Getting Chemotherapy

Learn the basics about getting chemotherapy and important safety precautions you need to consider to protect your health and those you live with.

Where will I get chemotherapy?

The place you get your treatment depends on which chemotherapy (chemo) drugs you’re getting, the drug doses, your hospital’s policies, your insurance coverage, what you prefer, and what your doctor recommends.

You may get chemotherapy:

  • At home
  • In your doctor’s office
  • In a clinic
  • In a hospital’s outpatient infusion center
  • In a hospital

Some of these settings may have private treatment rooms, while others treat many patients together in one large room. Ask your doctor or nurse about this ahead of time so you know what to expect your first day.

How often will I need chemotherapy and how long will it last?

How often you get chemo and how long your treatment lasts depend on the kind of cancer you have, the goals of the treatment, the drugs being used, and how your body responds to them.

You may get treatments daily, weekly, or monthly, but they’re usually given in on-and-off cycles. This means, for example, that you may get chemo the first 2 weeks and then have a week off, making it a cycle that will start over every 3 weeks. The time off lets your body build healthy new cells and regain its strength.

Your cancer care team can tell you how many cycles are planned and how long they expect your treatment to last.

Many people wonder how long the actual drugs stay in their body and how they’re removed. Your kidneys and liver break down most chemo drugs which then leave your body through urine or stool. How long it takes your body to get rid of the drugs depends on many things, including the type of chemo you get, other medicines you take, your age, and how well your kidneys and liver work. Your cancer care team will tell you if you need to take any special precautions because of the drugs you are getting.

If your cancer comes back, you might have chemo again. This time, you could be given different drugs to relieve symptoms or to slow the cancer’s growth or spread. Side effects might be different, depending on the drugs, the doses, and how they’re given.

How will I be given chemotherapy?

Through a vein

Most chemotherapy drugs are put right into your bloodstream through a tiny, soft, plastic tube called a catheter. A needle is used to put the catheter into a vein in your forearm or hand; then the needle is taken out, leaving the catheter behind. This is called intravenous or IV treatment. Intravenous drugs are given in these ways:

  • The drugs can be given quickly through the catheter right from a syringe over a few minutes. This is called an IV push.
  • An IV infusion can last from a few minutes to a few hours. A mixed drug solution flows from a plastic bag through tubing that’s attached to the catheter. The flow is often controlled by a machine called an IV pump.
  • Continuous infusions are sometimes needed and can last from 1 to 7 days. These are always controlled by electronic IV pumps.

The needles and catheters can scar and damage veins with ongoing chemo. Another option is a central venous catheter (CVC). A CVC is a bigger catheter that’s put into a large vein in the chest or arm. It stays in as long as you’re getting treatment so you won’t need to be stuck with a needle each time. Different kinds of CVCs are available.

Many people talk about CVC options with their doctor even before starting treatment. Some find out during treatment that they need a CVC because their hand and arm veins aren’t going to last to complete the planned chemo. Your doctor can help you decide if you need a CVC and the right type of CVC for you.

By mouth

You swallow the chemo as a pill, capsule, or liquid – just like other medicines. This chemo can often be taken at home. If you take chemo drugs by mouth, it’s very important to take the exact dosage, at the right time, for as long as you’re supposed to do so. For more, please see Oral Chemotherapy: What You Need to Know.

Intrathecal or IT

IT chemo is put into the spinal canal and goes into the fluid that surrounds the brain and spinal cord to reach cancer cells there. This fluid is called the cerebrospinal fluid or CSF. This is important because most chemo drugs delivered by IV or by mouth are unable to reach the brain due to the blood-brain barrier.

Chemo can be delivered to the CSF through a needle placed in the spinal area, or a long-term catheter and port that can be put under the skin on your head during surgery. This port is called an Ommaya reservoir. The Ommaya is a small drum-like device with a small tube attached to it. The tube goes into the CSF in a cavity of your brain. The Ommaya stays in place under your scalp until treatment is done.

Intra-arterial

In this use, the chemo drug is put right into the main artery that supplies blood to the tumor to treat a single area (such as the liver, an arm, or leg). This method helps limit the effect the drug has on other parts of the body and is called regional chemo.

