Chemotherapy

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Chemotherapy (chemo) refers to the many drugs that oncologists (cancer doctors) use to destroy cancer cells. Cancer treatments like surgery and radiation therapy target specific parts of the body, but chemo goes to all body parts.

Even with the most sophisticated imaging scans, there isn’t a way to be 100% certain that some cancer cells are not present somewhere in the body. It takes a large cluster of cancer cells to show on a scan, and even a few rogue cells are potentially dangerous. That’s why oncologists frequently recommend chemo even if all the scans look clear.

Types of Cancer We Treat

Oncologists can use chemotherapy to treat a wide variety of cancers:

How Chemotherapy Works

Because cancer cells generally grow and divide or multiply more quickly than normal cells, chemo kills all fast-growing cells. This explains why some chemo drugs make you lose your hair or give you mouth sores. It is also why chemo is held off while someone is healing from surgery or another injury.

Because the cancer medications used for chemotherapy are so powerful, they cause damage to many growing cells — including healthy ones. It is this damage that causes the side effects linked with chemo treatment. If your oncologist prescribes chemotherapy, your doctor or nurse will give you complete details about the particular drugs that they’re using in your care.

Types of Chemotherapy

Medical oncology teams may use chemo in several different situations:

People with early cancer. For people with early cancers, the goal of chemotherapy is cure. Although oncologists can’t ever promise someone that the cancer is truly gone, chemo frequently succeeds.
People with recurrent (returning) cancer. For people whose cancer has returned or was never completely removed by surgery, the oncologist can use chemo to control the disease. In these situations, you’ll receive treatment indefinitely — probably for the rest of your life.
Palliative chemo. Finally, the cancer team can use chemotherapy to ease side effects and generally help someone feel better. If you’re very ill, there is a balance between the benefits of chemo and the possible side effects. This inevitably means there are complicated and careful conversations with your doctors in order to make the best decision for you.

Specialty Nurses

While receiving chemotherapy at the Cancer Center, you’ll benefit from the expertise and deep training of our nurses. They have undergone specialized chemotherapy training from the Oncology Nursing Society.

How You Receive Chemotherapy

The Division of Medical Oncology care teams typically plan chemotherapy in cycles. This means — for example — that you might receive a treatment on Monday, called Day 1, and a second treatment the next Monday, called Day 8. This counts as one cycle.

You then have two to four weeks before the next round of chemo. The time off gives your body — especially your blood counts — time to recover. If you are undergoing rounds of chemo, you’ll quickly learn what the pattern is like for you and be able to plan your life around the days you feel best.

Many people think of chemo as an infusion through an intravenous (IV) line. There are, however, other possibilities. Some chemo drugs are received as an injection directly into a muscle in your arm, hip, buttocks or stomach. Sometimes, especially if the veins in your arm are hard to access, your oncologist may surgically place a port (opening) in your upper chest. Your care team then directly administers the chemo drugs into an artery there.

Preparing for Your First Chemo Treatment

There are strategies to prepare yourself and your household for the months of treatment. Even though you are likely to feel relatively well most days, some days you’ll feel fatigued or unwell. Advance planning can help. Here are some ideas:

Talk with your doctor about the specific drugs you’ll receive. Side effects vary greatly, and there’s no need to worry about something that isn’t relevant to your care.
If you might lose your hair, plan in advance how you want to manage it. Make sure that you have a wig, hats or scarves in your house if you think you’ll want to use them.
Cook ahead and freeze some portion-size meals. Think comfort food: soups, macaroni and cheese, or other favorite pasta dishes.
Buy a range of beverages. It will be important to drink lots of fluids, and you want a variety on hand. Ginger, mint or chamomile teas may be soothing. Plain water may carry a metallic taste, and mixing carbonated water with a little juice usually goes down easier.
Consider treating yourself to a new set of soft sheets. Naps will be nicer in comfort.
Buy a comfortable bathrobe or new set of sweats to wear on days you don’t feel well.
A nice gift would be a Kindle or some other tablet reader. iPads offer many entertainment choices. These are portable, easy to carry to appointments and lightweight to hold.
Think about small treats and plan them for a day or two after each treatment.
Do not expect to complete any lingering projects while you are home. Organizing decades of photographs and cleaning out the attic aren’t realities during chemotherapy.
Eliminate any unnecessary tasks. You are excused from sending holiday cards or even writing most thank you notes. Make yourself the priority during this time.
Assign jobs to your children and other household members. Even little ones can set the table, bring you a glass of water or rub your back. They are likely to feel better if they are helpful and included. Older children can rake leaves, do laundry and make simple meals.
Have more than one talk with your spouse or partner about allocating duties. You won’t feel up to doing your normal share, and they will need to do more than usual.

Cold Capping for Hair Loss

Cold caps or scalp cooling is a process to help some people lose less hair during chemotherapy, most often during breast cancer treatment. The Food and Drug Administration (FDA) has approved two systems for use in the United States: the DigniCap Scalp Cooling System and the Paxman System. Not all hospitals or treatment centers have these systems available.

The benefit and success of scalp cooling in reducing hair loss depends on several things, most importantly the drugs used and the dose. To learn more about this option, speak with your cancer care team before starting chemo.

The Chemotherapy Room at BIDMC

We’ve designed our chemotherapy room with your comfort in mind. The room features:

Large chairs (oversized recliners)
Regular chairs for any family or friends with you
A few hospital-like rooms for those who are very ill or will be spending the entire day for a long treatment
Warm blankets and pillows, if desired
Curtains or screens to provide privacy, if desired

You can ask for tea or a cold beverage. Someone will continuously check in to monitor the infusion and your well-being. Some people choose to sleep during chemotherapy. Most are talking quietly, working or watching a movie on a tablet or computer.

Managing Chemotherapy Side Effects

In the past, people having chemotherapy usually had to deal with negative side effects such as nausea and vomiting. Thankfully, today’s oncologists can prescribe medications to help people going through chemo better manage these side effects.

For your first treatment, we give the drugs that generally work best. However, everyone is different, and some people do better with a different mix of drugs. If you feel rotten after chemo, call your doctor. There is likely something they can prescribe or change to make you feel better.

Learn more about supportive services and palliative care available during and after your cancer treatment.