Chemotherapy

Chemotherapy (chemo) is a common type of cancer treatment. It uses strong medicine to destroy cancer cells. It can be used on its own or combined with other cancer treatments like surgery, radiation or targeted therapy.

Your health care team will work with you to create a personalized chemotherapy treatment plan (alone or in combination with other treatments) based on your specific type of cancer, how far it has spread, your overall health and your treatment goal. 

How does chemotherapy work?

Chemotherapy targets cancer cells, which grow and spread quickly. It destroys the cancer cells and prevents them from growing and dividing uncontrollably. It travels throughout the body, targeting cancer cells even if they have spread far from where they started. 

When is chemotherapy used?

Chemotherapy can help treat both primary cancer (cancer that hasn’t spread) and metastatic cancer (cancer that has spread). It may be used in different stages of cancer treatment with different goals:

• Before surgery: Called neoadjuvant chemotherapy, this helps shrink tumors so they are easier to remove and can also prevent the cancer from coming back.
• After surgery: Called adjuvant chemotherapy, this targets any remaining cancer cells to prevent the cancer coming back.
• Primary treatment: Chemotherapy may be used alone when surgery or radiation isn’t an option.
• Along with radiation or targeted therapy: This may make cancer treatment more effective. Experts recommend using several treatment approaches at the same time for many people with cancer.
• Palliative care: Palliative chemo may be used to relieve symptoms and improve comfort and quality of life in advanced or metastatic cancers.

Types of chemotherapy

Different types of chemotherapy are designed to treat various types of cancer:

• Systemic chemotherapy: Travels through your bloodstream to target cancer all over the body
• Regional chemotherapy: Focuses on specific areas to maximize benefits and limit side effects
• Single-agent chemotherapy (mono): Uses one drug to treat the cancer
• Combination chemotherapy (combo): Uses multiple drugs for better results 

What to expect before chemotherapy starts

Your care team will guide you through the preparation process. Health care providers will:

• Evaluate your medical history.
• Run blood tests to choose the best approach. Blood tests help make sure your liver, kidneys and blood cells can handle the doses of chemotherapy.
• Place a port or catheter if needed to get the medication into your body more easily. 
• Talk to you about possible side effects like hair loss, fatigue or digestive issues.
• Prescribe medications to help manage potential chemotherapy side effects like nausea. 

How chemotherapy is given

There are several ways you may receive chemotherapy. Your health care team will recommend a method based on the type of cancer you have and your treatment plan:

• Intravenous (IV) chemotherapy: The medication is delivered through a vein. This is the most common method.
• Oral chemotherapy: You take pills or liquids at home.
• Injection chemotherapy: You get a shot into your muscle or skin.
• Intrathecal chemotherapy: Medication is delivered into the spinal fluid for cancers in the brain or spine.
• Intraperitoneal chemotherapy: For certain cancers, drugs are placed directly into your abdominal cavity. 
• Isolated limb perfusion: Heated chemotherapy is delivered directly to tumors in the arm or leg.
• Hepatic arterial infusion: Drugs delivered into liver arteries may be used for liver tumors.
• Topical chemotherapy creams may be applied for skin cancer. 

What chemotherapy treatment looks like

Chemotherapy treatment usually happens in cycles. You’ll have treatment sessions followed by rest periods that give your body time to recover. Your treatment schedule depends on your cancer type, the strength of the chemotherapy medication and how your body responds to it.

The length of a treatment session can range from a few minutes to several hours or even several days in a row depending on the type of chemotherapy and the dosage. When you’re receiving treatment, your care team will monitor you closely for any side effects and adjust your doses if needed.

Depending on your treatment plan, chemotherapy may be given at home, in a clinic, doctor’s office or in a hospital.

Common chemotherapy side effects

Chemotherapy destroys cancer cells, which divide quickly. But some healthy blood cells and other normal cells also divide quickly, which is why chemotherapy may cause side effects.

Short-term side effects

• Hair loss: This is usually temporary, with hair growing back after treatment is finished.
• Fatigue: This is very common and is caused by many factors such as damage to healthy cells, energy used for tissue repair, sleep disturbance or stress. 
• Nausea and vomiting: These side effects can usually be prevented or managed effectively with medications.
• Low blood cell counts: These will be monitored closely and may increase your risk of anemia, infections and bruising.
• Mouth sores: These can make it difficult for you to eat.

Long-term side effects

Some chemotherapy drugs may cause nerve damage, heart problems, fertility issues or in some cases, even cancer years later. Your health care provider will explain any risks before you start any treatment.

Managing side effects and supporting your immune system

Your care team will support you and help you manage side effects:

• Medications: Different drugs can help reduce nausea, boost your blood cell counts, help prevent infections and relieve pain.
• Diet and hydration: Eating healthy foods and drinking plenty of fluids can support your energy levels and immune function. 
• Exercise and rest: Light activity helps with fatigue, but rest is also important.
• Regular blood tests: Testing can show how well your organs are functioning and whether you need to adjust your doses of chemotherapy.

Life after chemotherapy

Once chemotherapy is finished, you may need follow-up care: 

• Blood tests and imaging scans: Testing can monitor your recovery and watch for any signs of the cancer returning. 
• Managing side effects: It may take a while for side effects like fatigue or nerve damage to improve.
• Support groups and survivorship programs: Support can help you readjust to daily life after cancer treatment.

Why choose Banner MD Anderson Cancer Center?

At Banner MD Anderson, we provide compassionate, leading-edge care that helps you overcome cancer with confidence. You can count on our team of experts for personalized cancer care, plus you’ll have access to advanced treatments and clinical trials. Both you and your family can count on our support throughout your journey.