Chemotherapy Can Cause Side Effects
Chemotherapy not only kills fast-growing cancer cells, but also kills or slows the growth of healthy cells that grow and divide quickly. Examples are cells that line your mouth and intestines and those that cause your hair to grow. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss. Side effects often get better or go away after you have finished chemotherapy.
The most common side effect is fatigue, which is 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
- Asking for help with meals and childcare on the day of and at least one day after chemotherapy
There are many ways you can help manage chemotherapy side effects. For more information, see the section on side effects.
What to Expect When Receiving Chemotherapy
How Chemotherapy Is Given
Chemotherapy may be given in many ways. Some common ways include:
The chemotherapy comes in pills, capsules, or liquids that you swallow
- Intravenous (IV)
The chemotherapy goes directly into a vein
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
The chemotherapy is injectedinto the space between the layers of tissue that cover the brain and spinal cord
- Intraperitoneal (IP)
The chemotherapy goes directly into the peritoneal cavity, which is the area in your body that contains organssuch as your intestines, stomach, and liver
- Intra-arterial (IA)
The chemotherapy is injected directly into the arterythat leads to the cancer
The chemotherapy comes in a cream that you rub onto your skin
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. IV chemotherapy may also be given through catheters or ports, sometimes with the help of a pump.
A catheter is a thin, soft tube. A doctor or nurse places one end of the catheter in a large vein, often in your chest area. The other end of the catheter stays outside your body. Most catheters stay in place until you have finished your chemotherapy treatments. Catheters can also be used to give you other drugs and to draw blood. Be sure to watch for signs of infection around your catheter. See the section about infectionfor more information.
A port is a small, round disc that is placed under your skin during minor surgery. A surgeonputs it in place before you begin your course of treatment, and it remains there until you have finished. A catheter connects the port to a large vein, most often in your chest. Your nurse can insert a needle into your port to give you chemotherapy or draw blood. This needle can be left in place for chemotherapy treatments that are given for longer than one day. Be sure to watch for signs of infection around your port. See the section about infection for more information.
Pumps are often attached to catheters or ports. They control how much and how fast chemotherapy goes into a catheter or port, allowing you to receive your chemotherapy outside of the hospital. Pumps can be internal or external. External pumps remain outside your body. Internal pumps are placed under your skin during surgery.
How Your Doctor Decides Which Chemotherapy Drugs to Give You
There are many different chemotherapy drugs. Which ones are included in your treatment plan depends mostly on:
- The type of cancer you have and how advanced it is
- Whether you have had chemotherapy before
- Whether you have other health problems, such as diabetesor heart disease
Where You Go for Chemotherapy
You may receive chemotherapy during a hospital stay, at home, or as an outpatient at a doctor’s office, clinic, or hospital. Outpatient means you do not stay overnight. No matter where you go for chemotherapy, your doctor and nurse will watch for side effects and help you manage them. For more information on side effects and how to manage them, see the section on side effects.
How Often You 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
- Whether chemotherapy is used to:
- Cure your cancer
- Control its growth
- Ease symptoms
- The type of chemotherapy you are getting
- How your body responds to the 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 chemotherapy every day for 1 week followed by 3 weeks with no chemotherapy. These 4 weeks make up one cycle. The rest period gives your body a chance to recover and build new healthy cells.
Missing a Chemotherapy Treatment
It is best not to skip a chemotherapy treatment. But, sometimes your doctor may change your chemotherapy schedule if you are having certain side effects. If this happens, your doctor or nurse will explain what to do and when to start treatment again.
How Chemotherapy May Affect You
Chemotherapy affects people in different ways. How you feel depends on:
- The type of chemotherapy you are getting
- The dose of chemotherapy you are getting
- Your type of cancer
- How advanced your cancer is
- How healthy you are before treatment
Since everyone is different and people respond to chemotherapy in different ways, your doctor and nurses cannot know for sure how you will feel during chemotherapy.
How Will I Know If My Chemotherapy Is Working?
You will see your doctor often. During these visits, she will ask you how you feel, do a physical exam, and order medical tests and scans. Tests might include blood tests. Scans might include MRI, CT, or PET scans.
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.
Special Diet Needs
Chemotherapy can damage the healthy cells that line your mouth and intestines and cause eating problems. Tell your doctor or nurse if you have trouble eating while you are receiving chemotherapy. You might also find it helpful to speak with a dietitian.
Working during Chemotherapy
Many people can work during chemotherapy, as long as they match their work schedule to how they feel. Whether or not you can work may depend on what kind of job you have. If your job allows, you may want to see if you can work part-time or 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.