Chemotherapy: Learn Side Effects of This Cancer Treatment

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Chemotherapy

Chemotherapy facts*

*Chemotherapy facts medical author: Benjamin Wedro, MD, FACEP, FAAEM

  • Chemotherapy is one option available to treat cancer patients.
  • The types of medication used and how they are administered depends upon the patient’s situation, the type of cancer, and the goal of cancer therapy.
  • Chemotherapy options are individualized for each patient. Treatment decisions are usually a collaboration between the patient, family, and cancer doctor.
  • There are different goals for chemotherapy. The treatment may be meant to cure the cancer, control its growth and spread, or provide comfort to the patient.
  • Chemotherapy affects people in different ways. The most common side effect is fatigue but other more serious complications may occur, depending upon the type of chemotherapy treatment.
  • The battle to treat cancer is ongoing. There are many new chemotherapeutic drugs and treatment protocols being developed. Clinical trials may be an option for some patients with cancer, but there is no guarantee that a new drug or treatment will work or is better than standard available treatment.

What is chemotherapy?

Chemotherapy (also called chemo) is a type of cancer treatment that uses drugs to destroy cancer cells.

How does chemotherapy work?

Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. It can also harm healthy cells that divide quickly, such as those that line your mouth and intestines or cause your hair to grow. Damage to healthy cells may cause side effects. Often, side effects get better or go away after chemotherapy is over.

What does chemotherapy do?

Depending on your type of cancer and how advanced it is, chemotherapy can:

  • Cure cancer – when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body and they will not grow back.
  • Control cancer – when chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
  • Ease cancer symptoms (also called palliative care) – when chemotherapy shrinks tumors that are causing pain or pressure.

How is chemotherapy used?

Sometimes, chemotherapy is used as the only cancer treatment. More often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy. Chemotherapy can:

  • Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
  • Destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy.
  • Help radiation therapy and biological therapy work better.
  • Destroy cancer cells that have come back (recurrent cancer) or spread to other parts of your body (metastatic cancer).

How does my doctor decide which chemotherapy drugs to use?

This choice depends on:

  • The type of cancer you have. Some types of chemotherapy drugs are used for many types of cancer. Other drugs are used for just one or two types of cancer.
  • Whether you have had chemotherapy before
  • Whether you have other health problems, such as diabetes, heart disease, or problems with the liver or kidneys.

Where do I go for chemotherapy?

You may receive chemotherapy during a hospital stay, at home, or in a doctor’s office, clinic, or outpatient unit in a hospital (which means you do not have to stay overnight). No matter where you go for chemotherapy, your doctor and nurse will watch for side effects and make any needed drug changes.

How often will I receive chemotherapy?

Treatment schedules for chemotherapy vary widely. How often and how long you get chemotherapy depends on:

  • Your type of cancer and how advanced it is
  • The goals of treatment (whether chemotherapy is used to cure your cancer, control its growth, or ease the symptoms)
  • The type of chemotherapy
  • How your body reacts to chemotherapy

You may receive chemotherapy in cycles. A cycle is a period of chemotherapy treatment followed by a period of rest. For instance, you might receive 1 week of chemotherapy followed by 3 weeks of rest. These 4 weeks make up one cycle. The rest period gives your body a chance to build new healthy cells.

Can I miss a dose of chemotherapy?

It is not good to skip a chemotherapy treatment. Sometimes your doctor or nurse may change your chemotherapy schedule. This can be due to s >

How is chemotherapy given?

Chemotherapy may be given in many ways.

  • Injection. The chemotherapy is given by a shot in a muscle in your arm, thigh, or hip or right under the skin in the fatty part of your arm, leg, or belly.
  • Intra-arterial (IA). The chemotherapy goes directly into the artery that is feeding the cancer.
  • Intraperitoneal (IP). The chemotherapy goes directly into the peritoneal cavity (the area that contains organs such as your intestines, stomach, liver, and ovaries).
  • Intravenous (IV). The chemotherapy goes directly into a vein.
  • Topically. The chemotherapy comes in a cream that you rub onto your skin.
  • Orally. The chemotherapy comes in pills, capsules, or liquids that you swallow.

Things to know about getting chemotherapy through an IV

Chemotherapy is often given through a thin needle that is placed in a vein on your hand or lower arm. Your nurse will put the needle in at the start of each treatment and remove it when treatment is over. Let your doctor or nurse know right away if you feel pain or burning while you are getting IV chemotherapy.

