Table of ContentsView AllTable of ContentsHow It WorksTreatment GoalsDrug TypesHow It Is GivenHow Long It LastsSide EffectsComplicationsQuestions to AskHow to Cope
Table of ContentsView All
View All
Table of Contents
How It Works
Treatment Goals
Drug Types
How It Is Given
How Long It Lasts
Side Effects
Complications
Questions to Ask
How to Cope
Chemotherapy (“chemo”) is a type ofcancer treatmentthat uses drugs that kill fast-replicating cells like cancer cells. Chemotherapy can be used to cure cancer, to clear any remaining cancer cells after surgery, or to prolong life in those who cannot undergo surgery or haveadvanced cancer.
Chemotherapy drugs cause side effects because they not only kill fast-replicating cancer cells but other fast-replicating cells as well, such as those in the mouth, intestines, and hair. This accounts for common side effects like mouth sores, nausea, and hair loss. To minimize side effects and ensure the best results, chemo is administered in cycles with periods of recovery in between.
This article explains how chemotherapy works, including its uses, drug types, methods of administration, and side effects. It also offers tips on how to cope and speak with your cancer specialist about chemotherapy.
Isaac Lane Koval/Corbis/VCG / Getty Images
How Chemotherapy Works
A cell becomes cancerous when an accumulation of mutations causes it to reproduce and divide out of control.
Local treatments, such as surgery and radiation therapy, treat cancer where it begins. In contrast, chemotherapy is a systemic (whole-body) treatment that uses drugs to “search and destroy” cancer cells wherever they are in the body.
Chemotherapy can not only treat the primary (original) tumor but also areas where cancer has spread (metastasized). These includemicrometastasesthat may not be spotted in imaging studies.
Chemotherapy is also invaluable in the treatment of blood cancers like leukemia that freely circulate in the bloodstream.
Cancer cells that grow rapidly respond well to chemotherapy. In contrast, slow-growing cancers, like certain types of lymphoma, respond less well or not at all.
Ways That Chemotherapy Is Used
Chemotherapy may be given for different reasons and with several different goals in mind. It’s important to talk to your healthcare provider and understand the exact purpose of chemotherapy as part of your treatment plan.
The purpose of chemotherapy may be:
Type of Chemotherapy Drugs
There are several types of chemotherapy drugs, which vary both inhowthey work (mechanisms) andwherethey work (what part of the cell cycle). Some drugs work on one of the four primary phases of cell division, whereas others—termed phase non-specific drugs—may work at multiple points.
Some of these classes of drugs include:
Combination Chemotherapy
A combination of different chemotherapy drugs, rather than a single drug alone, is usually used to treat cancer.There are several reasons for combination chemotherapy.
Cancer cells in a tumor are not all in the same place in the process of growth. Using drugs that affect the cell cycle at different points in multiplication and cell division increases the chance that as many cancer cells as possible will be treated.
Combination Chemotherapy AcronymsAcronyms are often used to describe chemotherapy protocols. For example,BEACOPPis a seven-drug regimen used in the treatment of Hodgkin’s lymphoma.
Combination Chemotherapy Acronyms
Acronyms are often used to describe chemotherapy protocols. For example,BEACOPPis a seven-drug regimen used in the treatment of Hodgkin’s lymphoma.
How Chemotherapy Is Given
Chemotherapy may be given in several different ways depending on the particular drug. Methods include:
How Long Does Chemotherapy Last?
Since chemotherapy treats cells that are in the process of cell division—and cancer cells are all in different states of division—repeated cycles allow a greater chance to treat as many cancer cells as possible.
The amount of time between sessions will vary depending on the drugs being used, but it is often scheduled at a time when your blood count is expected to return to normal.
Side Effects of Chemotherapy
Keep in mind that everyone responds to chemotherapy differently. Some people may have several of these side effects, while others may have none.
Fatigue
Fatigue is the most common side effect of chemotherapy, affecting nearly everyone who receives these treatments.Unfortunately, this kind of fatigue isn’t the type of tiredness that responds to a cup of coffee or a good night’s sleep.
There are a number of things that may help you cope withcancer fatigue, but the most important one is to allow yourself the extra time you need for rest.
