger beer are refreshing.
  • Some people find that cold foods taste better than hot foods.

A rash can also be itchy. Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to stop the itching and soothe your skin.

Don't use sunbeds or sit in the sun. Cover up or use sunscreen if you go out in the sun. 

Remember to put sun cream on your head or wear a hat if you have lost hair there.

Areas of skin previously treated with radiotherapy may also become red or sore. 

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them.

This can be triggered by cold air in the first 5 days after having oxaliplatin. This usually clears up on its own.

Tell your doctor or nurse if you have this and avoid cold drinks or ice cubes for the first few days after treatment.

Avoid ice cubes or cold drinks for the first few days. 

When you're having treatment into your bloodstream tell your nurse straight away if you have any redness, swelling, pain or leaking at your drip site. 

This drug can cause eye problems such as blurred vision and red eyes. Your eyes can also be sore. 

Tell your doctor if you have this. They can prescribe eye drops to soothe them. 

You may also have watery eyes. This happens when you produce many more tears than you usually do. 

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can all put you off food and drinks.

Tips

  • Eating several small meals and snacks throughout the day can be easier to manage.
  • Ask your doctor or nurse to recommend high calorie drinks to sip between treatments, if you are worried about losing weight.
  • You can make up calories between treatments for the days when you really don’t feel like eating.
  • Drink plenty of fluids even if you can't eat.
  • Don't fill your stomach with a large amount of liquid before eating.
  • Try to eat high calorie foods to keep your weight up.

You might notice a ringing sound in your ears (tinnitus). This often gets better on its own once the treatment ends.

Some people can have an allergic reaction while the treatment is going into their bloodstream.

Let your nurse or doctor know straight away if you have:

  • a sudden skin rash
  • itching
  • breathlessness
  • swelling of the lips, face or throat
  • feeling hot
  • shivering
  • redness of the face
  • dizziness
  • headache
  • anxiety
  • a sudden need to pass urine

Your chemotherapy nurse will keep a close eye on you and give you treatment straight away if this happens.

Rare side effects

Each of these effects happens in fewer than 1 in 100 people (1%). You might have one or more of them.

Swelling of hands and feet is due to fluid build up. This is called oedema. Your face may also become puffy. Let your doctor or nurse know if you have any swelling.

You might feel confused or unsteady. This usually stops when you finish treatment.

Changes to the heart muscle may happen in some people. This is usually temporary but for a small number of people might be permanent. Your doctor will check your heart before and after your treatment.

About EOF

More information about this treatment

We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.

You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
30 Apr 2018
  • Electronic Medicines Compendium

    Accessed April 2018

  • Handbook of Cancer Chemotherapy (8th edition)
    Roland K Keel
    Lippincott Williams and Wilkins, 2012

  • Report of two protocol planned interim analyses in a randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer receiving ECF
    K Sumpter and others
    British Journal of Cancer, 2005. Vol 92, Pages 1976-1983

  • Capecitabine and Oxaliplatin for Advanced Esophagogastric Cancer
    D Cunningham and others
    The New England Journal of Medicine, 2008. Vol 358, Pages 36-46

  • Oesophago-gastric Regimens
    North West London Cancer Network, 2011

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