Medical Oncologist
Emergency signs
Yellow Eyes, Dark Urine or — Severe Right-Sided Pain
Yellow eyes or skin, dark urine and right-sided pain during cancer treatment are not symptoms to watch at home. They need urgent medical assessment — today, not at your next scheduled appointment.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed August 2026
- Never watch and wait — Jaundice during treatment is a signal your body needs assessment now, not at your next scheduled visit.
- The treatment may be the cause — Chemotherapy, targeted therapy and immunotherapy can all affect the liver. This is manageable when reported quickly.
- A blockage is also possible — A blocked bile duct can cause jaundice and needs urgent imaging to diagnose and treat.
- Confusion means call emergency services — If the person with cancer is confused or difficult to wake alongside jaundice, call emergency services immediately.
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Jaundice during cancer treatment — yellow eyes, dark urine or right-sided pain — is never a normal side effect. It can mean liver stress from the treatment itself, a bile duct blockage, or another urgent cause. Go to the emergency department today. Do not wait for your next appointment.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
What causes jaundice during cancer treatment?
Jaundice means bilirubin — a yellow waste product the liver normally clears — is building up in your blood. Several things that happen during treatment can cause this, and you cannot tell which from home.
Checkpoint inhibitors and other immunotherapies can trigger immune-related hepatitis, where your activated immune system attacks liver cells. NCCN and ASCO guidance classifies new jaundice on immunotherapy as a high-priority toxicity requiring urgent, same-day assessment.
Some chemotherapy drugs and targeted therapies can also cause liver inflammation or reduced liver function. A blocked bile duct — from a tumour pressing on it, a swollen lymph node, or scar tissue — is a separate and equally urgent cause.
Blood tests and imaging are needed before the right treatment can be started. Reporting it immediately is what keeps the most effective options available.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
How urgent is what you are seeing?
| What you notice | Call your team today | Go to emergency now |
|---|---|---|
| Skin and eye colour | Mild yellow tint noticed gradually | Sudden deep yellow or orange — especially the whites of the eyes |
| Urine colour | Slightly darker than your usual | Dark brown or tea-coloured urine |
| Stool colour | No change noticed | Pale, grey or clay-coloured stools |
| Pain | Dull ache or discomfort under the right ribs | Severe, sharp or rapidly worsening right-sided pain |
| Mental state | More tired or foggy than usual | Confusion, difficulty waking, or changed behaviour |
| Fever | Low-grade, feeling off | High fever with chills alongside jaundice |
| Typically starts | Gradual onset over days — sometimes noticed by a family member before the patient | Can appear suddenly, particularly with a bile duct blockage or a severe liver reaction |
What to bring and tell the emergency team
- Write down when you first noticed the yellowing, dark urine or pain — even an approximate day is useful.
- Bring a written list of all current cancer treatments: chemotherapy, immunotherapy, targeted therapy, tablets and injections.
- Include anything taken outside the oncology team — supplements, over-the-counter medicines, herbal or Ayurvedic preparations.
- Note any other new symptoms: swollen ankles or abdomen, nausea, vomiting or itching of the skin.
- Tell the team if any doses were missed recently or if a new medicine was started in the past few weeks.
- Bring the most recent blood test results if you have them — this helps the emergency doctor compare against your baseline.
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Common questions
Frequently asked questions
Does jaundice mean the cancer has spread to my liver?
Not necessarily, and this is one of the most important things to understand before the test results come back. Jaundice during treatment has several causes, many of them related to the treatment rather than the cancer itself. Immune-related hepatitis from immunotherapy, drug-induced liver inflammation, and bile duct obstruction are all common causes — none of which mean new metastases. Blood tests and imaging will show the cause. Ask the emergency team to explain the findings once they have them, rather than assuming the worst before the results are known.
Can immunotherapy cause yellow eyes?
Yes. Checkpoint inhibitors can trigger immune-mediated hepatitis, where the immune system attacks liver cells as part of its activated response. Yellow eyes and skin are visible signs that bilirubin is accumulating. NCCN and ASCO guidance treats new jaundice on immunotherapy as a high-priority toxicity — it may require pausing or stopping the treatment and starting specific management. The sooner it is reported, the more options remain available and the more manageable the reaction is likely to be.
Is jaundice from cancer treatment reversible?
In many cases, yes — when it is caught and treated promptly. Immune-related hepatitis often responds well to the appropriate treatment when reported early. Drug-induced liver injury frequently improves once the responsible medicine is identified and adjusted. A blocked bile duct can often be relieved with an endoscopic or radiological procedure. Delay is what makes these harder to manage and more likely to cause lasting harm. Going to emergency as soon as you notice the signs is not overreacting — it is what gives the best chance of recovery.
What will happen when I arrive at the emergency department?
You will have blood tests to check liver function, bilirubin levels and markers of inflammation. The team will ask about your treatment, when symptoms started and whether you have pain, fever or a change in stool colour. Depending on the results, you may need an ultrasound or CT scan of the abdomen the same day. If a blockage is found, a surgical or gastroenterology team may be involved urgently. Your oncologist will also be contacted so that treatment decisions can be made with the full picture in front of the team.