Nausea and Vomiting
Nausea and vomiting are among the most feared side effects of chemo, but prevention and treatment of these symptoms have improved dramatically in recent years. Anti-nausea drugs (antiemetics) are frequently given along with chemotherapy drugs to prevent nausea.
Adjustment in diet can also help easechemotherapy-induced nausea and vomiting.
Acid Reflux During Chemotherapy
Hair Loss
Hair loss is common with chemotherapy, and though it’s not dangerous to your physical health, it can be very distressing emotionally. Hair loss commonly begins two to three weeks after your first treatment with regrowth occurring rapidly after your final treatment.
Bone Marrow Suppression
Suppression of the bone marrowis one of the more dangerous side effects of chemotherapy, but management of it—especially the risk of infections due to a low white blood cell count—has improved substantially in recent years.
Mouth Sores
Around 30% to 40% of people will experiencechemotherapy-induced mouth soresduring treatment, though some medications are more likely than others to cause this symptom. If you are receiving drugs likely to cause mouth sores, your chemotherapy nurse may encourage you to suck on an ice pop or ice chips while the drug is infused.
A few dietary adjustments can help ease symptoms. This includes avoiding citrus fruits, spicy or salty foods, extremely hot or cold foods, or foods with sharp edges (like crackers).
There is also a product called “magic mouthwash” used to treat chemo-related mouth sores.
Peripheral Neuropathy
Burning, tingling, or prickly sensations in the hands and feet are symptoms of chemotherapy-induced peripheral neuropathy. This affects roughly a third of people receiving chemotherapy.
Unlike many of the symptoms associated with chemotherapy, neuropathy often persists well after chemotherapy is completed.
Bowel Changes
Chemotherapy drugs can cause bowel changes ranging from constipation to diarrhea, depending on the drug.Constipation is also common with drugs used to prevent nausea, and your healthcare provider may recommend stool softeners or laxatives if symptoms are severe.
Diarrhea can quickly become a problem as it contributes to dehydration.Certain foods can help, but make sure to talk to your practitioner promptly if you have this issue.
Sun Sensitivity
Many chemotherapy drugs increase your chance of getting a sunburn when you go out in the sun, something referred to aschemotherapy-induced phototoxicity.Sunscreen alone may not be effective and may irritate your skin, especially if you are also receiving radiation therapy. The best way to deal with this is to stay out of the sun.
“Chemo Brain”
The term “chemo brain” has been coined to describe the cognitive effects some people experience during chemotherapy. Symptoms range from forgetfulness to difficulty concentrating.Some people find that keeping their minds active with word puzzles, sudoku, and other “brain teasers” can help them focus while on chemo.
Possible Risks and Complications
With all cancer treatments, the benefits of treatment need to be weighed against the possible risks. While eradicating or managing your cancer is your primary concern, it’s important to be aware of how chemotherapy might affect you months or even years after the completion of cancer treatment.
As with the short-term side effects, the odds that you will experience these issues depend on the particular chemotherapy drugs you receive.
Heart Disease
Some chemotherapy drugs, especially drugs such asAdriamycin (doxorubicin), can cause heart damage.The type of damage may range from heart failure to valve problems to coronary artery disease.
If you are receiving any of these drugs, your healthcare provider may recommend a heart test before you begin treatment. Radiation therapy to the chest may also increase the risk of heart-related problems.
Infertility
Secondary Cancers
An example of this is the development of leukemia in people who have been treated with Cytoxan (cyclophosphamide), a drug commonly used in breast cancer treatment. These cancers often occur five to 10 years or more after chemotherapy has been completed.
Other RisksOther possible late effects may include symptoms ranging from hearing loss or cataracts to lung fibrosis. Though the benefits of treatment often outweigh the risks, take a moment to talk with your healthcare provider about side effects that may be unique to your particular chemotherapy regimen.
Other Risks
Other possible late effects may include symptoms ranging from hearing loss or cataracts to lung fibrosis. Though the benefits of treatment often outweigh the risks, take a moment to talk with your healthcare provider about side effects that may be unique to your particular chemotherapy regimen.
