Chemotherapy : What happens

Chemotherapy can be carried out in many different ways, depending on your circumstances.

Before treatment starts

Deciding to have treatment

If you're diagnosed with cancer, you'll be cared for by a team of specialists. Your team will recommend chemotherapy if they think it's the best option for you, but the final decision is yours.

Making this decision can be difficult. You may find it useful to write a list of questions to ask your care team.

For example, you may want to find out:

  • what the aim of treatment is – for example, is it being used to cure your cancer, relieve your symptoms or make other treatments more effective
  • about possible side effects and what can be done to prevent or relieve them
  • how effective chemotherapy is likely to be
  • whether any other treatments could be tried instead

If you agree with your team's recommendation, they'll start to plan your treatment once you've given your consent to treatment.

Tests and checks

Before chemotherapy begins, you'll have tests to check your general health and make sure the treatment is suitable for you.

The tests you'll have may include:

  • blood tests – to check things such as how well your liver and kidneys are working, and how many blood cells you have
  • X-rays and scans – to check the size of your cancer
  • measurements of your height and weight – to help your team work out the correct dose 

During treatment you'll also have tests to monitor your progress.

Your treatment plan

Chemotherapy involves several treatment sessions, typically spread over the course of a few months.

Before treatment starts, your care team will draw up a plan that outlines:

  • the type of chemotherapy you'll have
  • how many treatment sessions you'll need
  • how often you'll need treatment – after each treatment you'll have a break before the next session to allow your body to recover

Your treatment plan will depend on things such as the type of cancer you have and what the aim of treatment is.

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How chemotherapy is given

Into a vein (intravenous chemotherapy)

In most cases, chemotherapy is given directly into a vein. This is known as intravenous chemotherapy.

This usually involves medicine being given slowly from a bag of fluid that's attached with a tube to one of your veins.

This can be done using:

  • a cannula – a small tube that's placed into a vein in the back of your hand or lower arm for a short time
  • a peripherally inserted central catheter (PICC) line – a small tube inserted into a vein in your arm that usually stays in place for several weeks or months
  • a central line – similar to a PICC, but inserted into your chest and connected to one of the veins near your heart
  • an implanted port – a small device inserted under the skin that's kept in place until your treatment course finishes; medicine is given using a needle inserted into the device through the skin

The time it takes to have a dose of intravenous chemotherapy can range from several hours to several days.

You usually come into hospital for the treatment and go home when it's finished.

Tablets (oral chemotherapy)

Sometimes chemotherapy is given in tablets. This is known as oral chemotherapy.

You'll need to come into hospital at the start of each treatment session to get the tablets and have a check-up, but you can take the medicine at home.

Make sure you follow the instructions given by your care team. Taking too much or too little medicine may reduce its effectiveness and could be dangerous.

Contact your care team if you have any problems with your medicine, such as forgetting to take a tablet or being sick shortly after taking one.

Other types of chemotherapy

Less commonly, chemotherapy may be given as:

  • injections under the skin – known as subcutaneous chemotherapy
  • injections into a muscle – known as intramuscular chemotherapy
  • injections into the spine – known as intrathecal chemotherapy
  • a skin cream

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Issues during treatment

During chemotherapy treatment, there are a number of important things to bear in mind.

Pregnancy and contraception

Women should avoid becoming pregnant while having chemotherapy, as many chemotherapy medicines can cause birth defects.

Use a barrier method of contraception, such as a condom, and contact your care team immediately if you think you may have become pregnant.

Men having chemotherapy should use condoms throughout their course of treatment, even if their partner is taking contraception.

Cancer Research UK has more about sex and chemotherapy.

Taking other medicines

While you're having chemotherapy, check with your care team before you take any other medication – including over-the-counter medicines and herbal remedies.

Other medicines could react unpredictably with your chemotherapy medication, which may affect how well it works and could cause dangerous side effects.

Side effects

Chemotherapy can cause a range of unpleasant side effects.

Deciding to stop treatment

Some people decide that the benefits of chemotherapy aren't worth the poor quality of life, due to the side effects.

If you're struggling with the treatment and are having doubts about whether to continue, it's a good idea to speak to your care team.

Your team can give you advice about the likely benefits of continuing with treatment, but the final decision to continue or stop is yours.

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