In most hospitals, a number of different health professionals will be involved in your treatment. These may include an oncologist (a doctor who specialises in cancer care), a specialist nurse and a pharmacist.
How long your chemotherapy lasts will depend on a number of factors. These include the type of cancer you have and how much it’s spread throughout your body. It also depends on the types of medicine you’re given, how severe your side-effects are and how successful the chemotherapy treatment is.
You may have a number of tests before, during and after your chemotherapy. These may include:
- blood and urine tests – to check the number of various blood cells in your blood and how well your kidneys and liver are working
- lung function tests – to see how well your lungs are working
- an ECG or echocardiogram – to see how well your heart is working
- an X-ray, CT scan, or MRI scan – to help your doctor decide which treatment you need
Your doctor or nurse may check your height and weight to work out the right dose of chemotherapy for you. They may also take your temperature. If you have a high temperature or an infection, this needs to be treated before you can have chemotherapy.
If you’re given chemotherapy tablets or capsules to swallow, you can take these at home. If you need to have injections of chemotherapy or wear a pump that gives you continuous infusions, you will usually have the treatment in a hospital. Sometimes, you may need to stay in hospital overnight. It may be possible to have certain chemotherapy injections and infusions at home if services are available in your area.
Your doctor will discuss with you what will happen before, during and after your chemotherapy. You may be given written information about the particular chemotherapy planned and the possible side-effects it may cause.
If you’re unsure about anything, don’t be afraid to ask. No question is too small. It may help if you prepare some questions in advance. For example, you may want to know more details about the risks, benefits and any alternatives to chemotherapy. It’s important that you feel fully informed so you feel happy to give your consent for the treatment to go ahead. You may be asked to do this by signing a consent form.
You can have chemotherapy in different ways. Most commonly, you will have chemotherapy through a drip into your bloodstream (intravenous chemotherapy) or as tablets or capsules that you swallow.
Other ways of having chemotherapy medicines include:
- injections into the area around your spinal cord (intrathecal injection)
- injections into an affected body cavity such as your bladder (intracavity chemotherapy)
- creams for skin cancers
If you’re having intravenous chemotherapy, the medicines can be given through:
- a small tube in a vein in your arm or the back of your hand
- a thin tube inserted through the skin of your chest into a main vein near your heart (central line) – this can be left in for many months so medicines can be injected through it
- a thin tube placed into a vein in the crook of your arm and threaded through until it’s in a vein near your heart (a PICC – peripherally inserted central catheter line) – this can also stay in place for many months
- a thin tube put into a vein ending in an opening (port) just under the skin on your arm or chest (called an implantable port or ‘portacath’) – medicines are passed via needles through the port
- an infusion pump – this is a portable pump that attaches to a PICC line or a central line and feeds in the correct dose of chemotherapy over a period of time
You will usually have several sessions of chemotherapy. Each session may take between 30 minutes and a few hours. You will then have a rest period, which could be anything from a few days to several weeks, to allow your body to recover. Treatment and rest periods make up a cycle. You may have a number of cycles depending on how well your cancer responds to chemotherapy. Your doctor will explain your treatment in more detail.
Different people react to chemotherapy in different ways.
You may be able to continue with your life as usual during and after your treatment. You may even feel better as the symptoms of your cancer decrease. Some people find that it takes them a while to get back to normal though, as chemotherapy can have an impact on their everyday activities. In particular, you may feel too tired to work full-time or to keep as active as usual. Some side-effects may not appear until days or even weeks after your chemotherapy treatment has finished.
Chemotherapy can also make you feel a bit down. It often helps if you talk to someone about how you’re feeling. It’s important to speak to your doctor or nurse about what to expect after chemotherapy or if you’re worried about anything in particular. Take things at your own pace and don’t overdo it, particularly after you have just had treatment. See our information on tiredness and chemotherapy below for more information.
During and after chemotherapy, you may experience some unwanted side-effects, which are mostly temporary. All medical treatments carry some risks. Your reaction to chemotherapy will be specific to you and will depend on the treatment you’re given. Your doctor or nurse can explain how these risks apply to you.
