Common questions about chemotherapy
If you have been diagnosed with cancer, your doctors may recommend that you have chemotherapy. This is a common cancer treatment, but people often have a number of questions about it. The answers below provide some general information.
Your health care team can give you more details about your particular treatment.
Learn more about:
- How is chemotherapy given?
- Why does chemotherapy cause side effects?
- Does chemotherapy hurt?
- How much does treatment cost?
- Can I have chemotherapy during pregnancy?
- How long does treatment last?
- Where will I have treatment?
- How do I prepare for chemotherapy?
- Who will be in my health care team?
How is chemotherapy given?
Chemotherapy is most often given into a vein (intravenously). It is sometimes given in other ways, such as tablets you swallow (oral chemotherapy), as a cream you apply to the skin, or injections into different parts of the body. The choice depends on the type of cancer being treated and the chemotherapy drugs being used.
For more on this, see Having chemotherapy.
Why does chemotherapy cause side effects?
Chemotherapy damages cells that divide rapidly, such as cancer cells. However, some normal cells – such as blood cells, hair follicles and cells inside the mouth, bowel and reproductive organs – also divide rapidly.
When these normal cells are damaged, side effects may occur. Some people have few or mild side effects, while others may feel more unwell. As the body constantly makes new cells, most side effects are temporary. The drugs used for chemotherapy are constantly being improved to give you the best possible outcomes and to reduce potential side effects.
See Managing chemotherapy side effects for more information and talk to your treatment team for tips on dealing with side effects.
Does chemotherapy hurt?
Having a needle inserted for intravenous chemotherapy may feel like having blood taken. At first, it may be uncomfortable to have the temporary tube (cannula) put into your hand or arm, but it can then be used for the rest of the chemotherapy session. If you have something more permanent, such as a central venous access device, it shouldn’t be painful.
Some chemotherapy drugs can cause inflamed veins (phlebitis), which may be sore for a few days. It is important to let your treatment team know if this is a problem because there may be ways to reduce this discomfort or pain.
How much does treatment cost?
Chemotherapy drugs can be expensive. However, the Pharmaceutical Benefits Scheme (PBS) subsidises the cost of many chemotherapy drugs for people with a current Medicare card.
You usually have to contribute to the cost of oral chemotherapy drugs you take at home. This cost is known as a co-payment. Depending on the arrangements in your state or territory, and whether you are treated as an inpatient or an outpatient, or in a private or public hospital, you may have to contribute to the cost of some intravenous chemotherapy drugs.
There may be other out-of-pocket expenses. For example, you will usually have to pay part of the cost for any medicines that you take at home to relieve the side effects of chemotherapy (such as anti-nausea medicine). Remember to keep copies of your receipts if you are getting your prescriptions filled at different pharmacies, or ask your pharmacy to collate your prescription receipts. Once you have spent a certain amount of money on drugs in a year, you will be eligible for reduced cost or free drugs through the PBS Safety Net.
You have a right to know whether you will have to pay for treatment and drugs and, if so, what the costs will be. This is called informed financial consent. Ask your treatment centre for a written estimate that shows what you will have to pay. For more on this, see Cancer care and your rights.
Can I have chemotherapy during pregnancy?
Being diagnosed with cancer during pregnancy is rare – it is estimated that 1 in every 1000 pregnant women are affected.
Having chemotherapy in the first trimester (12 weeks) may increase the risk of miscarriage or birth defects, but there seems to be a lower risk in the later stages of pregnancy. Chemotherapy drugs may also cause premature delivery, and preterm babies often have other health issues, such as respiratory problems.
If you are already pregnant, it may be possible to have some types of chemotherapy. It’s best to discuss the potential risks and benefits with your oncologist or haematologist before treatment begins.
If you have chemotherapy during pregnancy, you will probably be advised to stop at least 3–4 weeks before your delivery date. This is because the side effects of chemotherapy on your blood cells increase your risk of bleeding or getting an infection during the birth. Talk to your doctor about your specific situation and what is best for your health and your unborn baby.
In some cases, chemotherapy can be delayed until after the baby’s birth. The treatment recommended will be based on the type of cancer you have, its stage, other treatment options and protecting your developing baby.
You will be advised not to breastfeed during chemotherapy as drugs can pass through breastmilk and may harm the baby. For more on this see, Cancer and pregnancy.
How long does treatment last?
How often and for how long you have chemotherapy depends on the type of cancer you have, the reason for having treatment, the drugs that are used and whether you have side effects.
Chemotherapy treatment before or after surgery is often given for up to 6 months. Maintenance chemotherapy (to prevent the cancer coming back) and palliative treatment (to control the cancer or relieve symptoms) may continue for many months or years. If you feel upset or anxious about how long treatment is taking or the impact of side effects, let your treatment team know.
Where will I have treatment?
Most people have chemotherapy as an outpatient during day visits to a hospital or treatment centre. In some cases, an overnight or extended hospital stay may be needed. People who use a portable pump or have oral chemotherapy can usually have their treatment at home. Sometimes a visiting nurse can give you chemotherapy intravenously or by injection in your home.
Podcast: Making Treatment Decisions
Prof Timothy Price, Medical Oncologist, The Queen Elizabeth Hospital, SA; Graham Borgas, Consumer: Dr Joanna Dewar, Medical Oncologist and Clinical Professor, Sir Charles Gairdner Hospital and The University of Western Australia, WA; Justin Hargreaves, Medical Oncology Nurse Practitioner, Bendigo Health Cancer Centre, VIC; Angela Kritikos, Senior Oncology Dietitian, Dietetic Department, Liverpool Hospital, NSW; Dr Kate Mahon, Director of Medical Oncology, Chris O’Brien Lifehouse, NSW; Georgie Pearson, Consumer; Chris Rivett, 13 11 20 Consultant, Cancer Council SA; Marissa Ryan, Acting Consultant Pharmacist (Cancer Services), Pharmacy Department, Princess Alexandra Hospital, QLD.
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