Long-Term Side Effects of Chemotherapy
Questions to Ask Your Healthcare Provider
A cancer diagnosis thrusts you into a world of details—a lot of which are not always easy to understand. As you work to get a better hold on what chemotherapy may mean for you before, during, and after your course, you may find it helpful to ask your healthcare provider these questions:
Coping With Chemotherapy
Most people lead busy lives before a diagnosis of cancer. Facing chemotherapy may have you wondering if you can manage your normal commitments and obligations along with chemo. Take a moment to consider what support you will need to keep your life running smoothly.
Reach out to friends for help with errands and childcare or to simply share your feelings. To build a support team, launch a personal siteCaring Bridgeto share updates on how your treatment is going. These sites can also be a tremendous source of encouragement and allow friends to send love without worrying about disturbing you.
Sites such asLotsa Helping Handscan be invaluable in organizing tasks among those who have volunteered to help, whether it be preparing a meal or helping with housework.
Summary
Because chemo also kills fast-replicating cells of the digestive tract, hair, mucus membranes, and other tissues, you might experience side effects like nausea, hair loss, mouth sores, peripheral neuropathy, and “chemo brain.” It is important to remember that some people have few side effects and that the experience differs greatly from one person to the next.
Support from your care team and loved ones can help you prepare for and cope with chemotherapy.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Schillert A, Trumpp A, Sprick MR.Label retaining cells in cancer–the dormant root of evil?Cancer Lett.2013;341(1):73-9. doi:10.1016/j.canlet.2013.04.019Yardley DA.Drug resistance and the role of combination chemotherapy in improving patient outcomes.Int J Breast Cancer.2013;2013:137414. doi:10.1155/2013/137414Trüeb RM.Chemotherapy-induced alopecia.Semin Cutan Med Surg.2009;28(1):11-4. doi:10.1016/j.sder.2008.12.001Hofman M, Ryan JL, Figueroa-moseley CD, Jean-pierre P, Morrow GR.Cancer-related fatigue: the scale of the problem.Oncologist. 2007;12 Suppl 1:4-10. doi:10.1634/theoncologist.12-S1-4Lundqvist EÅ, Fujiwara K, Seoud M.Principles of chemotherapy.Int J Gynaecol Obstet.2015;131 Suppl 2:S146-9. doi:10.1016/j.ijgo.2015.06.011Apisarnthanarax N, Duvic MM.Photosensitivity Reactions. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine. 6th Edition.Hamilton (ON): BC Decker; 2003.Brower V.Tracking chemotherapy’s effects on secondary cancers.J Natl Cancer Inst.2013;105(19):1421-2. doi:10.1093/jnci/djt273Additional ReadingAmerican Society of Clinical Oncology. Cancer.Net.Understanding Chemotherapy.Longo, D. L.Harrison’s Principles of Internal Medicine. 2017. New York: McGraw-Hill.National Cancer Institute. SEER Training Manual.Types of Chemotherapy Drugs.Niederhuber, J., Armitage, J., Doroshow, J., Kastan, M., and J. Tepper. Abeloff’s Clinical Oncology: 6th Edition. 2019. Philadelphia: Churchill Livingstone/Elsevier.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Schillert A, Trumpp A, Sprick MR.Label retaining cells in cancer–the dormant root of evil?Cancer Lett.2013;341(1):73-9. doi:10.1016/j.canlet.2013.04.019Yardley DA.Drug resistance and the role of combination chemotherapy in improving patient outcomes.Int J Breast Cancer.2013;2013:137414. doi:10.1155/2013/137414Trüeb RM.Chemotherapy-induced alopecia.Semin Cutan Med Surg.2009;28(1):11-4. doi:10.1016/j.sder.2008.12.001Hofman M, Ryan JL, Figueroa-moseley CD, Jean-pierre P, Morrow GR.Cancer-related fatigue: the scale of the problem.Oncologist. 