Chemotherapy doesn't specifically target cancer cells, it targets any cells that divide rapidly. This includes cells in your bone marrow, cells that produce hair, and cells that line your mouth and digestive system. If these healthy cells are damaged, you may:
- feel tired
- feel sick or vomit
- have diarrhoea and/or constipation
- have thinning of your hair or hair loss
- have a sore mouth, mouth ulcers or changes in your sense of taste
- get numbness or ‘pins and needles’ in your hands and feet
- feel out of breath
- lose your appetite
- notice changes to your skin – your skin may become dry or more sensitive
- have changes to your hearing – some people get tinnitus (a ringing sound in your ears)
Side-effects vary greatly between the different types of chemotherapy and from person to person. You can control many of these side-effects with other medicines. For example, you can reduce any sickness by taking anti-sickness medicines alongside your chemotherapy. Your doctor can tell you what side-effects you may be likely to expect from the chemotherapy you’re having.
Chemotherapy can destroy the white blood cells that help your body fight infections. If you develop a fever (raised temperature) during or soon after chemotherapy, this is a sign that you may have an infection. If this happens, seek urgent medical advice from your chemotherapy unit, so that you can be prescribed antibiotics straight away.
If you’re sick or have diarrhoea after your chemotherapy, this can make the contraceptive pill less effective. Your doctor will advise you to use condoms during your chemotherapy treatment and for a few weeks afterwards. If you’re a woman, don’t try to get pregnant while you’re having treatment because the chemotherapy medicines can damage a developing baby.
Some chemotherapy medicines can affect your fertility. Others may bring on an early menopause in women. It’s important that you discuss these risks with your doctor before you start your chemotherapy. You may be offered the opportunity to store eggs, embryos, ovarian tissue or sperm for future fertility treatment. See our section on chemotherapy and fertility below for more information.
Certain chemotherapy medicines can slightly increase your risk of developing a type of blood cancer called acute myeloid leukaemia in later life. Your risk of developing leukaemia will depend on how much chemotherapy you have. Your doctor will give you more information about this.
Since different chemotherapy medicines cause different side-effects, it’s important to discuss your specific treatment with your doctor.
Why is tiredness a common side-effect of chemotherapy? Why is tiredness a common side-effect of chemotherapy?
Tiredness is a common side-effect of chemotherapy. This is because chemotherapy medicines don’t just kill cancer cells, they also damage the healthy cells that keep you well.
Chemotherapy targets any cells that divide rapidly. This includes red blood cells that carry oxygen around your body. You can get very tired and breathless if you have low levels of red blood cells and become anaemic.
Chemotherapy also targets the white blood cells that help you fight infections. You may be prone to getting ill if you have low numbers of white blood cells.
It can be frustrating if you feel tired all the time and struggle to cope with your usual daily activities. You may feel as if you have no energy, and like you can’t get out of bed or do your usual activities. This should get better once you finish chemotherapy but it can often last for several weeks or months after you finish your treatment.
There are many things that may help you cope with your tiredness.
- Cut down on unnecessary activities and ask your family or friends for help.
- Give yourself plenty of time to rest.
- Give yourself plenty of time to do tasks and to get to places.
- Spread tasks out over the week and do a little bit each day.
- Eat a healthy, balanced diet to help keep your energy levels up.
How long does it take for hair to grow back after chemotherapy? How long does it take for hair to grow back after chemotherapy?
Hair loss is a side-effect of some chemotherapy medicines. If you lose your hair, it will usually start to grow back any time between three and six months after your treatment has ended.
Some types of chemotherapy medicine can damage the cells that make your hair. This can make your hair brittle, causing it to break off near your scalp. How much hair you lose depends on the type, dose and length of your treatment.
