What it is
, or chemo, is a cancer treatment that uses medicines to kill cancer cells or stop them growing. It also affects some healthy cells that grow quickly, such as those in the mouth, gut and hair roots, which is why it causes side effects. There are many chemotherapy medicines, chosen to suit your cancer and your health.
Why it is done
may be recommended to try to cure the cancer, lower the chance it comes back, shrink it or stop it spreading, or relieve symptoms. It may be given before surgery to shrink a tumour, or after surgery or to destroy cancer cells that remain. Whether it is right for you depends on the type of cancer, whether it has spread, and your general health.
What it helps with
How to prepare
Your team will explain the treatment, answer your questions and tell you which side effects to expect.
Do
- Ask about fertility before treatment starts, as eggs or sperm can sometimes be stored
- Tell the team at once if you might be pregnant, and ask about contraception
- Arrange a lift to treatment, and help with meals and childcare on treatment days
- Tell the team about every medicine you take, and ask which to take or stop
Do not
- Do not skip treatments without telling the team
- Do not stop or change medicines yourself
What happens
A drip into a vein is the most common way:
- At each visit the team asks about side effects, checks your weight to set the dose, and takes a blood test.
- A thin tube is put into a vein, usually in the arm. Some people have a longer-lasting tube or a small port under the skin of the chest.
- The medicine runs in from a drip bag or pump. This can take 30 minutes or up to a few days.
- You go home afterwards unless a hospital stay is planned. A wearable pump goes home with you for a few days.
- A rest follows, so your body can recover before the next cycle.
Other is an injection, which takes a few minutes, or tablets taken at home with regular check-ups.
Afterwards
Side effects usually begin a few days or weeks after treatment starts and generally stop after it ends. Some last longer, and a few appear only afterwards. Plan to rest on treatment days and the day after. If eating is hard, tell the team.
Contact your cancer team straight away for:
- A high temperature, or feeling hot, cold or shivery
- A new sore throat or cough, diarrhoea, or pain when passing urine
- Pain, swelling and warmth in an arm or leg
- Sudden breathlessness, sharp chest pain, or coughing up blood
If you cannot reach your team, get emergency care.
Risks and side effects
Most people get some side effects but not all, and how hard they are varies a great deal. It is fine to ask for help. Common ones are:
- Tiredness, the most common
- Nausea and vomiting
- A sore mouth and throat
- A weaker immune system, so infections are more likely
- Anaemia, with low energy and breathlessness
- Bleeding or bruising more easily
- Constipation or diarrhoea
- Temporary hair loss
- Numbness or tingling in the hands or feet
- Memory and concentration problems
- Blood clots
Some affects fertility, temporarily or permanently.
Results and what comes next
The team checks how well treatment is working with examinations, blood tests and scans. What can achieve depends on the cancer, so ask whether the aim in your case is to cure, to control or to ease symptoms.
You cannot tell from side effects whether it is working: severe ones do not mean it works better, and few does not mean it is failing.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Will I lose my hair?
Hair loss is a common side effect, but not everyone loses their hair, and it depends on the treatment. When it happens it is temporary. Ask your team whether it is likely with your chemotherapy.
Does having a lot of side effects mean the chemotherapy is working better?
No. You cannot tell if chemotherapy is working from its side effects. Severe side effects do not mean it is working well, and having few does not mean it is not. The team checks with examinations, blood tests and scans.
Can I have chemotherapy at home?
Some types, such as tablets or capsules, are taken at home. Most chemotherapy is given in hospital or a clinic, often as a day visit, and a wearable pump can let you take the medicine home for a few days. Your team will explain which applies to you.
Can chemotherapy affect having children?
Some chemotherapy can affect fertility, temporarily or permanently, so ask about it before treatment starts, as eggs or sperm can sometimes be stored. Chemotherapy can also seriously harm an unborn baby, so tell your team at once if you might be pregnant and ask about contraception.
