If you're like many cancer patients, the thought of chemotherapy may provoke anxiety over potentially facing weeks of intense nausea and vomiting, diarrhea, fatigue and transient hair loss. But these preconceived ideas about chemotherapy aren’t entirely accurate. Many cancer patients do experience some side effects of chemotherapy—both short-term and long-term—but others experience very few. Cancer treatment is improving and changing rapidly. Many more chemotherapy drug options are available than ever before. These drugs may be used in combination with one another or with other innovative treatments, so they may be just one piece of your cancer care. Chemotherapy drugs don’t all come with the risk of the same side effects. More (and better) medications and supportive therapies are available to help patients prevent and manage potential side effects. Many patients are surprised to find that not everyone experiences hair loss, and some patients actually feel better after starting chemotherapy when it causes the disease to regress. Can you refuse chemotherapy? Yes, you can refuse chemotherapy. Your doctor presents what he or she feels are the most appropriate treatment options for your specific cancer type and stage while also considering your overall health, but you have the right to make final decisions regarding your care. To help you make an informed decision about the benefits and risks of chemotherapy, this article addresses: If you have questions about chemotherapy or other types of cancer treatment options, or if you’d just like to talk with someone at City of Hope® about your cancer care, call us or chat online with a member of our team. How is chemotherapy used in cancer treatment today? How chemotherapy is used in treatment depends on the type and stage of the cancer and how aggressive it is. Some cancers, such as an indolent lymphoma or prostate cancer, may not need immediate treatment, but chemotherapy may eventually be recommended if the cancer progresses. While chemotherapy may kill rapidly growing cancer cells, the downside is that it may also damage healthy cells in the process. This is often the cause of some common side effects of chemotherapy. For example, chemotherapy may temporarily decrease the production of red and white blood cells in the bone marrow, which may lead to anemia, fatigue and a suppressed immune system. Certain drugs—not all— damage cells that help hair grow, which may lead to temporary hair loss. Damage to cells in the digestive system may cause vomiting, diarrhea or constipation. Not everyone experiences the same side effects to the same degree. The side effects you may experience depend on the type of chemotherapy you receive, the combination of drugs you’re treated with, whether you have any other chronic illnesses, the medications you may be taking for other conditions and how active or fit you are going into treatment. Your oncologist considers these issues when determining which treatment options may benefit you and whether you can tolerate treatment. Common short-term side effects include: Long-term side effects are less common, but they include those listed below. Peripheral neuropathy: You may experience numbness or tingling in your fingers and/or toes. It often improves after treatment ends, but sometimes, it doesn’t entirely resolve. Heart problems: Some drugs have a higher risk of causing cardiac problems. Patients receiving these drugs should be monitored with electrocardiograms (EKG or ECG) and echocardiograms (echo) regularly.

No matter what type of cancer it is or how healthy a person is, chemotherapy will have some side effects. The severity or the nature of the side effects will vary but anyone being administered a chemo will suffer from some problems. The most common problem is fatigue. A person will feel tired or exhausted after every session of chemotherapy. This fatigue may last for a few minutes, a few hours or it can last for days. That depends on the health and lifestyle compulsions of the person. One may not be able to work or even do the normal chores if the fatigue or weariness is unbearable. 3. Suffer From Discomfort Discomfort is very common as well. It is difficult to define or explain this discomfort because people experience it differently. Some people feel uncomfortable, they don’t like to lie down, sitting may not be convenient and one may not like anything around. Some people feel nauseous, vomiting tendency is very common and one may even struggle to breathe. There are medications that can control or reduce the severity of such symptoms. Some people can get complete relief from such symptoms with the help of prescribed medications but these side effects are common and it is rare for someone to not experience them at all. 4. Not Available Everywhere Chemotherapy isn’t always available everywhere. Someone living far away from the nearest hospital or healthcare facility where chemo can be administered and a doctor can be consulted with will have to travel long distances and on many occasions in a month. This is not a desirable approach to treatment. Inactivity in the brain or temporary fogging of cognitive senses is a relatively common side effect of chemotherapy. 8. Daily Life Impacted Eating, exercising and sleeping may be hampered due to chemotherapy. Appetite and taste would be substantially affected. Ability to exercise will be curtailed and sleeping may be very uncomfortable at times. One may also get very little sleep while undergoing chemo. 9. Hair Loss Hair loss is another very common side effect. The skin becomes more sensitive to the sun. Many of these side effects can be managed with adequate planning and guidance from the doctor. From using certain medicines to being prepared to handle the mental and physical impact of chemotherapy, there are ways to overcome certain cons of chemotherapy. Chemotherapy is not a simple or an ordinary medical treatment. The procedure or the treatment plan itself is complicated and would be influenced by several factors. Chemo or chemotherapy is a treatment for many types of cancer where medications or drugs are used to target and destroy cancer cells. Cancer is caused when cancerous cells start to grow, divide and regenerate rampantly without any order and start to destroy healthy cells or noncancerous cells. Hence, to cure or to manage cancer the cancerous cells must be destroyed. That is what chemotherapy does or aims to do. In some cases, chemotherapy can destroy all cancer cells in the human body and as a result a person can be completely cured of cancer. There is a possibility of the cancerous cells growing again but then chemo is recommended as an ongoing treatment precisely to counter that recurrence.

Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body, they can affect normal, healthy cells that are fast-growing, too. Damage to healthy cells causes side effects. Side effects are not always as bad as you might expect, but it's normal to worry about this part of cancer treatment. The normal cells most likely to be damaged by chemo are: Some chemo drugs can damage cells in the heart, kidneys, bladder, lungs, and nervous system. Sometimes, you can take medicines with the chemo to help protect your body’s normal cells. There are also treatments to help relieve side effects. Doctors try to give chemo at levels high enough to treat cancer, while keeping side effects at a minimum. They also try to avoid using multiple drugs that have similar side effects. What do I need to know about side effects? Every person doesn’t get every side effect, and some people get few, if any. The severity of side effects (how bad they are) varies greatly from person to person. Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them. Your doctor may give you medicines to help prevent certain side effects before they happen. Some chemo drugs cause long-term side effects, like heart or nerve damage or fertility problems. Still, many people have no long-term problems from chemo. Ask your doctor if the chemo drugs you’re getting have long-term effects. While side effects can be unpleasant, they must be weighed against the need to kill the cancer cells. Be sure to talk to your cancer care team about which side effects are most common with your chemo, how long they might last, how bad they might be, and when you should call the doctor’s office about them. How long do side effects last? Many side effects go away fairly quickly, but some might take months or even years to go away completely. These are called late effects. Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later. People often become discouraged about how long their treatment lasts or the side effects they have. If you feel this way, talk to your cancer care team. You may be able to change your medicine or treatment schedule. They also may be able to suggest ways to reduce any pain and discomfort you have. What are common side effects of chemo? Most people worry about whether they’ll have side effects from chemo, and, if so, what they’ll be like. Here are some of the more common side effects caused by chemotherapy: Chemotherapy can cause side effects. Learn about the common side effects, how long they might last, and what can be done to prevent to lessen them.

“Chemotherapy kills bad cells and good cells in the body,” says Iheme. “When chemotherapy kills the good cells, that’s when side effects occur.” Some common side effects from chemotherapy include: Low blood count: A low red blood cell count can put you at risk for conditions like anemia and infections. The side effects from chemotherapy tend to be the worst the day after it’s administered. “If you’re on a strong chemo regimen, usually the day after is when you’ll experience the worst symptoms,” says Iheme. “By worst, I mean you’ll experience the most fatigue, weakness and nausea. Normally, three or four days after chemo, your symptoms will get better.” Most side effects last just for the duration of your chemotherapy treatment. However, some side effects, such as fatigue, neuropathy, hair loss and heart damage, can last a lifetime. “But that’s rare,” says Iheme. “The good news for symptoms like fatigue is that a few weeks or months after you complete chemo, your body gets used to not receiving treatment and your fatigue will start to go away.” How can chemotherapy side effects be managed? Most times, the side effects from chemotherapy can be managed with medication or adjustments to your chemo dosage. Nausea, vomiting and fatigue can be managed with medication. To manage neuropathy, physicians will often lessen a patient’s dosage and prescribe medications to help restimulate the growth of your nerves. “That’s why it’s important to see your physician before every chemo cycle, especially if you’re on a very strong chemo regimen,” says Iheme. “We have to know if your symptoms get worse, so we can cut your dosage, if necessary.” Patients should disclose their full medical history before beginning chemotherapy. “We tailor your chemo treatments based on your current health status,” says Iheme. “We have to make sure we administer the right dosage – not giving you too much or too little – to prevent long-term side effects.” For example, diabetic patients can receive chemotherapy, but it’s done with caution to prevent more nerve damage and other side effects that are more common in diabetics.

