What is Chemotherapy? Purpose, Procedure & Results

Chemotherapy is a cancer treatment that uses powerful medicines to destroy cancer cells throughout your body. These medications work by targeting cells that grow and divide quickly, which is a key characteristic of cancer cells. While the word "chemotherapy" might feel overwhelming, understanding what it involves can help you feel more prepared and informed about this important treatment option.

What is chemotherapy?

Chemotherapy is a systemic treatment that uses anti-cancer drugs to fight cancer cells wherever they may be in your body. Unlike surgery or radiation that targets specific areas, chemotherapy travels through your bloodstream to reach cancer cells that have spread or might spread to different parts of your body.

The medicines used in chemotherapy are called cytotoxic drugs, which means they're designed to damage or kill cells. These drugs are particularly effective against cancer cells because cancer cells divide much faster than most normal cells in your body. However, some healthy cells that also divide quickly can be affected, which is why side effects occur.

There are over 100 different chemotherapy drugs available today. Your oncologist will choose the specific combination that works best for your type of cancer, your overall health, and your treatment goals. Some people receive just one drug, while others get a combination of several medications.

Why is chemotherapy done?

Chemotherapy serves several important purposes in cancer treatment, and your doctor will recommend it based on your specific situation. The main goal is always to give you the best possible outcome while maintaining your quality of life.

Your oncologist might recommend chemotherapy to cure your cancer completely. This approach, called curative chemotherapy, aims to eliminate all cancer cells from your body. It's often used when cancer is caught early or when it responds well to treatment.

Sometimes chemotherapy is used to control cancer growth and spread. This approach, known as palliative chemotherapy, helps manage symptoms and can significantly extend your life even when a complete cure isn't possible. Many people live fulfilling lives for years with this type of treatment.

Chemotherapy can also shrink tumors before other treatments. This neoadjuvant approach makes surgery easier or radiation more effective. Conversely, adjuvant chemotherapy is given after surgery or radiation to eliminate any remaining cancer cells that might not be visible.

What is the procedure for chemotherapy?

Chemotherapy can be given in several different ways, and your treatment team will choose the method that works best for your specific medication and situation. Most people receive chemotherapy as an outpatient treatment, meaning you can go home the same day.

The most common method is intravenous (IV) chemotherapy, where medication flows directly into your bloodstream through a thin tube. This might be given through a temporary IV in your arm or through a more permanent device like a port, which is a small disc placed under your skin with a tube leading to a large vein near your heart.

Some chemotherapy medications come as pills or capsules that you take at home. This oral chemotherapy is just as powerful as IV treatment and requires careful attention to timing and dosing. Your pharmacy and medical team will provide detailed instructions about when and how to take these medications.

Less common methods include injections into muscles, under the skin, or directly into specific body areas like the spinal fluid or abdomen. Your oncologist will explain exactly which method you'll receive and why it's the best choice for your treatment.

How to prepare for your chemotherapy?

Preparing for chemotherapy involves both practical steps and emotional preparation. Your healthcare team will guide you through everything you need to know, but taking an active role in your preparation can help you feel more confident and ready.

Before your first treatment, you'll have several appointments and tests. Your doctor will order blood tests to check your organ function, especially your liver and kidneys, since they process chemotherapy drugs. You might also have heart tests if you're receiving medications that can affect your heart.

Your medical team will discuss potential side effects and give you medications to help manage them. You'll receive anti-nausea medications to take before and after treatment, and your doctor might prescribe other supportive care medications. Stock up on these at home before your first treatment.

Consider practical preparations that can make your treatment days easier. Arrange for someone to drive you to and from treatments, especially for the first few sessions until you know how you'll feel. Prepare comfortable clothes, snacks, entertainment like books or tablets, and a water bottle for treatment days.

Taking care of your overall health before treatment begins can help your body handle chemotherapy better. Eat nutritious foods, get adequate rest, and stay hydrated. If you have dental problems, address them before treatment since chemotherapy can affect your mouth and make dental procedures more complicated.

