Listen to the Cancer.Net Podcast: Chemotherapy - What to Expect, adapted from this content
Your chemotherapy team
If you need chemotherapy, a team of highly trained medical professionals will work together to give you the best possible care. Your team may include the following people:
Medical oncologist. This is a doctor who specializes in treating cancer with medication. Your oncologist works with other team members to develop your treatment plan. He or she is also in charge of your chemotherapy treatments.
Oncology nurse. An oncology nurse cares for patients with cancer, including giving chemotherapy. He or she answers questions and helps support you and your family. Your nurse also helps keep track of your health during treatment. This can include managing any side effects.
Other health care professionals. Other team members include pharmacists, social workers, nutritionists, physical therapists, and dentists. Learn more about the oncology team.
Before you start chemotherapy
Meeting with your oncologist. Before you start chemotherapy, you will meet with your medical oncologist. Your doctor will review your medical records and do a physical examination. You will also have tests to help plan treatment. Your exact treatment depends on:
- The type, size, and location of the cancer
- Your age
- Your general health
- Other factors that are different for each person
Most chemotherapy treatments are given in repeating cycles. The length of a cycle depends on the treatment being given. Most cycles ranges from 2 to 6 weeks. The number of treatment doses scheduled within each cycle also varies depending on the drugs being given. For example, each cycle may contain only 1 treatment on the first day. Or, a cycle may contain more than one dose given weekly or daily. Often after completing 2 cycles, a re-evaluation is done to make sure the treatment is working. Most people have several cycles of chemotherapy. Or the treatment cycles may continue for as long as the chemotherapy works well.
Giving permission for chemotherapy. Your doctor will talk with you about the risks and benefits of chemotherapy. If you choose to have it, your team will ask you to sign an informed consent form. Signing means:
- You give written permission for treatment.
- Your team gave you information on your treatment options.
- You choose to have chemotherapy.
- You understand treatment is not guaranteed to give the intended results.
Foods and medications with chemotherapy. Your team will tell you what to eat, drink, or avoid on chemotherapy days so the treatment will work best. Please tell your doctor about any prescription and non-prescription medicines you take. This includes vitamins and other supplements, such as herbs.
Questions to ask before chemotherapy starts
Before chemotherapy starts is a good time to ask questions. These may include:
- Learning more about the schedule and side effects of your specific treatment
- Getting after-hours contact numbers for your doctor or nurse
- Where you will receive treatment, such as the specific building and floor
Find a list of questions you might have.
Planning for your chemotherapy treatments
Preparing for side effects. Depending on the most common side effects of your chemotherapy, your doctor may recommend planning for:
- Nausea and vomiting: Nausea and vomiting are common side effects of some chemotherapy. The best way to manage nausea and vomiting is to prevent them. So it is important to talk with your health care team before you start treatment. Medications can prevent nausea and vomiting in most patients. Learn more about ASCO’s guideline for preventing these side effects.
- Dental health: Chemotherapy can cause mouth sores and a dry mouth. It can also lower your ability to fight infections. So it is a good idea to have a complete dental checkup and cleaning before you start chemotherapy. Learn more about dental health during cancer treatment.
- Heart health: Some types of chemotherapy can affect your heart. It can help to check your heart before treatment. This way, doctors can tell if treatment causes problems later. One common test is an echocardiogram (echo). This test uses ultrasound waves to create a moving picture of the heart.
- Reproductive health: Some types of chemotherapy can affect your fertility. For women, this is the ability to get pregnant and carry a pregnancy. For men, fertility is the ability to make a woman pregnant. If you think you might want children later, talk with your health care team before chemotherapy. Learn more about fertility and cancer treatment.
Women might need a test called a Pap test before starting chemotherapy. This is because chemotherapy can cause misleading results on the test.
If there is a chance you could get pregnant during chemotherapy, you should use effective birth control. This is very important, because chemotherapy during pregnancy can harm the fetus (unborn baby). It is especially harmful in the first 3 months of pregnancy. If you do get pregnant during chemotherapy, tell your doctor right away. Learn more about pregnancy and cancer.
- Hair: You might lose some or all of your hair during chemotherapy. Ask your doctor if your treatment is likely to cause hair loss. If so, you can consider if you want to keep your head covered. You can buy a wig, hats, or scarves before treatment starts.
Getting help with finances and work. Before chemotherapy starts, you may want to:
- Contact organizations that could provide financial assistance. This could be important if your insurance does not cover the whole cost of treatment.
- Talk with your employer to arrange time off work for treatment and recovery.
Chemotherapy can be given through a needle into a vein. This is called intravenous or IV chemotherapy. It can also be in pills you take by mouth. This is called oral chemotherapy. Or, it can be given as a medication you put on your skin, called topical chemotherapy.
How you get oral and topical chemotherapy
For oral or topical chemotherapy, you get your medication at the pharmacy and take it at home. Your health care team will give you directions. Ask about side effects and when to call your doctor. Your pharmacist can also help answer your questions.
How you get IV chemotherapy
You usually go to the hospital or clinic for IV chemotherapy. It can also be given through a small pump you wear. This type of IV chemotherapy is called continuous infusion therapy.
What happens on your first day of IV chemotherapy
You may want to bring a friend or family member on your first day of treatment. This person can support you and help you remember information. You may also bring items, such as an MP3 player, DVDs, books, or a blanket, to make your treatment time more comfortable.
Before your IV chemotherapy starts, you will:
- Meet the nurse or other health professionals who will give it
- Have a short physical exam to check your blood pressure, pulse, breathing, and temperature
- Have your height and weight measured to find the right doses of chemotherapy
- Have an IV tube put in your arm
- Have a blood sample taken
- Meet with your oncologist. He or she will check your health and the results of your blood tests and order the chemotherapy.
Giving chemotherapy with a port
Before your first appointment, you might have minor surgery to put in a port. This is a round metal or plastic disk the IV goes in during treatment. With a port, your nurse does not need to find a vein to put the IV in for every treatment. Learn more about catheters and ports.
How long does IV chemotherapy take?
Your IV chemotherapy can take minutes, hours, or several days if you have continuous infusion chemotherapy. You do not need to stay at the hospital or clinic for continuous infusion. The nurse will give you medication to prevent side effects such as nausea or possible allergic reaction. Then you get your chemotherapy medications.
To get the full benefit of chemotherapy, it is important to follow the schedule of treatments recommended by your doctor.
After your IV chemotherapy
After your treatment is finished, the nurse or another team member will take out your IV. If you have a port, it will stay until you finish all your treatments. The nurse will check your blood pressure, pulse, breathing, and temperature again.
Your oncologist or nurse will talk with you again about side effects. They will also give you medication, tips to manage side effects, and other tips. These may include:
- Avoiding children and crowds while you are getting chemotherapy. Chemotherapy weakens your body’s infection-fighting system, called the immune system. Avoid being around sick people.
- Drinking lots of fluids for 48 hours after chemotherapy. This helps move the drugs through your body.
- Making sure to get rid of all your body fluids and waste after chemotherapy. For example, flush the toilet twice after using it. This is important because the medication stays in your body for about 48 hours after treatment. It could harm healthy people in your home. Body fluids and waste include urine, bowel movements, vomit, semen, and fluid from the vagina.
Your medical team can tell you what activities to do or avoid on treatment days.
Before you leave your first treatment, ask for the phone number of the office and your oncologist's answering service. Call your doctor with any questions or concerns.