You may notice slight thinning, hair loss in patches or complete hair loss. Your head hair is usually affected first. Then your eyelashes, eyebrows, underarm, leg and, sometimes, pubic hair may also fall out. Your hair may fall out within a few days of starting chemotherapy or several weeks later. It’s best not to colour your hair when it’s thin because the colour may not work well. Wait until your hair gets back to normal before you colour it.
Once your chemotherapy ends, your hair may grow back slightly differently; for example, it may be a different colour or more curly than before.
Before you start treatment, ask your doctor whether your chemotherapy medicines may cause hair loss. It may not bother you if it does, and you may feel confident without having your head covered. But if you would prefer to cover your head, there are lots of different options to choose from., You could consider wigs, scarves and hats. Some men and women shave their heads or cut their hair very short before or during their chemotherapy treatment.
With some types of chemotherapy, you may be offered a ‘cold cap’. This cools down your scalp so less of the chemotherapy medicine reaches your hair follicles. This isn’t suitable for all types of cancer though, and it doesn’t work for everybody. Also, because there’s been little research about this therapy, some doctors are worried about the risk of cancer coming back after using a cold cap. You can discuss this more with your doctor if you’re considering cold cap therapy.
If you’re worried about hair loss as a result of your treatment, speak to your doctor or nurse for advice.
Yes, some chemotherapy medicines may affect your fertility. It’s important to discuss the risk of infertility with your doctor before you start your treatment.
Many people go on to have healthy children after chemotherapy. But there is a risk with some chemotherapy medicines will that they may temporarily or permanently affect your fertility. The impact of chemotherapy on your fertility is influenced by:
- your age
- the type of chemotherapy medicine
- the dose and duration of chemotherapy
- your general health
- the type of cancer
In men, chemotherapy may temporarily or permanently reduce the number of sperm produced and their ability to fertilise an egg. You may be offered the opportunity to bank your sperm so it can be frozen and stored for future fertility treatment.
In women, chemotherapy may temporarily stop your ovaries from working. Your periods may become irregular or stop and you may develop symptoms of the menopause. Speak to your doctor about this before you start chemotherapy. Sometimes, your doctor will give you hormonal treatment during chemotherapy to try to protect your ovaries. It usually takes about six months to a year for your periods to return to normal after chemotherapy.
Some chemotherapy medicines stop your ovaries working permanently. Depending on the type of cancer you have, and whether it is safe to delay treatment, you may have three options for future fertility treatment:
- freezing embryos (eggs that have been fertilised with your partner’s sperm)
- freezing your eggs
- a new treatment to remove and freeze ovarian tissue and then put it back after chemotherapy so it produces eggs again – this is becoming more widely available as research continues to show it to be successful
Yes, chemotherapy may affect your sex life. But it affects different people in different ways, and doesn’t affect everyone.
Chemotherapy doesn’t affect everyone’s sex life, so you may not notice any changes at all. But if you’re feeling tired, sick or generally unwell, you may not feel like having sex. Feeling anxious about your condition and how your treatment is going can also affect your desire to have sex. If you have lost your hair after chemotherapy, this can make you feel less confident about your appearance and may affect your sex life too.
There usually isn’t any medical reason why you can’t have sex. The chemotherapy medicines don’t have any effect on your performance or enjoyment of sex. But you may prefer to wait for a rest period in your chemotherapy treatment cycle to have sex again. If you don’t feel ready, you may rather wait until you finish chemotherapy treatment completely. Most people regain their usual energy levels between a few months to a year after chemotherapy ends. For many people, it’s sooner than this.
It’s best to use condoms for a few days after chemotherapy because it isn’t known if chemotherapy medicines pass into semen or vaginal fluids. So using a condom will protect your partner. If you’re a woman, don’t try to become pregnant while you’re having treatment because chemotherapy medicines can harm a developing baby.
It’s important to remember that if your feelings about having sex do change during your chemotherapy treatment, this won’t last forever. Any side-effects will usually wear off gradually when your treatment is finished and your feelings may well change. If you have concerns about sex, you may find it helpful to talk to your partner, doctor or nurse for advice and support.
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