Chemotherapy drugs kill cancer cells by preventing them from growing and dividing. But because healthy cells also create new cells, chemotherapy can harm them, too. This is what causes many of the side effects to chemotherapy treatment. What Can Chemotherapy Do? Chemotherapy can treat many different cancers. It can work in your body to: We use chemotherapy: Chemo travels throughout your whole body. This has both positive and negative effects: Your doctor will need to weigh these factors when choosing your treatment. How Do You Get Chemo? Usually, you get chemo drugs through an IV. Also called infusion therapy, we insert a soft tube, or catheter, through a large vein. You can also get chemo: You can get chemo at an infusion center, hospital, or at home. Treatment can take from several minutes to hours. Sometimes we can use a small pump that gives a continuous infusion of medicine over several days or weeks. Some chemo drugs can’t go through a regular IV. If so, you'll need a permanent central line IV or port. If you need long-term therapy, a central line IV makes it easier to give you chemo on a regular basis. You may have just a few side effects or you might not have any. What you feel and how severe it is depends on the kind of chemotherapy you get, the dosage, and how your body reacts. The most common side effects include: You don't have to suffer without relief. We have support teams, groups, and tips for managing side effects with self-care. Chemotherapy drugs kill cancer cells by preventing them from growing and dividing. Learn what it can do, the pros & cons, possible side effects, & more.

Some chemotherapy side effects are mild and treatable, while others can cause serious complications. Chemotherapy is used to kill cancer cells in people with cancer. There are a variety of settings in which chemotherapy may be used in people with cancer: To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer. After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy. To prepare you for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy. To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy. Some chemotherapy drugs have proved useful in treating other conditions, such as: Bone marrow diseases. Diseases that affect the bone marrow and blood cells may be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is often used to prepare for a bone marrow transplant. Immune system disorders. Lower doses of chemotherapy drugs can help control an overactive immune system in certain diseases, such as lupus and rheumatoid arthritis. There is a problem with information submitted for this request. Side effects of chemotherapy drugs can be significant. Each drug has different side effects, and not every drug causes every side effect. Ask your doctor about the side effects of the particular drugs you'll receive. Common side effects of chemotherapy drugs include: Many of these side effects can be prevented or treated. Most side effects subside after treatment ends. Chemotherapy drugs can also cause side effects that don't become evident until months or years after treatment. Late side effects vary depending on the chemotherapy drug but can include: Ask your doctor if you have a risk of any late side effects. Ask what signs and symptoms you should be aware of that may signal a problem. How you prepare for chemotherapy depends on which drugs you'll receive and how they'll be administered. Your doctor will give you specific instructions to prepare for your chemotherapy treatments. You may need to: Have a device surgically inserted before intravenous chemotherapy. If you'll be receiving your chemotherapy intravenously — into a vein — your doctor may recommend a device, such as a catheter, port or pump. The catheter or other device is surgically implanted into a large vein, usually in your chest. Chemotherapy drugs can be given through the device. Undergo tests and procedures to make sure your body is ready to receive chemotherapy. Blood tests to check kidney and liver functions and heart tests to check for heart health can determine whether your body is ready to begin chemotherapy. If there's a problem, your doctor may delay your treatment or select a different chemotherapy drug and dosage that's safer for you. See your dentist.

