What is chemotherapy?

Chemotherapy is the use of medicines to treat cancer. Chemotherapy medicines are used to destroy or slow the growth of cancer cells.

Chemotherapy is also known as 'chemo'.

How does chemotherapy work?

Your body is made up of billions of small building blocks called cells. The different tissues and organs of your body are made up of different types of cells.

Your body's cells divide to make new cells. When you are healthy, this process of division is tightly controlled and only takes place when needed, for example, to replace damaged or old cells. If your cells begin to grow and divide in an uncontrolled way, you may develop a cancer.

Chemotherapy is designed to target cancer cells that are dividing too quickly.

Chemotherapy may be used in cancer treatment for a few different reasons:

• Curative chemotherapy is designed to directly treat the cancer and try to destroy it, usually without the use of other treatments.
• Neoadjuvant chemotherapy can be used before surgery to shrink the cancer and make the surgery more effective.
• Adjuvant chemotherapy is used after other cancer treatments such as surgery and radiotherapy to increase the chance of successfully destroying the cancer.
• Palliative chemotherapy is not usually meant to cure cancer. It can be used to reduce cancer size, which can improve symptoms, or to limit the growth and spread of the cancer. This kind of chemotherapy may be used for months or years.

Chemotherapy can also be used together with cancer immunotherapy.

How is chemotherapy given?

Chemotherapy can be given in a few different ways, depending on the type of cancer and the chemotherapy medicines being used.

Chemotherapy is often given through a vein (intravenously, or IV). If this is the case, it will often be given at a day hospital or day-treatment centre. You can usually go home between sessions. Sessions may last for anywhere between 20 minutes and several hours. It depends on the kind of chemotherapy you are getting and how you feel during and after treatment.

If the medicine needs to be given for only a short time, it can be given through a small plastic tube (cannula) inserted into a vein, usually in your hand or arm.

If you need to receive IV treatment for longer, your doctor or oncologist may suggest using a device that can stay in place for weeks or months. This saves you from getting a new IV line every time you receive chemotherapy.

Chemotherapy can also be given in other ways, for example, as tablets or a cream. It can also be injected into a specific body area for certain types of cancer.

What are the side effects of chemotherapy?

Chemotherapy uses medicines which often have side effects. Everyone responds differently to chemotherapy. You may experience many or a few side effects and feel them strongly or only mildly.

Most commonly, people on chemotherapy feel fatigued (tired).

As chemotherapy affects fast-growing cells, it commonly causes side effects in your skin, hair, gut and immune system.

Side effects can include:

• hair loss
• nausea and vomiting
• diarrhoea or constipation
• mouth sores
• frequent infections

Some chemotherapy medicines can have a higher chance of damaging specific areas of your body, such as your heart, lungs or nervous system. These effects may last temporarily or permanently. Ask your doctor about the medicines recommended for you and any specific effects that they may have on your body.

There are many medicines and strategies which can help ease your side effects. For example:

• your doctor can prescribe medicines to help with nausea
• ice chips can help sooth a sore mouth
• 'cold caps' may help reduce hair loss

Your medical team can give you more detailed advice about what is available to help you remain as comfortable as possible during your treatment.

How long will I need chemotherapy?

The specific type, dose and length of your chemotherapy will depend on:

• the type and stage of your cancer
• your general health
• the purpose of the chemotherapy
• how well your cancer is responding to treatment
• any side effects

Chemotherapy is usually given in 'cycles'. For example, 2-weeks of treatment followed by a 2-week break. This gives your body a chance to recover.

You may need blood tests or scans between treatment cycles. This is to check on the cancer and to make sure your body has recovered enough to cope with the next cycle of chemotherapy.

Your medical team may make changes to your treatment based on how you feel and on your test results.

Will chemotherapy affect my fertility?

Chemotherapy can affect your fertility by damaging the cells of your reproductive organs, such as eggs or sperm. Sometimes these cells will recover months or years after chemotherapy, but sometimes the damage is permanent.

Chemotherapy may also affect your menstrual cycle (periods). Your periods can become irregular or stop completely while you are receiving treatment. Your cycle may return after you stop chemotherapy, but it can sometimes stop permanently, causing early menopause. This makes it impossible to conceive naturally.

Some people choose to take steps to preserve their fertility before starting cancer treatment. These steps can include freezing eggs, sperm or embryos, or more complex treatments.

Your options will depend on:

• the cancer you have
• the treatment suggested by your doctor

You may wish to discuss fertility preservation with your medical team before you start any cancer treatments.

Despite this, it is important to realise that you may still be fertile while undergoing cancer treatment.

Chemotherapy may be dangerous for an unborn baby, who has many fast-growing cells, so you may also wish to discuss contraception with your doctor before starting treatment.

Safety advice for carers of people having chemotherapy

Chemotherapy medicines may remain in your body for about a week after each treatment session. During this time, very small amounts of chemotherapy drugs may be in your body fluids.

To protect people who you are in close contact with at home:

• sit down when using the toilet and flush with the lid down
• store any chemotherapy medicines safely
• it's safest for people without cancer to avoid touching the medicines

During chemotherapy, it's also important to have safe sex (using condoms) and avoid pregnancy.

If you are caring for, or in close contact with, someone having chemotherapy, there are some precautions you can take, including:

• wearing disposable waterproof gloves when you touch anything with body fluids on it
• disposing of gloves and cleaning products in a sealed plastic bag

Usually, there is little risk to your visitors. This is because they aren't likely to have contact with any chemotherapy medicines or body fluids.

Resources and support

Dealing with cancer and cancer treatment can feel very overwhelming. There are many organisations that can help with information and support.

Cancer Council has information about cancer and cancer treatment, as well as support and services for people with cancer — call 13 11 20.

• Cancer Council NSW has cancer information in different languages.
• Cancer Council has resources for Aboriginal and Torres Strait Islander peoples.
• Cancer Australia also has cancer resources in languages other than English and resources for Aboriginal and Torres Strait Islander people.

Children and teenagers

• Canteen is a cancer support network for 12 to 25-year-olds, and their families and carers.
• Camp Quality supports kids (aged 0 to 15 years) dealing with cancer.
• healthdirect has information on dealing with childhood cancer.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.