Side effects of chemotherapy (2023)

Chemotherapy drugs kill cancer cells, but they can also damage healthy cells. Damage to healthy cells causes side effects. Different cells and tissues in the body cope differently with chemotherapy. Chemotherapy drugs affect cells that are actively growing and dividing, such as blood cells in the bone marrow, cells lining the mouth and gastrointestinal (GI) tract and hair follicle cells.

Side effects can happen with any type of treatment, but not everyone has them or experiences them in the same way. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

You may worry about the side effects of chemotherapy. But many types of chemotherapy given today are easier to tolerate than they were in the past. And your healthcare team is there to help prevent side effects and help you treat them. Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health.

The following are the most common side effects that people tend to experience with chemotherapy. Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Low blood cell counts @(Model.HeadingTag)>

Low blood cell counts happen because of chemotherapy’s effect on blood cells made in the bone marrow. Blood cell counts often reach their lowest level about 7 to 14 days after chemotherapy. Low blood cell counts is the most common and most serious side effect of chemotherapy. When it happens, the dose of chemotherapy is adjusted right away or chemotherapy may have to be stopped temporarily.

  • A low white blood cell count (neutropenia or leukopenia) increases the risk for infection.
  • A low platelet count (thrombocytopenia) increases the risk for bruising and bleeding.
  • A low red blood cell count (anemia) causes fatigue, paleness, dizziness, shortness of breath and malaise.

Fatigue @(Model.HeadingTag)>

Fatigue makes a person feel more tired than usual and can interfere with daily activities and sleep. Fatigue may be caused by anemia, specific chemotherapy drugs, poor appetite or depression. It may also be related to toxic substances that are made in the body when cancer cells break down and die. Fatigue can happen within days after a chemotherapy treatment and can last long after treatment ends. It also tends to be worse when you are having other treatments, such as radiation therapy. Fatigue usually gets better over time.

Nausea and vomiting @(Model.HeadingTag)>

Nausea and vomiting can start within the first few hours after chemotherapy drugs are given and usually last about 24 hours. However, nausea and vomiting may start more than 24 hours after treatment and last several days (called delayed nausea and vomiting). Some people may have anticipatory nausea after having a few treatments, where they feel nauseated even before treatment is given because they expect to be sick. The healthcare team can help you manage nausea and vomiting by prescribing antinausea drugs.

Not all chemotherapy drugs cause nausea and vomiting. Nausea and vomiting are more likely when combinations of chemotherapy drugs are given.

Loss of appetite @(Model.HeadingTag)>

(Video) Chemotherapy side effects

Nausea and vomiting, fatigue or a buildup of waste products as cancer cells die can cause a loss of appetite. Some chemotherapy drugs can cause temporary changes in taste and smell, which can make food less appetizing. Some people may not feel like eating at all, even though they know they need to. This can lead to weight loss and malnutrition. Having good nutrition during and after chemotherapy is important to help you recover from treatment.

Hair loss @(Model.HeadingTag)>

Hair loss (alopecia) is a common side effect of many, but not all, chemotherapy drugs. Hair follicles are damaged by chemotherapy because the drugs affect cells that are growing quickly. It’s hard to predict how much hair you will lose and how long hair loss will last because it depends on the type and dose of drugs used as well as your body. Hair loss can happen on any part of the body, not just your head. You may begin to lose hair within a few days or 2 to 3 weeks after chemotherapy starts. Hair usually grows back once you finish chemotherapy.

Diarrhea @(Model.HeadingTag)>

Diarrhea is the frequent passing of loose, watery stools. It happens because chemotherapy drugs often affect the cells that line the gastrointestinal (GI) tract. Many factors increase the risk of diarrhea, including the type and dose of chemotherapy. Diarrhea is often worse when combinations of chemotherapy drugs are given. Diarrhea can happen soon after chemotherapy starts and may continue for up to 2 weeks after treatment has ended.

Constipation @(Model.HeadingTag)>

Constipation is when stools become hard, dry and difficult to pass. Constipation can happen for a number of reasons including the type of chemotherapy drug used, medicines given with chemotherapy to relieve nausea and vomiting, and drinking less fluids. Constipation tends to happen within a few days after chemotherapy starts.