Chemotherapy has been proven to effectively attack cancer cells, but it can cause serious side effects that can severely impact your quality of life. You should weigh these side effects against the risk of going untreated when deciding if chemotherapy is right for you. Chemotherapy is primarily used to: If you’ve undergone surgery to remove a cancerous tumor, such as a lumpectomy for breast cancer, your oncologist may recommend chemotherapy to ensure that any lingering cancer cells are killed, as well. Chemotherapy is also used to prepare you for other treatments. It could be used to shrink a tumor so it can be surgically removed, or to prepare you for radiation therapy. In the case of late-stage cancer, chemotherapy may help relieve pain. Besides treatment for cancer, chemotherapy may be used to prepare people with bone marrow diseases for a bone marrow stem cell treatment, and it may be used for immune system disorders. Doses much lower than those used to treat cancer can be used to help disorders in which the body’s immune system attacks healthy cells, like lupus or rheumatoid arthritis. Chemotherapy is designed to kill cells that divide quickly. While cancer cells are the kind that divide quickly, other cells in your body do this, as well. Cells in the following areas can be adversely affected by chemotherapy: Because of this, the side effects of chemotherapy include: Your doctor can help you manage these side effects with medications, lifestyle tips, and more. Most side effects of chemotherapy subside when treatment is over. But there’s also the risk of long-lasting effects that may develop even years after treatment, depending on the type of chemotherapy used. These effects could include damage to the: There’s also the chance of developing a second cancer as a result of chemotherapy. Before beginning treatment, talk to your doctor about the possible risks and what symptoms you should be aware of. As chemotherapy is a serious treatment for a serious condition, it’s important to plan ahead before beginning therapy. Your doctor and hospital staff will help you anticipate the potential problems associated with treatment. Before you begin therapy, you’ll undergo a series of tests to help determine if you’re healthy enough for chemotherapy. This will include examinations of your heart and blood tests to determine the health of your liver. These tests can also help guide your doctor in deciding which types of chemotherapy to use in your treatment. Your doctor may also recommend that you visit your dentist before beginning treatment. Since chemotherapy affects your body’s ability to heal, any infection in your gums or teeth could potentially spread throughout your body. Your doctor may install a port if you’re getting chemotherapy through an intravenous (IV) line. A port is a device that’s implanted in your body, typically in your chest near your shoulder.

Chemotherapy drugs can cause side effects, but they don’t have to take over your life. If you're about to start cancer treatment, talk to your medical team about the possible side effects and how you can feel better. This is common during chemotherapy. Some people feel just a little low in energy, while others feel wiped out. Depending on how tired you are, your doctor might give you medicines to treat other side effects that can make you feel tired, like depression, pain, and anemia. Studies have shown these drugs can boost energy in people with cancer. Aside from taking medicines, you can practice these habits to fight fatigue: Don't try to do everything at once or by yourself. If your family or friends ask what they can do for you, get their help with shopping, cooking, or other chores. Adjust your work schedule if you need to. Eat a healthy diet of fruits, vegetables, whole grains, and lean protein. Exercise, even if it's just a little bit every day. Drink plenty of water. Take short naps if you need to, but not too close to bedtime. These can happen before, during, or after treatment. The good news is that a lot of drugs can ease upset stomach. Your doctor will probably recommend specific ones based on the kind of chemotherapy you’re getting. You might need to try a few nausea medicines before you find the right one for you. Or you might need to take more than one. Other tips: Eat several small meals throughout the day rather than three big ones. Drink liquids an hour before you eat rather than during the meal. Sip clear liquids all day long. Plan your eating around your chemo. For some people, a snack right before a session helps keep nausea away. Others do better on an empty stomach. Chemotherapy kills platelets, which help your blood clot. You have higher chances of bleeding and bruising, even if you haven't bumped yourself. Platelet transfusions can help. So can injections of drugs that help your body make more blood cells. To prevent bleeding and bruising: Use an electric shaver instead of a razor. If you need to blow your nose, do it gently. Don't play rough sports. Don't use dental floss or toothpicks, which can make your gums bleed. You might get this blood condition during chemo because some drugs can kill cells that form red blood cells in the bone marrow. It can also be a major cause of fatigue during treatment. Your doctor might recommend iron supplements, vitamin B12, or folic acid supplements. They may tell you to try a few treatments at once. If your anemia is severe, you could need a blood transfusion. In some cases, your doctor might prescribe drugs that trigger your body to make more red blood cells. Foods rich in iron such as spinach, red meat, and beans might also help boost your energy. Chemo also kills white blood cells, which fight germs. This can make you more likely to get an infection. Let your doctor know right away if you notice signs of a possible infection such as a fever, a sore throat, a cough, or swollen red skin. They can give you medicines to fight it.

