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Chemotherapy

Key points

  • Chemotherapy destroys cancer cells with medicines.
  • You can have chemotherapy on its own or you can have it alongside other treatments.
  • You can have chemotherapy medicines as tablets or intravenously (directly into your bloodstream).
  • Side-effects of chemotherapy vary greatly between different medicines and even different patients.

Featured FAQ

Will chemotherapy affect my fertility?

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.

Read all our FAQs on chemotherapy

Chemotherapy is a treatment to destroy cancer cells with medicines. There are more than 100 chemotherapy medicines available. These can be used in a variety of ways according to the type of cancer you have, how advanced it is and your general health.

Your care may differ from what is described here as it will be designed to meet your individual needs. It’s important that you discuss your chemotherapy treatment with your doctor.

About chemotherapy

Chemotherapy is used to destroy many different types of cancer at various stages. Chemotherapy kills cancer cells that are dividing and reproducing. Your healthy cells can repair the damage caused by chemotherapy, but cancer cells can’t and die.

Chemotherapy treats solid tumours (cancerous lumps) that affect organs such as the breast or bowel, as well as blood cancers such as leukaemia.

You may have chemotherapy to:

  • shrink a cancer before surgery or radiotherapy
  • reduce the chance of a cancer coming back after surgery or radiotherapy
  • treat a cancer on its own (some cancers are very sensitive to chemotherapy)
  • treat cancer that has spread from where it first started

The type of chemotherapy medicine you have will depend on a number of factors including:

  • the type of cancer you have
  • where the cancer started
  • what the cancer cells look like under a microscope
  • whether the cancer has spread to other parts of your body
  • your general health

Chemotherapy can be used on its own or alongside other treatments, such as radiotherapy, surgery or hormonal, biological and immune therapies.

Preparing for chemotherapy

In most hospitals, a number of different health professionals will be involved in your treatment. An oncologist (a doctor who specialises in cancer care) and a specialist nurse will usually oversee your chemotherapy. A dietitian, pharmacist, psychologist and physiotherapist may also be involved in your treatment.

Your doctor will explain why you’re having chemotherapy and how to prepare for your treatment. The length of time you will need to have chemotherapy for will depend on a number of things. These include the type of cancer you have and how much it has spread through your body. It also depends on the types of medicine you have, 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 your blood count (the number of various blood cells in your blood) and how well your kidneys and liver are working
  • blood pressure checks
  • an ECG or echocardiogram – to see how well your heart is working
  • an X-ray, CT scan, or MRI scan

A doctor or nurse may also check your height and weight to work out the right dose of chemotherapy for you.

You can take chemotherapy tablets at home, whereas you will usually need to have injections or infusions in hospital. However, some people may be able to have certain chemotherapy injections and infusions at home if services are available.

Your doctor will discuss with you what will happen before, during and after your chemotherapy. This is your opportunity to understand what will happen. You can help yourself by preparing questions to ask about the risks, benefits and any alternatives to chemotherapy. This will help you to be informed, so you can give your consent for the treatment to go ahead. You may be asked to do this by signing a consent form.

What happens during chemotherapy?

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.

Recovering from chemotherapy

Your doctor or nurse will advise you on what to expect after chemotherapy and any side-effects you may have. Some people manage to continue with their lives as usual during and after chemotherapy. A small number of people even feel better as the symptoms of their cancer decrease. However, for many people chemotherapy can have an impact on everyday life. In particular, tiredness often prevents people from working full-time or doing their usual levels of physical activity. Take things at your own pace and don’t overdo it, particularly after you have just had treatment (see our FAQs for more information)

What are the risks?

There are some risks associated with chemotherapy. We haven’t included the chance of these happening as they are specific to your treatment and differ for every person. Ask your doctor to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the treatment.

Chemotherapy doesn’t only target cancer cells, but any cells that divide rapidly. This includes those in your bone marrow and skin, cells that produce hair and those that line your mouth and digestive system. Damage to these healthy cells may produce possible side-effects, including:

  • tiredness
  • feeling sick or vomiting
  • diarrhoea
  • thinning of your hair or hair loss
  • sore mouth, mouth ulcers or changes in your sense of taste
  • numbness or ‘pins and needles’ in your hands and feet
  • breathlessness
  • skin changes – your skin may become dry or discoloured
  • changes in 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. Many side-effects can be controlled using other medicines. For example, sickness can be reduced by taking antisickness medicines alongside your chemotherapy.

The side-effects of chemotherapy, such as sickness and diarrhoea, can make the contraceptive pill less effective. 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 and for some women, it brings on early menopause. It’s important that you discuss these risks with your doctor before you start the treatment. You may be offered the opportunity to store eggs, embryos, ovarian tissue or sperm for future fertility treatment (see our FAQs for more information).

Treatment with 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 years later will vary depending on how much chemotherapy you have. Your doctor will give you more information about this.

Different chemotherapy medicines cause different side-effects, so it’s important to discuss your specific treatment with your doctor.

 

Produced by Rachael Mayfield-Blake, Bupa Health Information Team, June 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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Interested in having chemotherapy at home?

With Bupa Home Healthcare you could choose to have your chemotherapy at home. For more info call 01279 456 789.