Chemotherapy uses drugs to kill or slow the growth of cancer cells while doing the least possible damage to healthy cells.
Learn more about:
- When chemotherapy is used
- Having chemotherapy
- Side effects of chemotherapy
- Video: What is chemotherapy?
When chemotherapy is used
If the cancer has spread to lymph nodes or to other organs, chemotherapy may be recommended before or after surgery or on its own.
| Before surgery (neoadjuvant) | Some people with rectal cancer have chemotherapy before surgery to shrink it so it’s easier to remove. You may have only chemotherapy or with radiation therapy (chemoradiation). |
| After surgery (adjuvant) | Chemotherapy after surgery for colon or rectal cancer aims to destroy any remaining cancer cells and reduce the chance of the cancer coming back. If your doctor recommends chemotherapy, you usually start treatment within 6–8 weeks, when your wounds have healed and you’ve recovered your strength. |
| On its own | If the cancer has spread to other organs, such as the liver or lungs, chemotherapy may be used either to shrink the tumours or to reduce symptoms and make you more comfortable. |
Having chemotherapy
Chemotherapy is usually given through a drip into a vein (intravenously). To avoid repeated needles, you may have it through a device inserted beneath your skin, such as a port-a-cath or peripherally inserted central catheter (PICC). Sometimes chemotherapy is taken as tablets (orally).
Chemotherapy is commonly given as a period of treatment followed by a break. This is called a cycle. Adjuvant chemotherapy is usually given for 3–6 months, in cycles that last for 2–3 weeks each. Your medical oncologist will explain your treatment schedule. Usually, you have chemotherapy during day visits to a hospital or treatment centre. Some people have chemotherapy at home through a portable pump.
Side effects of chemotherapy
The side effects of chemotherapy vary, depending on the drugs used and the dose. Your medical oncologist or nurse will talk to you about the likely side effects, including how they can be prevented or controlled.
If side effects are hard to manage, the chemotherapy treatment can be adjusted to reduce the side effects while still giving you a good result.
Side effects may include:
- tiredness
- neutropenia (low white blood cells)
- feeling sick (nausea and vomiting)
- diarrhoea
- lip and mouth sores
- changes in appetite, taste and smell
- sore hands and feet (peripheral neuropathy)
- hair loss or thinning.
The chemotherapy drug oxaliplatin may make your hands, feet, mouth and throat sensitive to cold items (e.g. cold food and drinks, air conditioning), causing pins and needles and numbness. Skin rash and increased sensitivity to sunburn are more common if using the chemotherapy drug fluorouracil or capecitabine.
Keep a record of the doses and names of your chemotherapy drugs handy. This will save time if you get an infection and need to visit the emergency department (see below). You may also find it helpful to keep a symptom diary when you start chemotherapy, so you can monitor side effects as they occur.
For more on this, see Chemotherapy and Managing cancer side effects.
If you are having chemotherapy, you have a higher risk of getting an infection or bleeding. If you have a temperature of 38°C or higher, or the “shivers and shakes”, contact your doctor or go to the emergency department immediately. Tell your doctor if you feel more tired than usual, or if you bruise or bleed easily.
→ READ MORE: Treatment for advanced bowel cancer
Video: What is chemotherapy?
Watch this short video to learn more about chemotherapy.
Podcast: Making Treatment Decisions
Listen to more episodes from our podcast for people affected by cancer
More resources
Prof Alexander Heriot, Colorectal Surgeon and Director Cancer Surgery, Peter MacCallum Cancer Centre, Director, Lower GI Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Dr Cameron Bell, Gastroenterologist, Royal North Shore Hospital, NSW; Graham Borgas, Consumer; Prof Michael Bourke, Director of Gastrointestinal Endoscopy, Westmead Hospital, The University of Sydney, NSW; Laura Carman, 13 11 20 Consultant, Cancer Council Victoria, VIC; Amanda Connolly, Specialist Bowel Care Nurse, Icon Cancer Centre Windsor Gardens, SA; A/Prof Melissa Eastgate, Operations Director, Cancer Care Services, Royal Brisbane and Women’s Hospital, QLD; Anne Marie Lyons, Stomal Therapy Nurse, Concord Repatriation General Hospital and NSW Stoma Ltd, NSW; Lisa Nicholson, Manager Bowel Care Services, Bowel Cancer Australia, NSW; Stefanie Simnadis, Clinical Dietitian, St John of God Subiaco Hospital, WA; Rafi Sharif, Consumer; Dr Kirsten van Gysen, Radiation Oncologist, The Nepean Cancer and Wellness Centre, NSW; Sarah Williams, Clinical Nurse Consultant, Lower GI, Peter MacCallum Cancer Centre, VIC.
View the Cancer Council NSW editorial policy.
