Chemotherapy

What is chemotherapy?

Chemotherapy means treating cancer with medicine. These medicines target cancer cells that divide quickly. Healthy cells that also divide quickly, such as hair root cells, the lining of the mouth and gut, and bone marrow, can be harmed too. Most chemotherapy side effects come from this.

Chemotherapy is a systemic treatment, which means the medicine travels through the blood to reach the whole body. This is different from radiation therapy, which targets only one area.

Who is it for?

Doctors may suggest chemotherapy in different situations:

• Before surgery or radiation therapy, to shrink the tumor
• After surgery, to lower the chance that the disease comes back
• Together with radiation therapy
• For cancers that have spread or come back, to control the disease and ease symptoms

The type of medicine and the treatment plan depend on the type of cancer, its stage, your age, your physical condition, and your test results. Only your treating doctor decides the name and dose of your medicine.

Every patient’s treatment plan is different; ask your doctor about your own situation.

How is chemotherapy given?

The most common way is an IV (intravenous) infusion. The medicine goes in through a needle in a vein in your hand or arm. Sometimes a catheter or a port is used. A port is a small device under the skin that makes it easier to reach a vein. Some medicines are taken as pills or capsules, and others are given as shots into a muscle or under the skin, or placed directly into a space in the body.

Treatment is usually given in cycles. This means you get the medicine for a while, then have a rest period so your body can recover. For example, one day of treatment followed by three weeks of rest could be one cycle. This is only an example; your doctor decides your schedule.

Blood tests are usually done before each cycle. If your blood cell counts are low, your doctor may delay treatment or change the plan. Do not delay or skip sessions without talking to your doctor.

What is each session like?

For an IV infusion, you usually sit in a chair or lie on a bed in an outpatient unit or hospital. A nurse places an IV in your vein and connects the medicine. A session can last anywhere from a few dozen minutes to several hours.

A few practical tips:

• Bring someone with you, or plan how you will get there and back.
• Bring a book, headphones, or a charger, and wear comfortable clothes.
• Plan to rest on the day of treatment and the day after.
• If you feel itching, burning, pain at the IV site, dizziness, or trouble breathing during the infusion, tell the nurse right away.

Common side effects and how to care for yourself

Side effects depend on the type of medicine and differ from person to person. The most common ones are:

• Fatigue. This is the most common side effect. Save important tasks for the hours when you have more energy, and ask others for help.
• Nausea and vomiting. There are anti-nausea medicines to prevent this. It is best to take them as your doctor directs, before symptoms start.
• Mouth sores. Check your mouth every day, clean your teeth with a soft toothbrush, and avoid spicy, sour, and very hot foods.
• Hair loss. Not every medicine causes this. Hair usually grows back after treatment ends.
• Low white blood cells and risk of infection. Wash your hands often, stay away from sick people and crowded places, and cook meat, eggs, and fish all the way through.
• Changes in appetite and taste. Eat small, frequent meals, and get help from a dietitian if you need it.

Before taking any medicine for fever or pain, even one you can buy without a prescription, check with your care team. Some medicines can mask a fever and hide the sign of a serious problem.

Many side effects get better after treatment ends, but some last longer.

When to call right away

During chemotherapy the risk of infection is higher, and an infection can be serious. Call your care team right away or go to the emergency room if you have:

• A fever of 38 degrees Celsius (100.4 degrees Fahrenheit) or higher, or severe chills
• Vomiting or diarrhea that will not stop, and you cannot keep fluids down
• Unusual bleeding, bruising for no reason, or blood in your urine or stool
• Trouble breathing, chest pain, or a new cough
• A catheter or port site that is red, swollen, painful, or draining pus
• Mouth sores so bad that you cannot eat or drink
• Severe pain, confusion, or sudden weakness

Before treatment starts, it is a good idea to ask your care team when a phone call is enough and when you should go straight to the emergency room.

Every patient’s treatment plan is different; ask your doctor about your own situation.