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Chemotherapy side effects

When to Call Your Team — and When to Wait

Not every new symptom on chemotherapy needs an emergency call. Some need the hospital right now. Some need a call today. And some are expected and can wait. Knowing which is which is the most useful thing you can have before your first cycle.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • Three clear tiers — Every symptom fits one response: go to hospital now, call today, or note it for your next visit.
  • Fever is never ordinary — Any fever during chemotherapy is treated as an emergency until your team says otherwise.
  • When in doubt, go up a tier — Choosing the more urgent response for a mild symptom is always safer than waiting on a serious one.
  • Print this page — Keep it where your family can find it — these decisions are hard to make alone at 2am.
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During chemotherapy, some symptoms are emergencies needing hospital care right now. Others need a call to your team today — not your next scheduled visit. And some side effects are expected and can wait. This page gives you a clear three-tier guide so you know what to do the moment a new symptom appears.

Which symptoms mean go to the emergency department right now?

Fever during chemotherapy, difficulty breathing, chest pain, confusion, and uncontrolled bleeding cannot wait for a callback. These need the emergency department now.

Go now if you have any fever at all. Chemotherapy reduces the white blood cells that fight infection. NCCN guidance identifies fever in a patient on chemotherapy as an oncological emergency. Go now for difficulty breathing, chest pain, or a racing heartbeat. Go now if you are confused, cannot be woken, or someone near you says you are not making sense.

Go now for bleeding that will not stop with firm pressure, if you cannot swallow, or if you feel too faint to stand safely. Do not drive yourself. Ask someone to take you, or call for an ambulance.

Which symptoms need a call to your team today — not your next visit?

Any fever you are unsure about, persistent vomiting, worsening diarrhoea, mouth sores that prevent swallowing, and a spreading skin rash all need a call today, including evenings and weekends.

Call today for any fever you are unsure about, or for vomiting that prevents you keeping fluids down for several hours. Call today for diarrhoea that is clearly increasing rather than settling, mouth sores so severe you cannot swallow your medications, a rash that is spreading, or new pain your current medicines are not controlling.

If you are not sure whether a symptom belongs here or in the emergency tier above, choose the emergency tier. Acting quickly on something mild costs very little. Waiting on something serious can cost a great deal.

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Which side effects can wait until your next appointment?

Mild nausea controlled by the anti-nausea medicines you were given, steady tiredness that is not getting worse, hair thinning that has already started, and mild constipation that responds to fluids — these are expected and can wait for your next visit.

Your team will have prepared you for these before your first cycle. When a change matches what you were warned about and is not getting worse, a note for your next appointment is usually enough.

Write each side effect down as it appears, with the date and how severe it felt that day. Bring that record to your next appointment. Your team uses it to adjust your care accurately.

What to tell your team when you call

  • Your name and patient number or date of birth
  • Which chemotherapy you are on and when your last cycle was
  • What the symptom is, in your own words
  • When it started and whether it is getting worse or staying the same
  • Whether you have a fever, and how you checked
  • Whether you can drink fluids and keep them down
  • Whether you are able to take your regular medicines
  • Any new medicine, supplement or herbal preparation started since your last visit
  • Whether you have had this symptom before during treatment, and what happened then

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

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Common questions

Frequently asked questions

Is any fever dangerous during chemotherapy?

Yes — any fever during chemotherapy is treated as an emergency until proven otherwise. Chemotherapy lowers the white blood cells your body uses to fight infection, sometimes to a level where even a minor infection can become life-threatening within hours. NCCN guidelines identify fever in a patient receiving chemotherapy as requiring urgent assessment. Do not wait to see if it settles, and do not take a fever-reducing medicine first and then wait. Call or go to the emergency department immediately.

My clinic is closed. Who do I call at night or on a weekend?

Your treating team should have given you an out-of-hours contact number at the start of your treatment — check the discharge paperwork or the card you were given. If you cannot find it and your symptoms are urgent, go to the nearest emergency department and tell them you are on chemotherapy. Emergency departments can manage oncology emergencies. Do not wait until your clinic opens the next morning.

What if my family thinks I am overreacting by calling?

You are not overreacting. The symptoms that matter most on chemotherapy can look mild at first and become serious within hours. Your oncology team expects these calls and would far rather reassure you at 11pm than manage a crisis the next morning. If your family is hesitant, show them this page. The call takes minutes. Waiting on something serious is the actual risk.

Can I take paracetamol to bring down a fever before I call?

Do not take paracetamol before calling your team for a fever during chemotherapy. Paracetamol can bring a fever down temporarily and hide the severity of what is happening, making it harder for your team to assess how unwell you are. This is specifically flagged in NCCN guidance on febrile neutropenia. Call first — your team will advise you on whether it is safe to take anything while you wait or travel to the hospital.

I feel unwell but I am not sure it is from the chemotherapy. Should I still call?

Yes. You do not need to be certain of the cause before calling. An infection, a drug reaction, and a chemotherapy side effect can all feel very similar from the inside. Your team's job is to separate them. Tell them what you feel and let them decide what it means. Uncertainty is a reason to call sooner, not later.

Will calling always mean I have to come in?

Not always. Your team will ask you a few questions and judge how urgent your situation is. For mild or expected symptoms, they may reassure you and ask you to monitor and call back if it worsens. For symptoms that need review, they will tell you whether to come to clinic, go to the emergency department, or wait for a scheduled appointment. The call is how they decide — without it, they have no way to help.

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