Planning your chemotherapy treatment

Your cancer doctor will explain the aims of the chemotherapy and its possible side effects. They may ask you to sign a form giving your permission to have the treatment.

You often have chemotherapy given into a vein as one or more sessions of treatment, followed by a rest period of a few weeks. This makes up one cycle of your treatment.

Some people have it as tablets for longer periods, or through a pump they can go home with. How often you have chemotherapy, how it’s given and how long the whole course takes depends on:

  • the type of cancer you have
  • the chemotherapy drugs
  • how the side effects affect you
  • how the cancer responds to chemotherapy.

Chemotherapy affects your blood cells and may also affect organs, such as your kidneys or liver. Sometimes a treatment session can be delayed because the number of white cells in your blood is too low. But when your white blood cell count returns to normal you can have it again.

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

Planning your chemotherapy

Your treatment is planned by your cancer doctor (clinical or medical oncologist) who is an expert in treating people with cancer using chemotherapy, radiotherapy and other anti-cancer drugs.

Other health professionals are also involved in your care. You may be introduced to a chemotherapy nurse specialist who will give you information and support.

Your cancer specialist or your 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.


Your course of chemotherapy

How often you have chemotherapy, how it’s given, and how long your whole 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 chemotherapy tablets.

Chemotherapy is usually given as several sessions of treatment followed by a rest period of a few weeks. 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.

Some people are given drugs to take a day or two before treatment to reduce the risk of an allergic reaction or sickness. This depends on the type of chemotherapy and your nurse will go over this with you.

Chemotherapy and the rest period together 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 your the chemotherapy may take several months.

Chemotherapy is sometimes given by an infusion pump continuously 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.


Blood tests

Before chemotherapy you’ll have a blood test. To save time it may be checked a day or two before chemotherapy. This can be done at the hospital where you’re having chemotherapy, or by your GP, practice nurse or a hospital closer to home. The results will be ready for you when you go to have your chemotherapy.


Changes to your treatment plan

Sometimes people may need their chemotherapy treatment plan changed. If this happens your cancer doctor or nurse will explain why it’s advised in your situation.

It may be because of the effects of the chemotherapy on your body or on the cancer itself. Sometimes changes can be made to suit your personal circumstances.

Effects on your body

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

Depending on the problem your doctor may delay your chemotherapy for a short while, reduce the dose or change you to another chemotherapy drug.

Delaying your chemotherapy

The most common reason for delaying chemotherapy is the number of white cells in the blood being too low.

This isn’t unusual so try not to get too worried about it. Once your white cells are back up to a healthy level you can get on with your next cycle of chemotherapy.

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

Effects on the cancer

Your doctor may arrange tests or a physical examination to check the effects of chemotherapy on the cancer.

If the results show the cancer isn’t responding well enough your doctor may change your treatment plan to different chemotherapy drugs.


Back to Chemotherapy explained

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is usually given by injection or as tablets.

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.