Chemotherapy

What is chemotherapy?

Chemotherapy is a type of cancer treatment. Also called “chemo,” it’s one of several cancer treatments that use drugs against various types of cancer. Other drug therapies include:

• Hormone therapy: Drugs that prevent certain cancers from getting the hormones they need to grow.
• Immunotherapy: Drugs that help your immune system fight cancer.
• Targeted therapy: Drugs that change how cancer cells multiply and behave.

A medical oncologist oversees treatment. These healthcare providers specialize in chemotherapy and other cancer-fighting drugs.

Chemotherapy may get used with surgery or radiation therapy to treat cancer.

How does chemotherapy work?

Cancer cells grow and divide uncontrollably. Chemotherapy destroys the cancer cells and prevents them from multiplying.

Your oncologist may use chemotherapy in different ways:

• Adjuvant therapy: Chemotherapy destroys cancer cells after surgery or radiation therapy.
• Curative therapy: Chemotherapy (which may also include radiation and/or surgery) eliminates the cancer, and it doesn’t return.
• Neoadjuvant therapy: Chemotherapy shrinks a tumor before surgery or radiation therapy.
• Palliative therapy: Chemotherapy shrinks tumors and lessens symptoms but doesn’t cure the cancer.

What types of cancer can chemotherapy treat?

Chemotherapy can treat a wide range of cancers, including:

• Primary cancer: Cancer that hasn’t spread to other areas of your body.
• Metastatic cancer: Cancer that’s spread to other areas of your body.

The type of chemotherapy you receive depends on several factors:

• Location of the cancer.
• Stage of the cancer, or how advanced it is.
• Your overall health.

How do I prepare for chemotherapy treatment?

Your oncologist will ensure you’re healthy enough for treatment by running tests. In the meantime, you can take steps to prepare for chemo.

• Learn everything you can about your treatment. The more you know about your treatment, the better prepared you’ll be to adjust to life with chemotherapy. Ask your oncologist about the specific chemo drugs you’ll receive, including their benefits and potential side effects. Ask about resources available (including online sources, organizations and support groups) where you can learn as much as possible about your treatment.
• Plan for side effects. Take steps to manage potential side effects before treatment starts. For example, if you know that hair loss is possible, you can plan to get a wig made that matches your current hair color and style, or buy scarves or head wraps. Purchase skin care products with gentle ingredients if you know that skin changes and sensitivity to sunlight are likely side effects. There are many more steps you can take to prepare.
• Visit a dentist. Common chemotherapy side effects include mouth sores and changes in your taste buds that make eating less pleasurable. You don’t want to navigate dental problems on top of these challenges. Make sure your teeth are healthy and your mouth is infection-free before starting treatment.
• Ease financial stress. Most insurance companies cover chemotherapy treatments. Still, knowing that you have the resources to cover care can ease your mind so you can focus on fighting cancer and feeling better. Know what resources are available through your insurance. Ask about services like patient assistance programs. Visit the National Cancer Institute’s support services page to access resources (including financial resources) available to people with cancer.
• Make arrangements at work. You may need a modified work schedule during chemotherapy. Depending on your job, working remotely or taking time off may be an option. You may need to take time off on treatment days. Ask your oncologist how treatments will likely impact your ability to do your job. Make arrangements with your employer based on this information.
• Have a treatment routine. Ask your oncologist what treatment will involve, including what your environment will be and how long it will take. Use this information to plan your treatment. For example, if treatment takes a long time, you may need to pack a lunch or plan to entertain yourself (with a book, music, etc.). Many people eat a snack about an hour before treatments to prevent side effects like nausea.

What happens during treatment?

Your experience depends on how your oncologist will administer your chemotherapy drug treatments.

Chemotherapy is usually systemic, meaning the chemotherapy drug travels throughout your entire body. You may receive systemic chemo:

• Intravenously (IV), or through a vein as an “infusion.” Most people receive chemo through an IV.
• As an injection, or a shot.
• Orally, as a pill or liquid that you swallow.
• Topically, as a cream that you rub into your skin.

Some cancers don’t respond well to systemic chemotherapy. In certain cases, you might need chemotherapy delivered to a specific area of your body. Examples include:

• Intra-arterial chemotherapy: Goes into a single artery that supplies blood to a tumor.
• Intracavitary chemotherapy: Goes directly into a body cavity, such as your bladder or belly. One form is hyperthermic intraperitoneal chemotherapy (HIPEC). It puts heated chemotherapy in your abdomen after surgery.
• Intrathecal chemotherapy: Goes into the area between your brain and spinal cord.