Sore mouth @(Model.HeadingTag)>

A sore mouth (also called stomatitis or oral mucositis) happens because of chemotherapy’s effect on cells inside the mouth. Many drugs can cause a sore mouth, but it happens more often when higher doses of drugs are used. Your mouth may become sore anywhere from 5 to 10 days after chemotherapy starts. It often gets better on its own a few weeks after treatment is finished.

You may develop painful sores, ulcers or infection in the mouth, throat or gums. Regular mouth care can help prevent a sore mouth and lower the chance of infection. The healthcare team will tell you how often to clean and rinse your mouth and what to use. Some people may need to take pain medicines.

(Video) What are the Side Effects of Chemotherapy for Women with Gynecological Cancer?

Inflamed mucous membranes @(Model.HeadingTag)>

Mucous membranes line many of the organs in the body, from the mouth to the rectum and vagina. Chemotherapy can damage cells in the mucous membrane so they become inflamed (a condition called mucositis). This can lead to painful ulcers, bleeding and infection. Mucositis is usually temporary and goes away a few weeks after treatment.

Difficult or painful swallowing, heartburn or pain in the upper abdomen should be reported to the doctor or healthcare team. Pain caused by an inflamed esophagus (called esophagitis) can affect eating. You may need to change what you eat or take pain-relieving medicines if you have trouble swallowing or it hurts to swallow.

Report vaginal itching, discharge, odour, pain and bleeding to the doctor or healthcare team. Use cool compresses or a warm water bath to help relieve vaginal itching and pain. Avoid using scented tampons and feminine hygiene pads. If you develop a vaginal infection or have severe pain, your doctor may prescribe medicines to help.

Changes in taste and smell @(Model.HeadingTag)>

Some chemotherapy drugs can affect taste buds causing changes in taste. For example, you may find that meats have a metallic taste. Even foods that you normally crave, such as sweet or salty snacks, can taste bad. You may become more sensitive to smells. Smells that others don’t notice may make you nauseous. It can take months for both the sense of smell and taste to return to normal after chemotherapy.

Skin changes @(Model.HeadingTag)>

Some drugs can cause skin problems or skin irritation. Skin changes can happen during and for some time after chemotherapy. Skin reactions can include redness, itching, dryness, rash or nail changes.

Skin may also be more sensitive to or easily irritated by the sun during chemotherapy treatment.

Eye changes @(Model.HeadingTag)>

Some chemotherapy drugs cause eye changes, such as blurry vision, watery eyes and trouble wearing contact lenses. Tell the doctor or healthcare team if you have changes to your eyes.

Pain @(Model.HeadingTag)>

Some chemotherapy drugs can cause painful side effects, such as aching in the muscles and joints, headaches and stomach pains. Pain may be felt as burning, numbness, tingling or shooting pains in the hands and feet (called peripheral nerve damage). This type of pain can last long after treatment ends. The healthcare team will tell you what medicines to use to relieve the pain.

Pain at the injection site @(Model.HeadingTag)>

Many chemotherapy drugs are given by an injection, usually into a vein (intravenously, IV). Getting the needle or catheter into the vein may cause some discomfort or pain. But you probably won’t feel any pain or discomfort when the IV chemotherapy drugs are given.

There is a small risk that chemotherapy drugs will escape from the vein and leak into the surrounding tissues. This is called extravasation. Some chemotherapy drugs irritate tissues. These drugs are called vesicants. In some cases, chemotherapy drugs that escape from the vein can cause severe damage to the skin and surrounding soft tissue. Your healthcare team will monitor you for signs of extravasation. Tell your healthcare team if you develop redness, swelling, pain, burning or stinging at the injection site.

