Chemotherapy

• Cure your cancer.
• Prevent the cancer from growing or spreading (metastasizing).
• Ease symptoms and improve your quality of life (palliative care).
• Improve the effects of radiation treatment.
• Shrink a tumor before surgery.
• Rid the body of cancer cells that remain after having a tumor surgically removed.

• The type and stage of your cancer.
• How you respond to the chemotherapy.
• Your side effects.

What are the risks?

• Infection.
• Bleeding.
• Allergic reactions to medicines.

• The type of chemotherapy medicine used.
• Your dosage.
• How long the medicine is used for.
• Your overall health.

What happens before treatment?

• You will meet with your cancer care team to discuss:
  • Your treatment schedule.
  • How your chemotherapy medicine will be given.
  • Common side effects and how to prevent or treat them, which may include being given medicines.
• You may have blood tests.

What happens during treatment?

• As a pill or capsule.
• As a shot (injection).
• As a skin (topical) cream.
• As a special wafer that is put in your body where the cancer is. The wafer contains chemotherapy medicine.
• As an injection into the cerebrospinal fluid (CSF) in the brain or spinal cord (intraventricular or intrathecal chemotherapy).
• As an installation into the intraperitoneal (abdominal) cavity.
• Through a small, thin tube (catheter). There are different kinds of catheters. You might have one that:
  • Goes into a vein (intravenous catheter). An IV may be inserted into a vein each time you get a treatment or it can be used over several days.
  • Goes into a vein in your neck that leads to a large vein close to your heart (non-tunneled catheter). This catheter has a risk of infection, so it is used for only a short time.
  • Goes into a vein near your elbow (PICC line) and passes through into a large vein in your chest or upper arm. This may be used for weeks or months.
  • Connects to an implanted device (port) that is inserted under the skin of your chest (port catheter). The port is attached to a catheter that is passed through into a large vein in your chest or upper arm. The port may stay in place for months or years.
  • Goes through the skin of your chest and into a large vein close to your heart (tunneled catheter). This catheter may stay in place for months or years.

While you are receiving your chemotherapy medicine, your cancer care team may monitor your blood pressure, heart rate, breathing rate, and blood oxygen level (vital signs) and watch for any problems.

Some types of chemotherapy medicine are given only one time. Others are given for months, years, or for life.

What can I expect after treatment?

• Nausea and vomiting.
• Appetite loss or a change in the way foods taste.
• Constipation or diarrhea.
• Fatigue.
• Increased risk of infections, bruising, or bleeding.
• Hair loss.
• Mouth or throat sores.
• Tingling, pain, or numbness in the hands and feet.
• Dry, sensitive, itchy, or sore skin.
• Memory changes.

Follow these instructions at home:

General instructions

• If you get chemotherapy through an IV, PICC line, or port, check the site every day for signs of infection. Check for redness, swelling, pain, fluid, or warmth.
• Wash your hands frequently with soap and water. Scrub your hands for at least 20 seconds. If soap and water are not available, use an alcohol based hand sanitizer that contains at least 60% alcohol. Have other members of your household wash their hands often.
• Chemotherapy medicines leave the body through urine or stool (feces), but they can also be present in other body fluids including vomit, blood, vaginal fluids, and semen for up to 48 hours after receiving the medication. You must carefully follow some safety precautions to prevent harm to others while you are taking these medicines:
  • Wash laundry that comes in contact with your body fluids separately. This includes clothing, sheets, and towels. Machine wash laundry twice in hot water with regular laundry detergent.
  • Use a condom during vaginal, anal, and oral sex while you are taking chemotherapy medicines. These medicines can stay active in your body for at least 48 hours after you receive treatment. Ask your health care provider how long you should take precautions.
  • Practice good bathroom hygiene:
    • If possible, use a toilet separate from others in the household.
    • Always sit when using the toilet. Close the toilet seat lid before you flush.
    • Wash your hands thoroughly with soap and water for at least 20 seconds after each time you use the toilet.
• Keep all follow-up visits. This is important.

Eating and drinking

• Talk with a dietitian about what you should eat and drink during cancer treatment.
• Always wash fresh fruits and vegetables well before eating them.
• Drink enough fluid to keep your urine pale yellow.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Talk with your health care provider about all medicines, vitamins, and herbal or dietary supplements that you take. Some vitamins and supplements should not be taken during chemotherapy because they may interfere with the treatment.

Activity

• Get plenty of rest.
• Get regular exercise such as walking, gentle yoga, or tai chi.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Contact a health care provider if:

• You have soreness or redness at your injection, IV, or catheter site.
• You have a headache or stiff neck.
• You have a cough, cold, or flu-like symptoms.
• You have painful, frequent, foul-smelling, or bloody urine.
• You have constipation, diarrhea, or bloody stool.
• You have uncontrolled nausea or vomiting.
• You cannot eat because of mouth or throat pain.
• You have a skin rash or are bleeding or bruising easily or often.

Get help right away if:

• You have a fever. This is important.
• You have more redness, swelling, pain, fluid, or warmth near your injection, IV, or catheter site.
• You have bleeding that does not stop.
• You have a seizure.
• You have chest pain or difficulty breathing.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Chemotherapy is a way to treat cancer. It uses medicines to slow down or stop the growth of cancer.
• Before treatment, you and your cancer care team will discuss common side effects and how to manage them.
• The way that you will get chemotherapy medicines depends on your condition and the type of cancer being treated.
• Take over-the-counter and prescription medicines only as told by your health care provider.