What is chemo?

Chemotherapy, or chemo for short, means taking certain types of drugs to treat cancer. You might take these drugs before or after cancer surgery. You might take them with radiation (x-ray) treatment. Or you might take chemo alone.

Chemo has been helping people beat cancer since the early 1950s. The chemo drugs your doctor uses have been tested again and again. Research shows they work. Partly because of chemo, many people with cancer can have full, healthy lives.

How does chemo work?

If your doctor wants you to have chemo, it means something can be done to try to control, or maybe even cure, your cancer.

Cancer is a group of cells that divide very fast and grow out of control. The word cancer is a name for many different diseases. Each type of cancer affects the body in different ways. But all cancers have one thing in common: they are abnormal cells growing out of control.

Different chemo drugs are used to treat different cancers. The drugs go through the whole body to kill the cancer cells. More than one chemo drug will probably be used for your treatment. This is called combination chemotherapy. The drugs work together to kill more cancer cells.

Your doctor will tell you what chemo is best for you and your type of cancer. Together, you will plan a treatment that works best for you.

How is chemo given?

Most chemo drugs are given in one of these ways:

• You might just take a pill. If your chemo is a pill or liquid, you can often take it at home, but you must follow your doctor's directions carefully.

• You may be given chemo shots in your doctor's office, a hospital, a clinic, or at home.

• Most often, chemo is given into your veins through a needle or tiny plastic tube (called a catheter). This is called IV (intravenous) chemo.

You may get chemo once a day, once a week, or even once a month. It depends on the type of cancer you have and the chemo you are taking. How long you get chemo also depends on how your body responds to the drugs.

How much does chemo cost?

How much chemo costs depends on a lot of things, such as the kinds of drugs used, how you get them, how often you get them, and for how long. You can ask your doctor about cost and where to get help in paying for chemo if you need it.

If you have health insurance, check to see if it pays for your chemo. You will want to keep your health insurance, even if you must be out of work for treatment. If your insurance is through your job, don't quit until you find out ways to help you keep your insurance. See if you can take Family Medical Leave or if you are protected under the Americans with Disabilities Act. You can call us at 1-800-227-2345 to learn more.

If you have no health insurance, you may want to ask a social worker at your hospital or clinic to help you look into government programs such as Medicare and Medicaid, or other agencies that may help you. Cancer treatment can cost a lot. It is good to know what kind of coverage you have and what financial help you may be able to get.

What are the side effects of chemo?

Chemo drugs are very strong. They kill any cell that is growing (dividing) fast, whether it's a cancer cell or not. So, some of the normal, healthy cells in the body that grow quickly can be damaged. This causes side effects. Some people have no side effects from chemo. But sometimes chemo will make you feel sick.

Here are some normal cells that grow quickly. They are often affected by chemo, which causes side effects:

• cells in your bone marrow--this can make you feel tired, bruise and bleed easily, and put you at a higher risk of infection

• cells that grow hair--this can cause you to lose hair on your whole body

• cells of the skin and mouth--this can cause dry skin and make your mouth feel dry and have sores

• cells in your stomach and intestines--this can cause you to feel sick to your stomach, vomit, or have diarrhea

Other organs of the body can be affected by some chemo drugs, too. If you have bad side effects, your doctor may do blood tests to find out if you need a lower dose of chemo drugs, or if you need longer breaks between doses. Most side effects are short-term and will go away after treatment stops, but some can last forever. Here are some of the ways chemo can affect you:

Changes in your ability to have children

Some chemo can cause fertility problems and this effect does not always go away after treatment is over. If you think you may want to have children in the future, tell your doctor about this before you start treatment. To find out more about having children, see Fertility and Cancer: What are My Options?

Changes in your sex life

Chemo can affect sexuality in both men and women. Sometimes sexual desire is low or even gone for some time, but it comes back when treatment ends. Some drugs given during chemo may affect a woman's hormones, causing hot flashes and dryness of the vagina. Most chemo can cause birth defects if a woman is pregnant during treatment. Ask your doctor about what kinds of birth control you should use and how long you need to use it. To learn more about the sexual effects of cancer treatments and how to deal with them, please see our documents Sexuality for the Man with Cancer or Sexuality for the Woman with Cancer.

Changes in your hair, skin, mouth, and stomach

Cells in your hair, skin, mouth, and stomach and intestines (gastrointestinal tract, or GI tract) can be affected by chemo. This can lead to hair loss, sores in your mouth and throat, dry skin, nausea, vomiting, and diarrhea.

If you have any side effects, tell your cancer care team about them right away. There are often things they can do to help you and keep the problems from getting worse.

Changes in your bone marrow

Bone marrow is found in the inner part of some bones. It is where all of your blood cells are made (red blood cells, white blood cells, and platelets). It is often affected by chemo and can cause your blood counts to change. These are the cells in the blood that make up the blood count:

Red blood cells carry oxygen from the lungs to all parts of the body. During chemo, the bone marrow may not be able to make enough red blood cells. Not having enough red blood cells is called anemia. It can make you feel short of breath, weak, and tired. Anemia can also make your skin, mouth, or gums look pale.