How to read your chemotherapy results?

Your response to chemotherapy is measured through various tests and scans rather than a single number or result. Your oncologist will use multiple methods to determine how well your treatment is working, and these results guide decisions about continuing, changing, or stopping treatment.

Blood tests provide valuable information about your treatment response. Tumor markers are proteins that some cancers produce, and decreasing levels often indicate that treatment is working. Your complete blood count shows how chemotherapy is affecting your bone marrow, which produces your blood cells.

Imaging tests like CT scans, MRIs, or PET scans show physical changes in your tumors. Your doctor will compare these images to scans taken before treatment started. Shrinking tumors or stable disease (meaning tumors aren't growing) are positive signs that treatment is effective.

Your oncologist will also assess how you're feeling and functioning. Improvements in symptoms like pain, fatigue, or breathing problems can indicate that treatment is helping. Your doctor considers all these factors together rather than relying on any single test result.

Complete response means no evidence of cancer can be detected in tests and scans. Partial response indicates significant tumor shrinkage, usually by at least 30%. Stable disease means tumors haven't grown or shrunk significantly, while progressive disease means cancer is growing despite treatment.

How to manage chemotherapy side effects?

Managing chemotherapy side effects is an essential part of your treatment plan, and your healthcare team has many effective strategies to help you feel as comfortable as possible. Every person's experience is different, and many people tolerate chemotherapy much better than they initially expected.

Nausea and vomiting are among the most common concerns, but modern anti-nausea medications are highly effective. Your doctor will prescribe medications to take before, during, and after treatment. Eating small, frequent meals and avoiding strong odors can also help. Ginger tea or ginger candies provide natural relief for some people.

Fatigue is another common side effect that can range from mild tiredness to exhaustion. Listen to your body and rest when you need to, but gentle exercise like short walks can actually help boost your energy levels. Plan your activities for times when you typically feel best, often in the morning.

Hair loss occurs with many chemotherapy drugs, though not all. If you're likely to lose your hair, consider getting it cut short before treatment begins. Some people choose wigs, scarves, or hats, while others embrace their baldness. Your hair will grow back after treatment ends, though it might initially have a different texture or color.

Chemotherapy can temporarily lower your white blood cell count, making you more susceptible to infections. Wash your hands frequently, avoid crowds when possible, and contact your doctor immediately if you develop a fever, chills, or signs of infection. Your medical team will monitor your blood counts closely.

What is the best chemotherapy regimen?

The best chemotherapy regimen is highly individualized and depends on many factors specific to you and your cancer. There's no single "best" chemotherapy because what works excellently for one person might not be the right choice for another.

Your oncologist considers your cancer type, stage, and genetic characteristics when selecting treatment. Different cancers respond to different drugs, and newer genetic testing can help identify which medications are most likely to work for your specific cancer. Your age, overall health, and other medical conditions also influence treatment choices.

The most effective regimen balances cancer-fighting power with manageable side effects. Sometimes a slightly less intensive treatment that you can complete fully is better than a more aggressive approach that might need to be stopped or reduced due to side effects.

Your treatment plan might change over time based on how you respond and tolerate therapy. Your doctor will regularly assess your progress and adjust your treatment as needed. This flexibility is actually a strength of modern cancer care, allowing your team to optimize your treatment continuously.

What are the risk factors for chemotherapy complications?

Several factors can increase your risk of experiencing more significant side effects from chemotherapy. Understanding these risk factors helps your medical team take appropriate precautions and monitor you more closely during treatment.

Age can influence how your body processes chemotherapy drugs. Older adults may experience more side effects or need dose adjustments, while younger patients might tolerate treatment better. However, age alone doesn't determine treatment decisions, and many older adults do very well with chemotherapy.

Your overall health and organ function significantly impact how you handle treatment. People with kidney, liver, or heart problems may need modified doses or special monitoring. Previous cancer treatments can also affect your tolerance to new chemotherapy drugs.

