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What your team may not have mentioned

Side Effects — Nobody Warns You About

Chemotherapy appointments focus on the effects most likely to send you to hospital. The smaller ones — the metallic taste, the streaming eyes, the dark nails — often go unmentioned. They are real, they have names, and most of them are predictable.

Medically reviewed by Dr. Owais Mohammed, Medical Oncologist · Last reviewed September 2026

  • Taste changes are common — Food and drink may taste metallic, bland, or completely different. This is caused by chemotherapy's effect on taste cells, not by the cancer.
  • Watery eyes are not an eye problem — Excess tearing is a chemotherapy effect on the tear ducts, not an infection or a sign that something is wrong inside the eye.
  • Nail darkening is expected — Some chemotherapy medicines cause nails to darken, ridge, or lift. It usually affects nails that grew during treatment.
  • Bone pain after injections is predictable — Growth-factor injections stimulate your bone marrow. The deep ache that follows is a sign the injection is working, not a sign of cancer spreading.
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Some chemotherapy side effects are real but rarely discussed — taste changes, watery eyes, nail darkening and bone pain after growth-factor injections. They are not signs that the treatment is harming you or not working. They are predictable, they have names, and most settle after treatment ends. Tell your team so they are on your record.

Why do some chemotherapy side effects never get mentioned?

The most serious effects — infection risk, nausea, hair loss — take up most of the pre-treatment conversation because they are the ones that lead to hospital admissions or missed cycles. The less visible effects get less time.

That leaves a gap. You notice something unexpected and cannot tell whether it is a warning sign or just part of treatment. It is almost always the latter, but not knowing that is its own burden.

Some of these effects, particularly taste changes, affect how well you can eat through treatment. Poor nutrition makes every other side effect harder to manage. Your team can help, but only if they know.

Which side effects might your team not have mentioned?

Taste changes (dysgeusia)
Food and drinks taste metallic, sour, overly sweet, or like nothing at all. Chemotherapy affects the taste cells lining your mouth, which are fast-dividing and sensitive to treatment. It commonly improves after treatment ends, though the timeline varies between people. Poor appetite caused by taste changes is worth raising with your team early.
Watery eyes (epiphora)
Your eyes produce excess tears, or tears do not drain away as they should. This is a chemotherapy effect on the tear ducts, not an eye infection. It does not mean anything has gone wrong inside the eye. Tell your team if it is affecting your vision or daily life — they can refer you to an eye specialist if needed.
Runny nose
A persistent runny nose during chemotherapy is a common effect on mucous membranes, the same lining that chemotherapy affects in your mouth and gut. On its own, without fever or other symptoms, it is not a sign of infection. It tends to settle after treatment ends.
Nail changes
Nails may darken, develop ridges, become brittle, or lift from the nail bed. Because nails grow slowly, changes may appear weeks after a cycle rather than immediately. Keep nails short and clean. Tell your team if a nail lifts or becomes painful, as infection can enter underneath a lifted nail.
Bone pain after growth-factor injections
Filgrastim and pegfilgrastim are injections given after some chemotherapy cycles to stimulate your bone marrow to produce more white blood cells. As the marrow becomes more active, many people feel a deep ache in the lower back, hips, or leg bones. This is expected. It is not a sign of cancer spreading.

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When do any of these need a same-day call to your team?

Most of these effects are uncomfortable rather than dangerous, and most do not need urgent action. But some specific signs mean your team needs to hear from you today.

Call the same day if your eyes become red, painful, or develop a discharge rather than just watering. Call if a nail has lifted, is painful, or looks infected around the edges. Call if bone pain after a growth-factor injection is severe and the pain relief your team suggested is not helping. Call if taste changes have made it impossible to eat or drink for more than a day.

Do not skip or delay a growth-factor injection because of the bone pain it causes without speaking to your team first. That injection is protecting your white blood cell count, and stopping it without guidance can increase your risk of infection.

Did you know?

Taste changes are among the most frequently reported but least-documented side effects of chemotherapy, yet they directly affect nutrition — and poor nutrition during treatment is associated with poorer tolerance of subsequent cycles.

Reporting taste changes early gives your team time to act before eating becomes a serious problem.

Source: MASCC/ESMO guidelines on nutritional care during anticancer treatment

Explore 74 more Common Side Effects and How They Are Managed topics

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Common questions

Frequently asked questions

Will my sense of taste come back after chemotherapy?

For most people, yes. Taste changes are caused by chemotherapy's effect on the taste cells lining the mouth, which do regenerate. Taste commonly improves after treatment ends, though how quickly varies between people. If you are still experiencing significant taste changes weeks after your last cycle, mention it at your follow-up appointment — it is worth documenting and, in some cases, investigating further.

Is watery eyes during chemotherapy something to worry about?

Watery eyes on their own — without redness, pain, or discharge — are a chemotherapy effect and not usually a sign of something serious. Mention it to your team so it is recorded. If you develop redness, pain, discharge, or any change in your vision alongside the watering, call the same day. Those additional symptoms need assessment rather than a wait-and-see approach.

Why do nails go dark during chemotherapy?

Chemotherapy affects rapidly dividing cells throughout the body, including those in the nail matrix at the base of the nail where new growth begins. The result can be banding, darkening, ridges, or brittleness in nails that grew during treatment. It is not a sign that the chemotherapy is too strong or that something has gone wrong. Most nail changes gradually improve after treatment ends, though nails take months to grow out fully.

How long does bone pain last after a growth-factor injection?

The ache typically begins within a day or two of the injection and settles on its own. It most commonly affects the lower back, hips, and thighs, where a large volume of bone marrow is active. For most people it is manageable with the pain relief their team has suggested. If the pain is severe, is not easing, or is accompanied by a fever, call your team the same day rather than waiting for your next appointment.

Is a runny nose during chemotherapy a sign of infection?

A runny nose on its own, without fever or other symptoms, is most likely a chemotherapy effect on the mucous membranes rather than an infection. That said, fever during chemotherapy always needs same-day assessment regardless of what seems to be causing it. If a runny nose is accompanied by fever, chills, shivering, or a feeling of being unwell, call your team immediately and do not wait to see whether it settles.

Are these side effects a sign that the treatment is not working?

No. Taste changes, watery eyes, nail darkening, runny nose, and bone pain from growth-factor injections are all effects of chemotherapy on healthy cells, not responses to the cancer. They have no relationship to whether the treatment is working against the tumour. How well the treatment is working is assessed through scans and blood tests, not through the presence or absence of these side effects. A treatment can cause all of them and be working well.

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