How intravenous (IV) chemotherapy drugs are given

The most common way to give chemotherapy is intravenously, through an IV. Chemotherapy can go directly into a vein through a:

• Needle: Usually in your arm.
• Catheter: A thin, flexible tube attached to a vein (usually in your chest).
• Port: A small disc inserted under the skin. A catheter attaches to the port to deliver chemotherapy. Port placement requires minor surgery.
• Pump: A device that attaches to a catheter or port that controls the amount of the chemotherapy drug you receive.

Catheters and ports are helpful if you need multiple rounds of chemotherapy. They avoid the need for constant needle sticks in your arm. Your oncologist may also use catheters and ports to deliver other medications. These may include antibiotics or antiemetics (medications to prevent nausea and vomiting).

How long is chemo treatment?

The length of chemotherapy treatment depends on the type of chemo you receive. A treatment session can take anywhere from a few minutes to a few hours. Some people need a continuous infusion, which can last several days. A continuous infusion might start at the hospital or infusion center and continue at home.

Most people need multiple rounds of chemotherapy. A single round of chemotherapy may involve treatment for several days or weeks, followed by a period with no chemotherapy. This time off allows your body time to recover from treatment. Afterward, you may receive another chemotherapy round following the same on-off pattern.

You may receive daily, weekly or monthly treatments.

Where will I receive chemotherapy treatments?

Chemotherapy treatments are typically outpatient procedures, which means you can go home that same day. You may receive treatment:

• In a clinic or infusion center.
• In your oncologist’s office.
• In a hospital.
• At home (if you’re taking a pill or liquid form of a chemotherapy drug).

What are the side effects of chemotherapy?

Chemotherapy drugs target all fast-growing cells, including cancer cells. This means chemotherapy drugs destroy cancer cells but can also damage other cells in your body, potentially causing side effects. Blood cells and the cells in your skin, hair follicles and digestive tract are examples of cells that grow and multiply quickly. That’s why some common side effects of chemotherapy occur in these areas, including:

• Anemia.
• Bleeding.
• Constipation.
• Diarrhea.
• Fatigue.
• Hair loss.
• Infection.
• Loss of appetite.
• Nausea and vomiting.

Talk to your care team about ways to manage the side effects of cancer treatment.

What are the benefits of chemotherapy?

Despite the potential side effects, chemotherapy has been an effective, reliable cancer treatment for decades. Chemo can rid your body of cancer completely, or it can help you have a better quality of life by reducing symptoms. Chemotherapy can also make other treatments, such as surgery or radiation therapy, more effective.

How long do the side effects of chemotherapy last?

Many side effects of chemotherapy will go away after you stop treatment. Some effects of chemotherapy, though, may not show up until months or years after treatment. Late effects of chemo can include:

• Cognitive (memory and thinking) issues, also called “chemo brain.”
• Early menopause.
• Cardiotoxicity, or heart problems caused by cancer treatment.
• Neuropathy, or symptoms of nerve damage.
• Infertility.

Many people find cancer rehabilitation helpful in managing the effects of cancer treatment.

Can cancer come back after chemotherapy?

Cancer can come back after chemotherapy or any type of cancer treatment. Once treatment ends, your care team often asks you to come for follow-up visits to check for disease. Your oncologist may recommend more cycles of chemotherapy to treat cancer that returns.

At what stage of cancer do people receive chemotherapy?

There isn’t a specific cancer stage when people receive chemotherapy treatments. The type of chemotherapy drugs you receive, the dose and timing of treatment depend on multiple factors. For example, you may have cancer that responds to chemotherapy as a first-line treatment. Or your oncologist may recommend chemotherapy only after other treatments haven’t worked.

Ask your oncologist about the best treatment approach for your specific situation.

Is taking chemotherapy painful?

Most people don’t experience pain during treatment sessions, especially if they’re taking pills or using a topical cream. If you’re receiving a shot or injection, you may feel an uncomfortable sting or prick when the needle goes in. You may feel slight burning once the medicine enters your body, but the sensation usually lessens during treatment.

Can cancer be cured with chemotherapy?

Yes. Some forms of cancer are sensitive to chemotherapy and go away completely following treatment. Healthcare providers take care when using words like “cure” when it comes to cancer because there’s always a chance it could return. Still, many cancer survivors are currently cancer-free thanks to chemotherapy.

A note from Cleveland Clinic

Chemotherapy is one of the most common types of cancer treatment. Chemotherapy can work on its own or be paired with other treatments like radiation therapy, surgery or other drug therapies. The type of chemotherapy you receive will depend on your cancer’s stage and location, as well as your overall health. Chemotherapy may cause side effects in the short term and long term. Before starting any cancer treatment, talk to your healthcare provider about the risks and benefits.