Certain medical conditions increase complication risks. Diabetes, heart disease, lung problems, or autoimmune conditions require special consideration. Your doctor will work with other specialists to manage these conditions during your cancer treatment.

Nutritional status affects your ability to tolerate chemotherapy. Being significantly underweight or overweight can influence drug dosing and side effects. Your healthcare team might recommend working with a nutritionist to optimize your nutritional status before and during treatment.

Is it better to have intensive or gentle chemotherapy?

The intensity of chemotherapy should be carefully balanced based on your specific situation, treatment goals, and ability to tolerate side effects. Neither intensive nor gentle approaches are universally better – the right choice depends on many individual factors.

More intensive chemotherapy regimens can be more effective at killing cancer cells and potentially achieving better outcomes. These treatments might be recommended when cure is the goal, when cancer is aggressive, or when you're young and healthy enough to handle stronger treatment.

Gentler chemotherapy approaches focus on controlling cancer while maintaining quality of life. This might be appropriate when cure isn't realistic, when you have other serious health conditions, or when your cancer grows slowly. Many people live well for years with less intensive treatment.

Your oncologist will recommend the approach that offers you the best balance of effectiveness and tolerability. Modern supportive care medications have made it possible for many people to receive more intensive treatment with manageable side effects. Your treatment can also be adjusted if needed.

What are the possible complications of chemotherapy?

While chemotherapy is generally safe when properly administered, it can cause various complications that your medical team monitors carefully. Understanding these possibilities helps you know what to watch for and when to seek immediate medical attention.

The most serious immediate complication is a condition called neutropenia, where your white blood cell count drops dangerously low. This makes you very susceptible to serious infections that can become life-threatening. Signs include fever, chills, sore throat, or unusual fatigue. This requires immediate medical attention.

Some chemotherapy drugs can affect your heart function, either during treatment or years later. Your doctor will monitor your heart with tests before and during treatment, especially if you're receiving drugs known to affect the heart. Most people don't experience heart problems, but monitoring helps catch any issues early.

Certain medications can cause nerve damage, called peripheral neuropathy, leading to numbness, tingling, or pain in your hands and feet. This usually develops gradually and might improve after treatment ends, though some people experience permanent changes. Your doctor can adjust treatment if neuropathy becomes problematic.

Less common but serious complications include kidney damage, hearing loss, lung problems, or secondary cancers that develop years after treatment. These risks are generally small compared to the benefits of treating your current cancer, but your doctor will discuss any specific risks relevant to your treatment plan.

Blood clots can occur more frequently in people receiving chemotherapy. Watch for leg swelling, pain, or redness, and chest pain or shortness of breath. While not common, these symptoms need immediate medical evaluation.

When should I see a doctor during chemotherapy?

Knowing when to contact your healthcare team during chemotherapy treatment is crucial for your safety and well-being. Your medical team would rather hear from you about concerns than have you wait and potentially develop serious complications.

Contact your doctor immediately if you develop a fever of 100.4°F (38°C) or higher. This could indicate a serious infection when your immune system is compromised by chemotherapy. Don't wait to see if the fever goes away on its own – call your oncology team right away, even if it's after hours.

Severe nausea or vomiting that prevents you from keeping fluids down for more than 24 hours needs medical attention. Dehydration can become serious quickly, and your doctor has additional medications and treatments that can help control these symptoms.

Watch for signs of infection beyond fever, including chills, sweats, cough, sore throat, mouth sores, or burning during urination. Any unusual pain, swelling, or redness at your IV site or port also warrants immediate attention.

Difficulty breathing, chest pain, severe diarrhea, signs of bleeding like unusual bruising or blood in stool or urine, or severe headaches should prompt immediate medical evaluation. Trust your instincts – if something feels seriously wrong, don't hesitate to call.

Your healthcare team will provide you with specific contact information for urgent situations. Many cancer centers have 24-hour phone lines staffed by nurses who can help determine if you need immediate care or if your concern can wait until the next business day.