Your Complete Chemotherapy Guide: What to Expect, Side Effects, and Self-Care

Overview

Chemotherapy (often shortened to 'chemo') is a type of cancer treatment that uses powerful, targeted medications to kill fast-growing cancer cells in your body. It is one of the most common cancer treatments, and may be used on its own or combined with other therapies like surgery, radiation, or immunotherapy. Chemo can be used to cure cancer, shrink tumors before surgery or radiation, kill remaining cancer cells after other treatments to prevent recurrence, or relieve symptoms and extend life for people with advanced cancer.

Signs & Symptoms

Chemotherapy side effects happen because the medications also affect healthy fast-growing cells in your body, such as hair follicles, bone marrow, and the lining of your mouth and digestive tract. Common side effects include:

• Fatigue and weakness
• Nausea, vomiting, or loss of appetite
• Hair loss or thinning
• Mouth sores or dry mouth
• Increased risk of infections (due to lower white blood cell counts)
• Easy bruising or bleeding (due to lower platelet counts)
• Numbness or tingling in the hands and feet (peripheral neuropathy)
• Skin changes, such as dryness, rash, or sensitivity to the sun

Causes & Risk Factors

Side effects from chemotherapy are caused by the medication’s impact on healthy, fast-dividing cells in your body, as well as its effect on cancer cells. You may have a higher risk of severe side effects if you are older, have pre-existing health conditions (such as kidney disease, diabetes, or heart disease), take other medications that interact with chemo, receive high doses of chemotherapy, or have a weakened immune system before starting treatment.

Diagnosis

To determine if chemotherapy is right for you, your oncology team will first confirm your cancer diagnosis through tests like a biopsy (removing a small sample of tissue to check for cancer cells), imaging scans (CT, MRI, or PET scans that create detailed pictures of the inside of your body), and blood work. They will also stage your cancer to see how far it has spread, and run specialized tests to check if your cancer cells have markers that make them likely to respond to chemotherapy. Your team will also review your overall health, age, and personal preferences to create a personalized treatment plan.

Treatment & Management

Chemotherapy is administered in many ways, depending on the type of cancer and medication you are receiving. Common administration methods include:

• Intravenous (IV) infusion: Medication is delivered directly into a vein through a needle or port, usually in a hospital, clinic, or infusion center
• Oral chemotherapy: Pills or capsules you take at home
• Injections: Medication is injected into a muscle, under the skin, or directly into the cancer
• Topical chemotherapy: A cream applied directly to the skin for certain skin cancers
• Regional chemotherapy: Medication is delivered directly to the area of the body with cancer, such as the abdomen (for ovarian cancer) or the fluid around the brain and spinal cord

Your care team will give you medications to manage side effects before, during, and after chemo sessions. Common supportive medications include anti-nausea drugs, pain relievers, medications to boost white blood cell counts, and creams or mouth rinses to treat mouth sores. You will also have regular blood tests and check-ups during treatment to monitor how your body is responding and adjust your plan as needed.

Living With It

Going through chemotherapy can be challenging, but there are steps you can take to make your treatment easier and improve your quality of life:

• Rest when you need to: Fatigue is common, so listen to your body and avoid overexertion
• Eat small, frequent meals: Choose bland, easy-to-digest foods if you have nausea, and stay hydrated by drinking water, broth, or electrolyte drinks
• Practice gentle hygiene: Use a soft toothbrush and mild soaps to avoid irritating mouth sores or sensitive skin
• Stay connected: Talk to friends, family, or a support group about your feelings; many cancer centers offer counseling services
• Avoid sick people: Wash your hands often, avoid crowded places, and stay away from people who are ill to reduce your risk of infection