Overview

Chemotherapy is a cancer treatment where medicine is used to kill cancer cells.

There are many different types of chemotherapy medicine, but they all work in a similar way.

They stop cancer cells reproducing, which prevents them from growing and spreading in the body.

When chemotherapy is used

Chemotherapy may be used if cancer has spread or there's a risk it will.

It can be used to:

• try to cure the cancer completely (curative chemotherapy)
• make other treatments more effective – for example, it can be combined with radiotherapy (chemoradiation) or used before surgery (neo-adjuvant chemotherapy)
• reduce the risk of the cancer coming back after radiotherapy or surgery (adjuvant chemotherapy)
• relieve symptoms if a cure is not possible (palliative chemotherapy)

The effectiveness of chemotherapy varies significantly. Ask your doctors about the chances of treatment being successful for you.

Types of chemotherapy

Chemotherapy can be given in several ways. Your doctors will recommend the best type for you.

The most common types are:

• chemotherapy given into a vein (intravenous chemotherapy) - this is usually done in hospital and involves medicine being given through a tube in a vein in your hand, arm or chest
• chemotherapy tablets (oral chemotherapy) - this usually involves taking a course of medicine at home, with regular check-ups in hospital

You may be treated with one type of chemotherapy medicine or a combination of different types.

You'll usually have several treatment sessions, which will typically be spread over the course of a few months.

Side effects of chemotherapy

As well as killing cancer cells, chemotherapy can damage some healthy cells in your body, such as blood cells, skin cells and cells in the stomach.

This can cause a range of unpleasant side effects, such as:

• feeling tired most of the time
• feeling and being sick
• hair loss
• an increased risk of getting infections
• a sore mouth
• dry, sore or itchy skin
• diarrhoea or constipation

Many of these side effects can be treated or prevented and most, if not all, will pass after treatment stops.

What happens?

How chemotherapy is given

There are lots of chemotherapy medicines and different ways you can have them.

The type of chemotherapy you have depends on the type of cancer you have and what medicines will work best for you.

You usually have treatment in hospital or a clinic, but you can have some types of chemotherapy at home.

You usually have chemotherapy in "cycles" over several months. This means you have treatment and then have a break of a few days or weeks to let your body recover before the next treatment.

Common ways of having chemotherapy
How it's given What happens

Tube into a vein

A thin tube is inserted into a vein (usually in your arm) and attached to a bag of medicine (a drip) or a pump. Can take from 30 minutes to a few days.

Injection

You have an injection into a vein, muscle or under your skin. Usually only takes a few minutes.

Wearable pump

A needle is inserted into a vein, which is attached to a tube and a small pump you can take home. The pump slowly gives you medicine over a few days.

Tablets or capsules

You're given medicine to take at home and have regular appointments to check how things are going and get more medicine.

Find out more

How you have chemotherapy (Cancer Research UK)

Before you have chemotherapy

Before starting chemotherapy, your care team will talk to you about your treatment and answer any questions you have.

Ask them about the side effects you might get and if there's anything you can do to prepare for them before treatment starts.

Some chemotherapy medicines can cause fertility problems, so you may want to ask about options for storing your eggs or sperm.

Each time you have treatment, your care team may:

• ask about any side effects you're having
• measure your height and weight to make sure you're given the right dose of chemotherapy medicine
• do a blood test to check if treatment is affecting your blood cells
• arrange an X-ray or scan to check how well treatment is working

These checks may be done on the same day you have treatment, or a few days before.

Sex and contraception

Chemotherapy medicines can be very harmful for an unborn baby.

If you think you could be pregnant, tell your care team as soon as possible. They may ask you to do a pregnancy test before having treatment.

It's important to use contraception during treatment if you could get pregnant or you could get your partner pregnant.

Find out more

Planning chemotherapy (Cancer Research UK)
Fertility and chemotherapy (Cancer Research UK)
Pregnancy and chemotherapy (Cancer Research UK)

Side effects

Side effects of chemotherapy

Chemotherapy can cause a range of side effects.

These usually start a few days or weeks after treatment begins and go away after treatment stops, although some side effects can last longer or may only start after treatment finishes.

Most people will get some side effects, but you will not get all of them. Ask your care team about the side effects you might get.

Common side effects of chemotherapy include:

• tiredness
   

• feeling sick (nausea) and being sick (vomiting)
   

• a sore mouth and throat (mucositis)
   

• a weakened immune system, which can mean you're more likely to get infections
   

• lack of energy, shortness of breath and noticeable heartbeats (palpitations) due to anaemia
   

• bleeding or bruising more easily than usual
   

• constipation or diarrhoea
   

• temporary hair loss
   

• numbness or tingling in your hands or feet
   

• problems with memory and concentration
   

• blood clots

Some types of chemotherapy can also affect your fertility. This can be temporary or permanent.

Let your care team know if you get side effects. They may be able to give you treatments to ease them and advice about things you can do.

Call your care team now if you have:

• a high temperature – signs include feeling hot, cold, sweaty or shivery, or the skin on your back or chest feeling hotter than usual
   

• other signs of an infection, such as a sore throat, cough, diarrhoea, peeing a lot or pain when peeing
   

• throbbing or cramping pain, swelling and warmth in a leg or arm
   

• sudden breathlessness, sharp chest pain (may be worse when you breathe in) and a cough or coughing up blood

These are signs of an infection or blood clot, which may need to be treated quickly.

Call NHS 111 if you're not sure how to contact your care team.

Find out more

Chemotherapy side effects (Macmillan Cancer Support)
Hair loss (Macmillan Cancer Support)
Living with chemotherapy (Cancer Research UK)

Support during chemotherapy

If you're having chemotherapy, your care team will support you during your treatment. They can give you information about local support services.

There are also national charities that offer support and information, such as Macmillan Cancer Support and Cancer Research UK.

Support from other people with cancer

You may find it useful to talk to or hear from other people with cancer, either online or in person.

Chemotherapy forum (Macmillan Cancer Support)
Find local support services (Macmillan Cancer Support)
People's stories about living with cancer (Macmillan Cancer Support)

Support for family, friends and carers

If you care for someone who has cancer, you can get advice and support from charities.

Supporting someone with cancer (Macmillan Cancer Support)
Family, friends, carers and cancer (Cancer Research UK)