Intracavitary

Chemo drugs may be given through a catheter into an enclosed area of the body such as the abdomen (this is called intraperitoneal chemo) or chest (called intrapleural chemo).

Intramuscular or IM

The drug is put in through a needle into a muscle (as an injection or shot).

Intralesional

A needle is used to put the drug right into a tumor. It’s only possible when the tumor can be safely reached with a needle.

Intravesical

The chemo is put right into the bladder through a soft catheter. It stays in for a few hours and is then drained out, and the catheter is removed.

Topical

The drug is put right on an area of cancer on the skin as a cream, gel, or ointment.

What should I eat before my first chemo treatment?

Your chemo can take anywhere from a few minutes to many hours. Make sure you eat something before treatment. Most people find that a light meal or snack an hour or so before chemo works best. If you’ll be there several hours, plan ahead and bring a small meal or snacks in an insulated bag or cooler. Find out if there’s a refrigerator or microwave you can use.

Can I be around my family and friends while I’m getting chemo?

Most chemo drugs make you less able to fight infection, but there are ways you can avoid them.

  • Stay away from anyone who is sick.
  • Wash your hands often, especially before touching your face, nose, mouth, or eyes. Ask your family and friends to do the same when they are with you.
  • Very few treatments require you to avoid close contact with loved ones for a short amount of time. If this is something you’ll have to do, your doctor will tell you about it when going over treatment options.
  • Make sure your vaccinations are up to date. The flu shot is especially important because people with cancer are at high risk of serious flu complications. Your health care provider will recommend which vaccines you need.
  • Infections can be picked up from food and drinks. So, food safety is very important when your immune system is weak. Talk to your cancer care team about whether you need to follow a special diet during your cancer treatment.
  • Some pets can also transmit infections. So be sure to keep them healthy and take precautions when you’re around them.

How can I protect myself and those I live with while I’m getting chemo?

There are many things you can do during and after chemo to keep yourself and your loved ones from being affected by the chemo drugs while your body is getting rid of them. It takes about 48 hours for your body to break down and/or get rid of most chemo drugs.

Most of the waste comes out in your body fluids – urine, stool, tears, and vomit. The drugs are also in your blood. When chemo drugs get outside your body, they can harm or irritate skin – yours or even other people’s. Keep in mind that this means toilets can be a hazard for children and pets, and it’s important to be careful. Talk to your cancer care team about these and any other precautions you should follow.

During – and for 48 hours after – chemo:

  • Flush the toilet twice after you use it. Put the lid down before flushing to avoid splashing. If possible, you may want to use a separate toilet during this time. If this is not possible, wear gloves to clean the toilet seat after each use.
  • Both men and women should sit on the toilet to use it. This cuts down on splashing.
  • Always wash your hands with warm water and soap after using the toilet. Dry your hands with paper towels and throw them away.
  • If you vomit into the toilet, clean off all splashes and flush twice. If you vomit into a bucket or basin, carefully empty it into the toilet without splashing the contents and flush twice. Wash out the bucket with hot, soapy water and rinse it; empty the wash and rinse water into the toilet, then flush. Dry the bucket with paper towels and throw them away.
  • Caregivers should wear 2 pairs of throw-away gloves if they need to touch any of your body fluids. (These can be bought in most drug stores.) They should always wash their hands with warm water and soap afterward – even if they had gloves on.
  • If a caregiver does come in contact with any of your body fluids, they should wash the area very well with warm water and soap. It’s not likely to cause any harm, but try to avoid this. At your next visit, let your doctor know this happened. Being exposed often may lead to problems, and extra care should be taken to avoid this.
  • Any clothes or sheets that have body fluids on them should be washed in your washing machine – not by hand. Wash them in warm water with regular laundry detergent. Do not wash them with other clothes. If they can’t be washed right away, seal them in a plastic bag.
  • If using throw-away adult diapers, underwear, or sanitary pads, seal them in 2 plastic bags and throw them away with your regular trash.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Medical Review: February 11, 2016 Last Revised: February 16, 2016

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