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). This doctor 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 see a chemotherapy specialist nurse and 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
  • benefits and disadvantages.


Giving 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.

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 do not understand what you have been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it is not unusual to need repeated explanations.

It is 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 is 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 do not have it. It is essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You do not 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.

We have a choice about chemo, but I feel really there’s no choice. If there’s anything I have to go through to give myself a chance of survival, I will.

Natty


Clinical trials

Clinical trials are medical research studies involving people. Doctors may use cancer clinical trials to:

  • test new treatments to see if they work better than current treatments
  • find which treatments have fewer side effects
  • find new ways to combine treatments to see if they work better
  • test new cancer drugs to find out more about them and their side effects
  • improve the way treatments are given to try to reduce side effects.

Results from clinical trials can improve cancer treatments and help people live longer. Trials can also look at improving things like diagnosis and symptom management.

I took part in a clinical trial of a new chemotherapy drug. I'd already had treatment so my progress was measured against the new one.

Ron, clinical trial participant


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. It also allows the number of healthy 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 will have a better idea of what to expect, 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 is given, and how long your course takes depends on:

  • the type of cancer you have
  • the chemotherapy drugs you are having
  • 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 are 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 the effects on the cancer. Sometimes changes can be made to suit your personal circumstances. Depending on the reason, your doctor may:

  • delay your chemotherapy for a short while
  • reduce the dose
  • give you a different chemotherapy drug.


Delaying your chemotherapy

The most common reason for delaying chemotherapy is a low number of white blood cells (neutrophils). This is not unusual, so try not to worry too much about it. When 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 is not usually a problem. Your cancer doctor or specialist nurse can tell you if this is advisable.


Effects on your body

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

Sometimes 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 treatment.

Back to Chemotherapy explained

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It can be given alone or with other treatments.

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.

When is chemotherapy used?

Chemotherapy is used to kill cancer cells in the body. Your doctor will explain if chemotherapy is advised for you.