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Cancer cells often grow quickly, and chemotherapy drugs can kill fast-growing cells. However, these drugs can also affect normal, healthy cells. Side effects can occur when healthy cells are damaged during treatment. Healthy cells that are more likely to be affected by chemotherapy include: Patients experiencing chemotherapy side effects should talk to their care team. They may be able to offer treatments to help alleviate some of the more severe symptoms. These treatments may include medications or complementary therapies. What are the side effects of chemotherapy? Chemotherapy can sometimes be utilized to prepare the body for a stem cell transplant or cellular therapies such as CAR T-cell therapy and tumor-infiltrating lymphocyte therapy. Depending on the type of cancer and how fast it is growing, chemotherapy may involve a single drug or a combination of two or more drugs. The side effects of chemotherapy depend on the specific drug or drugs a patient receives. The duration and severity of chemotherapy side effects differ from patient to patient. Most are temporary and will disappear once treatment has ended. The most common side effects of chemotherapy include: Low levels of certain blood cells. This can lead to an increased risk of bleeding and infection. Cognitive issues, such as memory problems and trouble concentrating. This side effect is often called chemobrain. Many of these side effects can be prevented or treated. While most side effects subside after treatment ends, chemotherapy drugs may also cause side effects that don't develop until months or years after treatment. These side effects can include: Risk of a second cancer. Fortunately, the benefits of chemotherapy far outweigh the risks. While many side effects are temporary, others may indicate serious problems. Contact your care team if you have any of the following symptoms during chemotherapy treatment: Learn more about chemotherapy.

What are the Advantages of Chemotherapy? Effective Cancer Treatment: Chemotherapy is highly effective in treating many types of cancer. It can shrink tumours, slow their growth, and, in some cases, completely eliminate cancer cells from the body, leading to remission or cure. Systemic Treatment: Unlike localised treatments such as surgery and radiation, chemotherapy is a systemic treatment that can reach cancer cells throughout the body. This is particularly beneficial for cancers that have spread (metastasized) to multiple areas. Combination Therapy: Chemotherapy can be combined with other treatments such as surgery, radiation therapy, and targeted therapy. This multi-faceted approach can improve overall treatment efficacy and outcomes. Prevention of Recurrence: By targeting and killing any remaining cancer cells after primary treatment, chemotherapy can reduce the risk of cancer recurrence, helping to ensure long-term remission. Palliative Care: For advanced or terminal cancer, chemotherapy can provide significant palliative benefits by reducing symptoms, shrinking tumours, and improving the quality of life. It can help manage pain and other cancer-related symptoms. Treatment for Blood Cancers: Chemotherapy is particularly effective for treating blood cancers such as leukaemia, lymphoma, and multiple myeloma. It can target and destroy cancerous cells in the blood and bone marrow. Reduction of Tumour Size: In cases where surgery is initially not feasible, neoadjuvant chemotherapy can shrink tumours to a manageable size, making surgical removal possible and more effective. Adjunctive Benefits: Chemotherapy can also help control cancer that has spread to other parts of the body, maintaining the patient’s health and prolonging survival even when a cure is not possible. Chemotherapy can be categorised based on the purpose and timing of the treatment in relation to other cancer therapies. Common types of chemotherapy include: Adjuvant chemotherapy is administered after the primary treatment, usually surgery, to eliminate any remaining cancer cells and reduce the risk of cancer recurrence. It is commonly used for cancers such as breast, colon, and ovarian cancer. For example, after a tumour is surgically removed, chemotherapy may be used to target any microscopic cancer cells that might still be present. The primary goal of curative chemotherapy is to eradicate cancer and achieve a complete cure.