Questions about chemotherapy

What is chemotherapy?

Chemotherapy is the use of strong drugs to treat cancer. You will often hear chemotherapy called “chemo” (KEY-mo), but it’s the same thing.

Chemo was first used to treat cancer in the 1950s. The chemo drugs you get have been tested many times. Research shows they work to help kill cancer cells.

What does chemo do?

There are more than 100 chemo drugs used today. Doctors choose what drugs to give you based on the kind of cancer you have and how much cancer is in your body (the stage). Your doctor will talk to you about the goals of chemo before you start treatment.

Chemo may be used to:

  • Keep the cancer from spreading
  • Make the cancer grow slower
  • Kill cancer cells that may have spread to other parts of the body (metastasizedmeh-TAS-tuh-sized)
  • Make side effects from cancer better, like pain or blockages
  • Cure cancer

Will chemo be my only cancer treatment?

Sometimes chemo is the only cancer treatment needed. More often, it’s part of a treatment plan that can include surgery and radiation therapy (RAY-dee-AY-shun THAIR-uh-pee).

Here’s why:

  • Chemo may be used to shrink tumors before surgery or radiation.
  • It may be used after surgery or radiation to help kill any cancer cells that are left.
  • It may be used with other treatments if the cancer comes back.

How does chemo work?

The body is made up of trillions of cells. Cancer starts when something causes changes in a normal cell. This cancer cell then grows out of control and makes more cancer cells. If cancer isn’t treated, it can spread to other places in your body and cause more problems.

Chemo kills cells that grow fast, like cancer cells. It can affect normal cells that grow fast, too, like the cells that make hair or blood. But most normal cells can fix themselves.

You will probably get more than one chemo drug. This is called combination chemotherapy. The drugs work together to kill more cancer cells.

How is chemo given?

Most chemo drugs are given in one of these ways:

  • Sometimes chemo is a pill or liquid. You just swallow it. You can take it at home, but you must be careful to follow the directions.
  • Chemo can be given like a flu shot. The shots may be given in your doctor’s office, a hospital, a clinic, or at home.
  • Most often, chemo drugs are put into your blood through a tiny plastic tube called a catheter (CATH-it-ur) that’s put in a vein. This is called IV (intravenous – in-truh-VEEN-us) chemo.
  • Other types of chemo can be put right into the spine, chest, or belly (abdomen), or rubbed on the skin.

You may get chemo once a day, once a week, or even once a month. It may all be given in 1 day, or you may need to get it for a few days in a row. It depends on the type of cancer you have and the drugs you’re getting.

Chemo is usually given with breaks between treatment cycles. The breaks give your body time to rebuild healthy new cells and help you get your strength back. How long you get chemo depends on the type of cancer you have, your treatment goals, and how the cancer and your body work with the drugs.

Does chemo hurt?

There may be a little pain when a needle is used (just like getting your blood taken can sting), but the drugs should cause no pain. If you do feel pain, burning, coolness, or anything new when getting chemo, tell your nurse right away.

Can I take my other drugs while I’m taking chemo?

Some other drugs can affect your chemo. Be sure to tell your cancer care team about all the drugs you take. Don’t forget prescription drugs and those you can get without a prescription. Tell them about vitamins, herbs, and anything else you take. Make and keep a list of all the drugs you take. Keep this list up to date and share it with all your doctors.

Your doctor can tell you whether it’s OK to take these drugs while you get chemo. Once chemo starts, be sure to check with your doctor before you start any new drugs, and before you stop the ones you’ve been taking.

How will I know if my chemo is working?

Your cancer team will tell how well your treatment is working by doing physical exams, blood tests, and x-rays. Ask your doctor to explain any test results to you, and how they show if your treatment is working.

Keep in mind that side effects do not tell you if the chemo is – or is not – working.

How much does chemo cost?

The cost of chemo depends on a lot of things, such as which drugs are used, how you get them, and how often you get them. You can ask your cancer care team about cost and, if you need it, where to get help paying for chemo.

If you have health insurance, check to see if it pays for your drugs. You will want to keep your health insurance, even if you must be out of work for treatment. If you have health insurance through your job, don’t quit until you find a way to 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 about this.

If your insurance does not pay for treatment, or if they told you they will not pay for a claim, talk to your cancer care team. You may also want to talk to a patient support person at your treatment center. This person can help you look into government programs, like Medicare or Medicaid, or find other groups that may help you. Drug assistance programs are also offered through many of the companies that make the drugs.

Cancer treatment can cost a lot. It’s good to know what kind of coverage you have and what help you may be able to get.

What should I ask my doctor?

Your chemo will be planned just for you. Work with your cancer care team to decide what’s best for you. Ask questions. Ask the doctor, nurses, and others on your team all the questions you have. They know the most about chemo and how it works.

Be ready. Write down your questions ahead of time. Take them with you. Don’t be afraid to say you are confused or need more information. Nothing you say will sound silly or strange to your cancer care team. They know you want to learn as much about chemo as you can. All patients getting chemo have questions – here are some you might want to ask:

  • What is the goal of chemo in my case?
  • How will we know if the chemo is working?
  • After chemo, will I be cured?
  • Are there other ways besides chemo to treat my cancer?
  • If chemo doesn’t work, are there other treatments for me?
  • How will I get chemo, how often, and for how long?
  • Where will I get chemo?
  • What side effects should I watch for? Should I call you if I have any of these side effects – even at night or on a weekend? At what phone number?
  • Will I need surgery or radiation? If so, when and why?
  • Does my insurance pay for chemo? If not, how will I pay for it?
  • Will I be able to work (or go to school) during treatment?

Will I be able to work during treatment?

During chemo, many people can keep doing the things they were doing every day, such as going to work or school. But the side effects of chemo keep some people from being able to do some things they used to do. Also, some treatments may need to be given in the hospital.

If chemo means you can’t work or play like you used to, you may need to make some changes. One way to do this is to get your chemo late in the day or right before the weekend. This way it may not affect your daily life as much.

Fatigue (fuh-teeg) – feeling very tired – is a common side effect of chemo. This can make it hard to put in a full day’s work or do other things you want to do. You might try changing your work hours either by working part time or working different hours so that you can get the rest you need.

Federal and state laws may say your employer has to allow you to change your work hours during treatment. If you’d like to know more about your rights at work, call your American Cancer Society toll free at 1-800-227-2345, or click on the "Live Chat" link at the top of this page.

The American Cancer Society medical and editorial content team

Last Medical Review: March 15, 2016 Last Revised: March 15, 2016