IV chemotherapy is often given through catheters or ports, sometimes with the help of a pump.

  • Catheters. A catheter is a soft, thin tube. A surgeon places one end of the catheter in a large vein, often in your chest area. The other end of the catheter stays outs >

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How will I feel during chemotherapy?

Chemotherapy affects people in different ways. How you feel depends on how healthy you are before treatment, your type of cancer, how advanced it is, the kind of chemotherapy you are getting, and the dose. Doctors and nurses cannot know for certain how you will feel during chemotherapy.

Some people do not feel well right after chemotherapy. The most common side effect is fatigue, feeling exhausted and worn out. You can prepare for fatigue by:

  • Asking someone to drive you to and from chemotherapy
  • Planning time to rest on the day of and day after chemotherapy
  • Getting help with meals and childcare the day of and at least 1 day after chemotherapy

There are many ways you can help manage chemotherapy side effects.

Can I work during chemotherapy?

Many people can work during chemotherapy, as long as they match their schedule to how they feel. Whether or not you can work may depend on what kind of work you do. If your job allows, you may want to see if you can work part-time or work from home on days you do not feel well.

Many employers are required by law to change your work schedule to meet your needs during cancer treatment. Talk with your employer about ways to adjust your work during chemotherapy. You can learn more about these laws by talking with a social worker.

Sometimes your doctor may advise you not to work from a period of time, such as when your immune system is low during chemotherapy.

Can I take over-the-counter and prescription drugs while I get chemotherapy?

This depends on the type of chemotherapy you get and the other types of drugs you plan to take. Take only drugs that are approved by your doctor or nurse. Tell your doctor or nurse about all the over-the-counter and prescription drugs you take, including laxatives, allergy medicines, cold medicines, pain relievers, aspirin, and ibuprofen.

One way to let your doctor or nurse know about these drugs is by bringing in all your pill bottles. Your doctor or nurse needs to know:

  • The name of each drug
  • The reason you take it
  • How much you take
  • How often you take it

Talk to your doctor or nurse before you take any over-the-counter or prescription drugs, vitamins, minerals, dietary supplements, or herbs.

Can I take vitamins, minerals, dietary supplements, or herbs while I get chemotherapy?

Some of these products can change how chemotherapy works. For this reason, it is important to tell your doctor or nurse about all the vitamins, minerals, dietary supplements, and herbs that you take before you start chemotherapy. During chemotherapy, talk with your doctor before you take any of these products.

How will I know if my chemotherapy is working?

Your doctor will give you physical exams and medical tests (such as blood tests and x-rays). He or she will also ask you how you feel.

You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well. Or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.

How much does chemotherapy cost?

It is hard to say how much chemotherapy will cost. It depends on:

  • The types and doses of chemotherapy used
  • How long and how often chemotherapy is given
  • Whether you get chemotherapy at home, in a clinic or office, or during a hospital stay
  • The part of the country where you live

Does my health insurance pay for chemotherapy?

Talk with your health insurance plan about what costs it will pay for. Questions to ask include:

  • What will my insurance pay for?
  • Do I or does the doctor’s office need to call my insurance company before each treatment for it to be pa >

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What are clinical trials and are they an option for me?

Cancer clinical trials (also called cancer treatment studies or research studies) test new treatments for people with cancer. These can be studies of new types of chemotherapy, other types of treatment, or new ways to combine treatments. The goal of all these clinical trials is to find better ways to help people with cancer.

Your doctor or nurse may suggest you take part in a clinical trial. You can also suggest the idea. Before you agree to be in a clinical trial, learn about:

  • Benefits. All clinical trials offer quality cancer care. Ask how this clinical trial could help you or others. For instance, you may be one of the first people to get a new treatment or drug.
  • Risks. New treatments are not always better or even as good as standard treatments. Even if this new treatment is good, it may not work well for you.
  • Payment. Your insurance company may or may not pay for treatment that is part of a clinical trial. Before you agree to be in a trial, check with your insurance company to make sure it will pay for this treatment.

Tips for meeting with your doctor or nurse

  • Make a list of your questions before each appointment. Some people keep a “running list” and write down new questions as they think of them. Make sure to have space on this list to write down the answers from your doctor or nurse.
  • Bring a family member or trusted friend to your medical visits. This person can help you understand what the doctor or nurse says and talk with you about it after the visit is over.
  • Ask all your questions. There is no such thing as a stup >

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