Chemotherapy is the treatment of cancer with drugs that kill cancer cells or slow their growth.
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When is it used?
Chemotherapy can be used at different times:
- before surgery to try to shrink the cancer and make it easier to remove the cancer (neoadjuvant chemotherapy)
- before or in combination with radiation therapy to make radiation therapy more effective (chemoradiation)
- after surgery to reduce the risk of the cancer returning (adjuvant chemotherapy)
- when cancer is advanced – to reduce symptoms and improve quality of life (palliative chemotherapy).
Having chemotherapy
Chemotherapy is usually given through a vein (intravenously). Each chemotherapy treatment is followed by a rest period to give your body time to recover. Together, the session and rest period are called a cycle. The number of cycles will depend on the type of lung cancer and side effects you have. You will probably have chemotherapy as an outpatient. Ask your doctor about the treatment plan recommended for you.
Some types of chemotherapy come in tablet form and can be taken by mouth (orally). These are sometimes used on an ongoing basis.
Side effects of chemotherapy
Chemotherapy works on cells that are dividing rapidly. Cancer cells divide rapidly, as do some healthy cells such as the cells in your blood, mouth, digestive system and hair follicles. Side effects occur when chemotherapy damages these normal cells. As the body constantly makes new cells, most side effects are temporary. Some side effects are listed below.
Anaemia
A low red blood cell count is called anaemia. This can make you feel tired, breathless or dizzy. Your treatment team will monitor your red blood cell levels and suggest treatment if necessary.
Risk of infections
Chemotherapy drugs can lower the number of white blood cells that fight infections caused by bacteria. If you get an infection caused by a virus, such as a cold, flu or COVID-19, the risk of getting a bacterial infection is increased even more. It is important to have good hand and mouth hygiene, and social distancing and isolation are recommended.
If you feel unwell or have a temperature above 38°C, call your doctor immediately or go to the hospital emergency department.
Mouth ulcers
Some chemotherapy drugs cause mouth sores, ulcers and thickened saliva, which make it difficult to swallow. Your treatment team will explain how to take care of your mouth.
Hair loss
You may lose hair from your head and chest, depending on the chemotherapy drugs you receive. The hair will grow back after treatment is completed, but the colour and texture may change.
Nausea or vomiting
You will usually be prescribed anti-nausea medicine with your chemotherapy drugs, but some people still feel sick (nauseous) or vomit, or become constipated. Let your treatment team know if you have these side effects, as they may be able to offer another anti-nausea medicine.
For more on this, see Chemotherapy, Mouth health and Hair loss, and listen to our podcast on Appetite Loss and Nausea.
Video: What is chemotherapy?
Listen to our podcast on Making Treatment Decisions
A/Prof Nick Pavlakis, President, Australasian Lung Cancer Trials Group, President, Clinical Oncology Society of Australia, and Senior Staff Specialist, Department of Medical Oncology, Royal North Shore Hospital, NSW; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Private Hospital Melbourne, VIC; Prof Kwun Fong, Thoracic and Sleep Physician and Director, UQ Thoracic Research Centre, The Prince Charles Hospital, and Professor of Medicine, The University of Queensland, QLD; Renae Grundy, Clinical Nurse Consultant – Lung, Royal Hobart Hospital, TAS; A/Prof Brian Le, Director, Palliative Care, Victorian Comprehensive Cancer Centre – Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, and The University Of Melbourne, VIC; A/Prof Margot Lehman, Senior Radiation Oncologist and Director, Radiation Oncology, Princess Alexandra Hospital, QLD; Susana Lloyd, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Nicole Parkinson, Lung Cancer Support Nurse, Lung Foundation Australia.
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