(Video) Chemotherapy Side Effects

Inflamed vein @(Model.HeadingTag)>

An intravenous (IV) needle or catheter can cause the vein to become inflamed (a condition called phlebitis). The area around the insertion site or along the vein can become red, warm, tender or painful and swollen. The chances of developing phlebitis increase with the:

  • length of time the IV needle or catheter is in place
  • type of drug or solution being given
  • size and location of the needle or catheter

Nurses often check IV sites for signs of phlebitis. If phlebitis occurs, the IV needle or catheter is usually removed and placed in another area. You may be given warm, moist compresses to help reduce inflammation.

Hearing problems @(Model.HeadingTag)>

Some types of chemotherapy drugs can damage the inner ear, which can cause hearing loss or balance changes. This usually goes away after treatment has ended, but your doctor may lower the dose of chemotherapy or change your treatment to prevent further damage to hearing.

Organ damage @(Model.HeadingTag)>

Some chemotherapy drugs can cause organ damage. The healthcare team takes steps to limit the damage to healthy cells, but organ damage can happen. Some of the organs that may be affected by chemotherapy include the:

  • heart
  • lungs
  • liver
  • kidneys
  • bladder
  • female reproductive system
  • male reproductive system
  • nervous system, including peripheral nerve damage

Some types of organ damage develop later than other types. For example, some types of chemotherapy drugs raise the risk of heart and lung problems later in life, years after chemotherapy was given.

Thinking and memory changes @(Model.HeadingTag)>

Chemotherapy can cause you to have trouble thinking clearly and concentrating. This is often called “chemo brain.” These effects can go away after chemotherapy is finished or may last up to a year after treatment is over. Sometimes these effects happen long after treatment is finished. Your healthcare team can suggest ways to help improve concentration and manage changes in memory. They may suggest cognitive exercises that help retrain memory and improve concentration.

(Video) Cancer Chemo Side Effects

Sexual and fertility problems @(Model.HeadingTag)>

Chemotherapy can cause you to feel tired and lose interest in sex. It can also damage the reproductive organs and cause fertility problems. It can also lead to treatment-induced menopause in women.

Talk to your doctor before starting treatment if keeping your fertility is important to you. There may be ways to protect your reproductive organs during treatment. This may make it possible for you to get pregnant or get someone else pregnant after treatment.

Second cancers @(Model.HeadingTag)>

Some types of chemotherapy drugs increase the risk of developing a second cancer, but this doesn’t happen very often. People who receive both radiation therapy and chemotherapy have the highest risk of developing a second cancer. The benefit of treating cancer usually far outweighs the risk of developing a second cancer. If a second cancer develops, it tends to develop later in life.

Note: Other side effects may occur. For more detailed information on specific drugs, go to sources of drug information.

Expert review and references

(Video) Cancer Treatment: Chemotherapy

FAQs

Side effects of chemotherapy? ›

For most people the side effects were worst in the first few days after treatment, then they gradually felt better until the next treatment. Some said the effects were worse with each successive treatment. Most side effects don't persist and disappear within a few weeks after the end of treatment.

What are the hardest days after chemo? ›

For most people the side effects were worst in the first few days after treatment, then they gradually felt better until the next treatment. Some said the effects were worse with each successive treatment. Most side effects don't persist and disappear within a few weeks after the end of treatment.

What is the most common side effect of chemotherapy *? ›

The most common chemotherapy-induced side effects are nausea and vomiting, fatigue, decreased appetite, changes in taste, hair loss, dry mouth, and constipation. Management of side effects can be improved the efficacy of tumor therapy.

How long do you feel bad after chemo? ›

Sickness caused by chemotherapy can start within a couple of hours of starting your treatment and only last a day or so. Or it can come on more than 24 hours after the start of treatment. This is called delayed onset nausea and vomiting and usually lasts about a week.

Do chemo side effects get worse with each treatment? ›

Most types of pain related to chemotherapy get better or go away between individual treatments. However, nerve damage often gets worse with each dose. Sometimes the drug causing the nerve damage has to be stopped. It can take months or years for nerve damage from chemotherapy to improve or go away.

What should you not do after chemo? ›

A person undergoing chemotherapy should avoid eating undercooked or raw food, interacting with actively infectious people, overexerting themselves, and consuming too much alcohol. There are also things that a person can do to minimize risks during chemotherapy.