White blood cells fight infection. Chemo lowers your white blood cell count, which makes you less able to fight infections. Your cancer care team may ask you to do certain things to avoid infection, such as:

• stay away from people who have infections or fevers
• eat only cooked foods (no raw foods, even fruits and vegetables)
• wash your hands very well and often

Platelets are tiny pieces that form blood clots to stop bleeding from cuts or bruises. If your bone marrow cannot make enough platelets, you may bleed too much, even from small cuts. If your platelet count is low, you will need to be very careful to avoid cuts, bruises, and other injuries. Even brushing your teeth could cause your gums to bleed. You may need a soft toothbrush or one made of a special foam. Check with your doctor or nurse about flossing.

Preventing and treating side effects

The good news is that there are things you can do to prevent or lessen some chemo side effects.

• Tell your doctor if you want to have children in the future. It is important to do this before you start chemo.

• There are medicines you can take before and while you are getting your chemo to keep you from vomiting or feeling sick to your stomach.

• Drugs called growth factors can be used to help the bone marrow recover from chemo and start making new blood cells.

• Many people can be helped by transfusions of red blood cells or platelets from blood donors.

Remember that not everyone gets the same chemo drugs. Chemo for some cancers may be much stronger and cause more side effects than chemo for other cancers. Also, everybody is different. Your overall health and fitness will affect how your body reacts to chemo.

You may be able to go on with what you normally do while you are on chemo. You may not have to stop working or be on a special diet. On the other hand, some people need to be in the hospital so that doctors can watch them closely and treat certain side effects. Most people have to change their work schedules to get chemo. Ask your cancer care team what you will be able to do while you're being treated -- on chemo days and in between treatments. Your cancer care team should give you this information up front, but make sure you are clear about what you can and can't do safely.

How chemo may affect your family

Cancer isn't catching, so you can be close to family and friends. Having chemo won't harm anybody else either. Depending on how your body reacts to the drugs, people may not notice you are on chemo at all. If you have side effects, your family and friends can do things to help. When someone asks, "How can I help?" have a few ideas ready.

• You may not feel like eating very much, so ask family members to take turns cooking foods that you think you can eat.

• You might get tired after each treatment and need extra rest. Ask your family to do little jobs for you until you feel better.

Keep in mind that your family cares very much about you, and they may feel nervous about your chemo. Let your family and friends know how much their support means to you. Be honest about how you feel. Get into the habit of talking things over with your loved ones so they can share your ups and downs.

There will be times when the people closest to you feel tired or sad, too. You can help them feel better by reminding them how important they are to you. You can also point out how much their support and help means to you.

You and your doctor

Because cancer is different for everyone, your chemo will be planned just for you. Work with your doctor to decide what's best for you.

• Ask questions. Ask the doctor, nurses, social workers, and other professionals on your team as many questions as you need to. They know the most about chemo and how it works.

• Be ready. Write down your questions ahead of time. Don't be afraid to admit you are confused or that you need to ask the same questions again. Nothing you say will sound silly or strange to your health care team. They know you want to understand your chemo plan as well you can. All patients getting chemo have questions.

Here are some questions you might want to ask:

• Does my insurance cover chemo? If not, how will I pay for it?
• How long will I be getting chemo?
• Where will I get chemo?
• How will we know if it’s working?
• What are the usual side effects of the chemo?
• Is there any way to lessen these side effects?
• How long do the side effects last? Are any permanent?
• How will this chemo affect my outlook (prognosis) for cure or long-term survival?
• Will I still be able to work (go to school) during treatment?
• Is there anything I should do to get ready for chemo?

If you would like more detailed information on chemotherapy, please see our document, Understanding Chemotherapy: A Guide for Patients and Families.

Additional resources

More information from your American Cancer Society

We have picked other information that may be helpful to you. You can find these on our Web site (www.cancer.org) or order them from our toll-free number (1-800-227-2345).

• After Diagnosis: A Guide for Patients and Families (also available in Spanish)

• Understanding Chemotherapy: A Guide for Patients and Families (also available in Spanish)

• Oral Chemotherapy: What You Need to Know

• Choosing a Doctor and a Hospital (also available in Spanish)

• Talking with your Doctor (also available in Spanish)

• Health Care Professionals Associated with Cancer Care

• Talking with Friends and Relatives about Your Cancer (also available in Spanish)

• Questions That People Ask about Cancer (also available in Spanish)

• Caring for the Patient with Cancer at Home: A Guide for Patients and Families

• Fertility and Cancer: What are My Options?

• Sexuality for the Man with Cancer (also available in Spanish)

• Sexuality for the Woman with Cancer (also available in Spanish)

• Health Insurance and Financial Assistance for the Cancer Patient

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.

Last Medical Review: 04/28/2009
Last Revised: 04/28/2009