Planning your chemotherapy treatment

Your treatment is planned by a cancer doctor who will explain the aims of the chemotherapy and its possible side effects. The doctor will ask you to sign a form agreeing to treatment and may talk to you about chemotherapy clinical trials. You may also see a chemotherapy nurse and a pharmacist.

Chemotherapy is usually given as several sessions of treatment, with rest periods in between. Chemotherapy and the rest period make up one cycle of your treatment. Your cancer doctor will explain the number of cycles you need. Sometimes treatment involves having chemotherapy in more than one way.

If your chemotherapy treatment plan needs to be changed, your cancer doctor or nurse will explain why. It may be because of the effects of the chemotherapy on your body or on the cancer itself. Your doctor may delay your chemotherapy for a short while, reduce the dose or put you on a different chemotherapy drug.

Your cancer doctor and nurse will monitor you closely during treatment.

Planning chemotherapy

Your treatment is planned by your cancer doctor (oncologist) who is an expert in treating people with chemotherapy, and other cancer treatments and drugs. Other health professionals are also involved in your care. You may be introduced to a chemotherapy nurse specialist and also a pharmacist who can give you information and support.

Your cancer doctor or specialist nurse will explain the aims of your chemotherapy, possible side effects, and the benefits and disadvantages to you.


Giving your consent

Before you have any treatment, your doctor will explain its aims. They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you don't understand what you've been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it's not unusual to need repeated explanations.

It's a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it's important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can't make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don't have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don't have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

I know we all have a choice whether to accept chemo. If there is anything I have to go through to give myself a chance of survival, then I will.

Natty


Research – clinical trials

Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are carried out on patients are known as clinical trials. These may be carried out to:

  • test new treatments, such as new chemotherapy drugs or targeted therapies 
  • look at new combinations of existing treatments, or change the way they are given to make them more effective or reduce side effects
  • compare the effectiveness of drugs used to control symptoms
  • find out how cancer treatments work
  • find out which treatments are the most cost-effective.

Trials are the only reliable way to find out if a different type of surgery, chemotherapy, hormone therapy, radiotherapy, or other treatment is better than what is already available


Your course of chemotherapy

Chemotherapy is usually given as several sessions of treatment, with rest periods in between the sessions. The rest period allows your body to recover from the side effects, and the number of cells in your blood to go back to normal.

Chemotherapy and the rest period make up a cycle of your treatment. Your cancer doctor will explain the number of cycles you need to treat the cancer. After your first cycle, you’ll have a better idea of what you can plan for, and how much you may or may not be able to do. The complete course of all the cycles of chemotherapy you need may take several months.

How often you have chemotherapy, how it’s given, and how long your course takes depends on:

  • the type of cancer you have
  • the chemotherapy drugs you’re having, and how the cancer responds to the drugs
  • how the side effects are affecting you.

Sometimes treatment involves having chemotherapy in more than one way. For example, you may have chemotherapy into a vein (intravenous) and also take chemotherapy tablets.

Chemotherapy is sometimes given continuously by an infusion pump for several days or several weeks. If you’re having chemotherapy as tablets or capsules, you may have them daily for several weeks or months before a rest period.

An icon of a green ring-binder calendar with the number 31 on it.

Changes to your treatment plan

If your chemotherapy treatment plan needs to be changed, your cancer doctor or nurse will explain why.

It may be because of the effects of the chemotherapy on your body or on the cancer itself. Sometimes changes are made to suit your personal circumstances. Depending on the reason, your doctor may delay your chemotherapy for a short while, reduce the dose or put you on a different chemotherapy drug.


Delaying your chemotherapy

The most common reason for delaying chemotherapy is a low number of white blood cells or neutrophils. This isn’t unusual, so try not to worry too much about it. Once your white blood cells are back to a healthy level, you can start your next cycle of chemotherapy.

You may also be able to delay chemotherapy if you have a special social occasion coming up. Depending on the type of cancer, a small delay in your treatment won’t usually be a problem. Your cancer doctor or specialist nurse will tell you if this is advisable.


Effects on your body

Chemotherapy can affect organs, such as the lungs, kidneys, liver or the bone marrow. You will have regular tests to monitor this. Some drugs can affect the nerves in your feet and hands (known as peripheral neuropathy) and others drugs may affect your hearing.

Depending on the problem, your doctor may need to reduce the dose of the drug or change your chemotherapy drug to a different one.


Effects on the cancer

Your doctor may arrange x-rays, scans, blood tests or a physical examination during treatment. This is to check the effects of chemotherapy on the cancer.

If the test results show that chemotherapy is not having enough effect on the cancer, your doctor may talk to you about having different chemotherapy drugs.

Back to Chemotherapy explained

Chemotherapy trials for ALL

Clinical trials use drugs and treatments for ALL that are already known to work well, but in different combinations.

Your feelings

You may experience difficult feelings while having chemotherapy treatment. Talking these over can be helpful.

Where can you have chemotherapy?

You usually have chemotherapy in a chemotherapy day unit or clinic. If your treatment is more complex, you may need to stay in hospital.

Who might I meet?

A team of medical specialists will be involved throughout the course of your chemotherapy treatment.