How will I feel after 1st chemo treatment? ›

You may be feeling tired, relieved, anxious, and happy all at the same time after your first treatment. Once you are home, follow all instructions given to you. Take your medications on time, rest, hydrate, and eat. Keep track of any side effects or new feelings you have, and report these to your care team.

How many rounds of chemo is normal? ›

During a course of treatment, you usually have around 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break, to allow your body to recover.

What 3 side effects a person can have with chemotherapy treatments? ›

Here's a list of many of the common side effects, but it's unlikely you'll have all of these.
  • Tiredness. Tiredness (fatigue) is one of the most common side effects of chemotherapy. ...
  • Feeling and being sick. ...
  • Hair loss. ...
  • Infections. ...
  • Anaemia. ...
  • Bruising and bleeding. ...
  • Sore mouth. ...
  • Loss of appetite.

Can you kiss a chemo patient? ›

If your cancer treatment includes taking oral chemotherapy, there are important safety tips you and your caregiver should follow. It is safe to touch other people while on chemotherapy. You can hug and kiss.

What hurts after chemo? ›

Some chemotherapy drugs can cause painful side effects, such as aching in the muscles and joints, headaches and stomach pains. Pain may be felt as burning, numbness, tingling or shooting pains in the hands and feet (called peripheral nerve damage). This type of pain can last long after treatment ends.

Which cancers are most likely to recur? ›

Breast cancer: Women with breast cancer have an overall 30% chance of recurrence. Many cases happen within five years of completing the initial treatment. Cervical cancer: Of those with invasive cervical cancer, an estimated 35% will have a recurrence.

What are signs chemo is working? ›

You might notice an improvement in cancer symptoms, such as less pain, reduced lymph node swelling, and improved energy levels. If you use topical chemotherapy on skin lesions, the area might feel irritated and look red and swollen for the first few weeks. These are all signs that chemotherapy is working.

Which chemo is the hardest? ›

Doxorubicin is considered one of the strongest chemotherapy drugs for breast cancer ever invented. It can kill cancer cells at every point in their life cycle, and it's used to treat a wide variety of cancers, not just breast cancer. Doxorubicin is also known as “The Red Devil” because it is a clear bright red color.

Do you always feel ill after chemo? ›

Uncontrolled sickness can affect your quality of life on many levels. But not all chemotherapy drugs make you sick. If they do, it generally starts from a few minutes to several hours after having the drug. With some drugs, the sickness lasts for a few hours, or until the next day.

Does your body ever fully recover from chemotherapy? ›

A return to normalcy is typical, but it takes a while – usually six months or so. “All who have done chemo do finally get back to normal,” Patricia said. “Treatment for breast cancer can take a whole year, but six months after it ends, life comes back – incisions heal, hair grows back, chemo brain fog lifts.”

What is the 7 day rule in chemotherapy? ›

Short, planned delays in chemotherapy for good-risk GCT patients (less than or equal to 7 days per cycle) appear to be acceptable since they may prevent serious toxicity in this curable patient population. Delays of longer than 7 days are strongly discouraged except in extraordinary life-threatening circumstances.

Can you sleep next to someone with chemo? ›

You may worry about the safety of family and friends while you are having chemotherapy. There is little risk to visitors (including children, babies and pregnant women) because they aren't likely to come into contact with any chemotherapy drugs or body fluids.

Can you sleep with someone after chemo? ›

There's usually no medical reason to stop having sex during chemo. The drugs won't have any long term physical effects on your performance or enjoyment of sex. Cancer can't be passed on to your partner during sex.

Is it normal to sleep a lot after chemo? ›

Nearly everyone who has chemotherapy has some tiredness. It can be due to the direct effect of chemotherapy on the body. But anaemia may also cause tiredness. This is because chemotherapy can stop your bone marrow from making red blood cells for a while.

How long after first chemo do you lose your hair? ›

Hair loss will usually begin gradually within two or three weeks of starting chemotherapy. For some people it may be sooner and more sudden. You may lose all or some of your hair. Your scalp might feel tender as the hair thins and falls out.