2007;12 Suppl 1:4-10. doi:10.1634/theoncologist.12-S1-4Lundqvist EÅ, Fujiwara K, Seoud M.Principles of chemotherapy.Int J Gynaecol Obstet.2015;131 Suppl 2:S146-9. doi:10.1016/j.ijgo.2015.06.011Apisarnthanarax N, Duvic MM.Photosensitivity Reactions. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine. 6th Edition.Hamilton (ON): BC Decker; 2003.Brower V.Tracking chemotherapy’s effects on secondary cancers.J Natl Cancer Inst.2013;105(19):1421-2. doi:10.1093/jnci/djt273Additional ReadingAmerican Society of Clinical Oncology. Cancer.Net.Understanding Chemotherapy.Longo, D. L.Harrison’s Principles of Internal Medicine. 2017. New York: McGraw-Hill.National Cancer Institute. SEER Training Manual.Types of Chemotherapy Drugs.Niederhuber, J., Armitage, J., Doroshow, J., Kastan, M., and J. Tepper. Abeloff’s Clinical Oncology: 6th Edition. 2019. Philadelphia: Churchill Livingstone/Elsevier.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Schillert A, Trumpp A, Sprick MR.Label retaining cells in cancer–the dormant root of evil?Cancer Lett.2013;341(1):73-9. doi:10.1016/j.canlet.2013.04.019Yardley DA.Drug resistance and the role of combination chemotherapy in improving patient outcomes.Int J Breast Cancer.2013;2013:137414. doi:10.1155/2013/137414Trüeb RM.Chemotherapy-induced alopecia.Semin Cutan Med Surg.2009;28(1):11-4. doi:10.1016/j.sder.2008.12.001Hofman M, Ryan JL, Figueroa-moseley CD, Jean-pierre P, Morrow GR.Cancer-related fatigue: the scale of the problem.Oncologist. 2007;12 Suppl 1:4-10. doi:10.1634/theoncologist.12-S1-4Lundqvist EÅ, Fujiwara K, Seoud M.Principles of chemotherapy.Int J Gynaecol Obstet.2015;131 Suppl 2:S146-9. doi:10.1016/j.ijgo.2015.06.011Apisarnthanarax N, Duvic MM.Photosensitivity Reactions. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine. 6th Edition.Hamilton (ON): BC Decker; 2003.Brower V.Tracking chemotherapy’s effects on secondary cancers.J Natl Cancer Inst.2013;105(19):1421-2. doi:10.1093/jnci/djt273
Schillert A, Trumpp A, Sprick MR.Label retaining cells in cancer–the dormant root of evil?Cancer Lett.2013;341(1):73-9. doi:10.1016/j.canlet.2013.04.019
Yardley DA.Drug resistance and the role of combination chemotherapy in improving patient outcomes.Int J Breast Cancer.2013;2013:137414. doi:10.1155/2013/137414
Trüeb RM.Chemotherapy-induced alopecia.Semin Cutan Med Surg.2009;28(1):11-4. doi:10.1016/j.sder.2008.12.001
Hofman M, Ryan JL, Figueroa-moseley CD, Jean-pierre P, Morrow GR.Cancer-related fatigue: the scale of the problem.Oncologist. 2007;12 Suppl 1:4-10. doi:10.1634/theoncologist.12-S1-4
Lundqvist EÅ, Fujiwara K, Seoud M.Principles of chemotherapy.Int J Gynaecol Obstet.2015;131 Suppl 2:S146-9. doi:10.1016/j.ijgo.2015.06.011
Apisarnthanarax N, Duvic MM.Photosensitivity Reactions. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine. 6th Edition.Hamilton (ON): BC Decker; 2003.
Brower V.Tracking chemotherapy’s effects on secondary cancers.J Natl Cancer Inst.2013;105(19):1421-2. doi:10.1093/jnci/djt273
American Society of Clinical Oncology. Cancer.Net.Understanding Chemotherapy.Longo, D. L.Harrison’s Principles of Internal Medicine. 2017. New York: McGraw-Hill.National Cancer Institute. SEER Training Manual.Types of Chemotherapy Drugs.Niederhuber, J., Armitage, J., Doroshow, J., Kastan, M., and J. Tepper. Abeloff’s Clinical Oncology: 6th Edition. 2019. Philadelphia: Churchill Livingstone/Elsevier.
American Society of Clinical Oncology. Cancer.Net.Understanding Chemotherapy.
Longo, D. L.Harrison’s Principles of Internal Medicine. 2017. New York: McGraw-Hill.
National Cancer Institute. SEER Training Manual.Types of Chemotherapy Drugs.
Niederhuber, J., Armitage, J., Doroshow, J., Kastan, M., and J. Tepper. Abeloff’s Clinical Oncology: 6th Edition. 2019. Philadelphia: Churchill Livingstone/Elsevier.
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