What is the first day after chemo like? ›

There Will Be First Chemo Treatment Side Effects

Fatigue: You may feel tired or very fatigued the day after your first treatment. This differs from tiredness that can be cured with sleep. It may feel like profound lack of energy you can't seem to shake.

How many hours does a chemo session last? ›

The length of time for chemotherapy regimens can range from 5 minutes to 8 or more hours. It all depends on the chemotherapy. Throughout the chemotherapy, your nurse will come in and check your vitals and make sure you aren't reacting to the medications.

Can you work while on chemo? ›

Having cancer does not necessarily mean you will stop working. You might take time off for appointments, treatments, or extra rest. You might work as much as possible or take a leave of absence and return later. There are benefits to working even when you have cancer.

Do you always lose your hair with chemo? ›

Most people think that chemotherapy drugs always cause hair loss. But some don't cause any hair loss at all or only slight thinning. Other types of chemotherapy may cause complete hair loss. It might include your eyelashes, eyebrows, underarm, leg and sometimes pubic hair.

How painful is chemotherapy? ›

Does chemotherapy hurt? IV chemotherapy should not cause any pain while being administered. If you experience pain, contact the nurse taking care of you to check your IV line. An exception would be if there is a leak and the drug gets into surrounding tissues.

What organ has side effects from chemotherapy? ›

Some anticancer medicines may affect cells of vital organs, such as the heart, kidney, bladder, lungs, and nervous system. Chemo may have no serious long-term problems for many people. But in some cases, it can cause permanent changes or damage to the heart, lungs, nerves, kidneys, and reproductive or other organs.

Can I shower during chemo? ›

Bathe every day and use warm water. Avoid soaking in spas or hot tubs. Use a mild soap for bathing. Use a soft towel to gently wash skin.

Why can't you share a bathroom with someone on chemo? ›

Traces of chemotherapy drug may be found in and on toilets, in disposable diapers or any clothing or laundry that a person has soiled after having a treatment. Cleaning the bathroom or handling body wastes or soiled laundry can expose you to these chemotherapy drugs.

Why can't you touch someone after chemo? ›

Chemo can be harmful if it touches skin. So you need to make sure caregivers and others close to you are not exposed to your body fluids during chemo and for a few days after treatment. It's OK to have normal contact with other people, including hugging and kissing.

What is chemo belly? ›

Bloating also can be caused when the movement of food through the digestive tract slows as a result of cancer treatments, including gastric surgery, chemotherapy, radiation therapy or other medications. The bloating associated with chemotherapy is often referred to as “chemo belly.”

What is a 21 day chemo cycle? ›

Your course of chemotherapy

Each cycle of TC takes 21 days (3 weeks). On the first day of each cycle, you will have docetaxel and cyclophosphamide. You will then have no chemotherapy for the next 20 days. At the end of the 21 days, you will start your second cycle of TC. You will usually have up to 4 cycles.

What painkillers can you take with chemo? ›

For mild and moderate levels of pain, pain relievers that don't require a prescription may help. Examples include aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others).

Which cancers spread the fastest? ›

Which Type of Cancer Spreads the Fastest? The fastest-moving cancers are pancreatic, brain, esophageal, liver, and skin. Pancreatic cancer is one of the most dangerous types of cancer because it's fast-moving and there's no method of early detection.

What are the hardest cancers to recover from? ›

Jump to:
  • Pancreatic cancer.
  • Mesothelioma.
  • Gallbladder cancer.
  • Esophageal cancer.
  • Liver and intrahepatic bile duct cancer.
  • Lung and bronchial cancer.
  • Pleural cancer.
  • Acute monocytic leukemia.
Sep 21, 2022

Which cancers are most beatable? ›

What Are the Most Treatable Forms of Cancer?
  1. Prostate Cancer. According to the Center for Disease Control [2], 13 out of 100 men will develop prostate cancer in their lifetime. ...
  2. Breast Cancer. ...
  3. Thyroid Cancer. ...
  4. Skin Cancer. ...
  5. Testicular Cancer. ...
  6. Cervical Cancer.
Dec 17, 2020

At what point does chemo start to affect you? ›

If you have side effects, they will usually start during the first few weeks of treatment and may become more intense with each treatment cycle.

Does each round of chemo get harder? ›

The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.

Which cancers respond best to chemotherapy? ›

' However, there are certain types of cancer that are known to respond highly to chemotherapy. These include all three major types of blood cancer namely leukaemia, lymphoma and multiple myeloma. Here are 3 types of blood-related cancers you should know about.

What is the easiest chemotherapy? ›

Today, many cancer patients receive oral chemotherapy as a treatment. This method is sometimes easier than getting chemotherapy by infusion at the hospital or clinic, because the medicine can be taken at home. It's important to understand that these pills can be just as strong as the intravenous form of chemotherapy.

How long do you feel bad on chemo? ›

Sickness caused by chemotherapy can start within a couple of hours of starting your treatment and only last a day or so. Or it can come on more than 24 hours after the start of treatment. This is called delayed onset nausea and vomiting and usually lasts about a week.

What percentage of chemo patients survive? ›

Chemotherapy is more commonly a part of the course of treatment for breast cancers diagnosed in middle or late stages. The overall five-year survival rate for breast cancer is 90%. Among those diagnosed in stage 1, the five-year survival rate is near 100%.

Can you live a full life after chemo? ›

When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. Or you may even have emotional scars from going through so much.

How do you flush chemo out of your body? ›

Drinking plenty of water before and after treatment helps your body process chemotherapy drugs and flush the excess out of your system.

When do chemo side effects peak? ›

If you have side effects, they will usually start during the first few weeks of treatment and may become more intense with each treatment cycle.

Does chemo get worse each week? ›

The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.

When do you start feeling better after chemo? ›

Most people say it takes 6 to 12 months after they finish chemotherapy before they truly feel like themselves again.

Do you have good days on chemo? ›

Most people have ups and downs during treatment, but support is available. Some people find they can lead an almost normal life during chemotherapy. But others find everyday life more difficult. You may feel unwell during and shortly after each treatment but recover quickly between treatments.

Does chemo make you lose weight? ›

Whether it's due to pain from a growing tumor, swallowing difficulties caused by radiation therapy, or the nausea, loss of appetite or mouth sores that are sometimes caused by chemotherapy, involuntary weight loss is a serious side effect of cancer and its treatment for many patients.

How long does it take to recover from first round of chemo? ›

One of the hardest things I see people struggling with is “recovery time,” particularly as it relates to fatigue from cancer treatment. The rule of thumb I usually tell my patients is that it takes about two months of recovery time for every one month of treatment before energy will return to a baseline.

How many weeks of chemo is normal? ›

Most cycles range from 2 to 6 weeks. The number of treatment doses scheduled within each cycle also depends on the prescribed chemotherapy. For example, each cycle may contain only 1 dose on the first day. Or, a cycle may contain more than 1 dose given each week or each day.

What is the first week of chemo like? ›

There Will Be First Chemo Treatment Side Effects

Fatigue: You may feel tired or very fatigued the day after your first treatment. This differs from tiredness that can be cured with sleep. It may feel like profound lack of energy you can't seem to shake.

Should I be alone after chemo? ›

Yes. It will take some extra planning and working out who can support you but it's possible to continue living alone when you have cancer. Having cancer and going through treatment raises many challenges and emotions. These may be harder to deal with when you live alone.

Should I be around people after chemo? ›

Is there any risk to family and friends? You may worry about the safety of family and friends while you are having chemotherapy. There is little risk to visitors (including children, babies and pregnant women) because they aren't likely to come into contact with any chemotherapy drugs or body fluids.

Should you kiss someone on chemo? ›

It is safe to touch other people while on chemotherapy. You can hug and kiss. But you do need to protect others from coming into contact with your medicine.

Videos

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4. Long Term Side Effects of Chemotherapy During Breast Cancer Treatment
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5. Understanding Chemotherapy and Managing Side Effects
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6. What Are the Side Effects of High-Dose Chemotherapy for Cancer?
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