Frequently Asked Questions (FAQ) About Chemotherapy
Q: What does chemotherapy do?A. Depending on your type of cancer and how advanced it is, chemotherapy can:
- Cure cancer – when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body and they will not grow back.
- Control cancer – when chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
- Ease cancer symptoms (also called palliative care) – when chemotherapy shrinks tumors that are causing pain or pressure.
Q. How is Chemotherapy used?A. Sometimes, chemotherapy is used as the only cancer treatment. But more often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy. Chemotherapy can:
- Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
- Destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy.
- Help radiation therapy and biological therapy work better.
- Destroy cancer cells that have come back (recurrent cancer) or spread to other parts of your body (metastatic cancer).
Q. How does my doctor decide which chemotherapy drugs to use??A. This choice depends on:
- The type of cancer you have. Some types of chemotherapy drugs are used for many types of cancer.
- Other drugs are used for just one or two types of cancer.
- Whether you have had chemotherapy before
- Whether you have other health problems, such as diabetes or heart disease
Q. Where do I go for chemotherapy?A. You may receive chemotherapy during a hospital stay, at home, or in a doctor’s office, clinic, or outpatient unit in a hospital (which means you do not have to stay overnight). No matter where you go for chemotherapy, your doctor and nurse will watch for side effects and make any needed drug changes.
Q. How often will I receive chemotherapy?A. Treatment schedules for chemotherapy vary widely. How often and how long you get chemotherapy depends on:
- Your type of cancer and how advanced it is
- The goals of treatment (whether chemotherapy is used to cure your cancer, control its growth, or ease the symptoms)
- The type of chemotherapy
- How your body reacts to chemotherapy
- You may receive chemotherapy in cycles. A cycle is a period of chemotherapy treatment followed by a period of rest. For instance, you might receive 1 week of chemotherapy followed by 3 weeks of rest. These 4 weeks make up one cycle. The rest period gives your body a chance to build new healthy cells.
Q. Can I miss a dose of chemotherapy?A.It is not good to skip a chemotherapy treatment. But sometimes your doctor or nurse may change your chemotherapy schedule. This can be due to side effects you are having. If this happens, your doctor or nurse will explain what to do and when to start treatment again.
Q. How is chemotherapy given?A. Chemotherapy may be given in many ways.
- Injection. The chemotherapy is given by a shot in a muscle in your arm, thigh, or hip or right under the skin in the fatty part of your arm, leg, or belly.
- Intra-arterial (IA). The chemotherapy goes directly into the artery that is feeding the cancer.
- Intraperitoneal (IP). The chemotherapy goes directly into the peritoneal cavity (the area that contains organs such as your intestines, stomach, liver, and ovaries).
- Intravenous (IV). The chemotherapy goes directly into a vein.
- Topically. The chemotherapy comes in a cream that you rub onto your skin.
- Orally. The chemotherapy comes in pills, capsules, or liquids that you swallow.
Q. How will I feel during chemotherapy?A. Chemotherapy affects people in different ways. How you feel depends on how healthy you are before treatment, your type of cancer, how advanced it is, the kind of chemotherapy you are getting, and the dose. Doctors and nurses cannot know for certain how you will feel during chemotherapy. Some people do not feel well right after chemotherapy. The most common side effect is fatigue, feeling exhausted and worn out. You can prepare for fatigue by:
- Asking someone to drive you to and from chemotherapy
- Planning time to rest on the day of and day after chemotherapy
- Getting help with meals and childcare the day of and at least 1 day after chemotherapy
Q. Can I work during chemotherapy?A. Many people can work during chemotherapy, as long as they match their schedule to how they feel. Whether or not you can work may depend on what kind of work you do. If your job allows, you may want to see if you can work part-time or work from home on days you do not feel well.
Many employers are required by law to change your work schedule to meet your needs during cancer treatment. Talk with your employer about ways to adjust your work during chemotherapy. You can learn more about these laws by talking with a social worker.
Q. I take over-the-counter and prescription drugs while I get chemotherapy?A. This depends on the type of chemotherapy you get and the other types of drugs you plan to take. Take only drugs that are approved by your doctor or nurse. Tell your doctor or nurse about all the over-the-counter and prescription drugs you take, including laxatives, allergy medicines, cold medicines, pain relievers, aspirin, and ibuprofen.
One way to let your doctor or nurse know about these drugs is by bringing in all your pill bottles. Your doctor or nurse needs to know:
- The name of each drug
- The reason you take it
- How much you take
- How often you take it
Q. Can I take vitamins, minerals, dietary supplements, or herbs while I get chemotherapy?A. Some of these products can change how chemotherapy works. For this reason, it is important to tell your doctor or nurse about all the vitamins, minerals, dietary supplements, and herbs that you take before you start chemotherapy. During chemotherapy, talk with your doctor before you take any of these products.
Q. How will I know if my chemotherapy is working?A. Your doctor will give you physical exams and medical tests (such as blood tests and x-rays). He or she will also ask you how you feel.
You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well. Or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.
Q. How much does chemotherapy cost?A. It is hard to say how much chemotherapy will cost. It depends on:
- The types and doses of chemotherapy used
- How long and how often chemotherapy is given
- Whether you get chemotherapy at home, in a clinic or office, or during a hospital stay
- The part of the country where you live
Q. Does my health insurance pay for chemotherapy?A. Talk with your health insurance plan about what costs it will pay for. Questions to ask include:
- What will my insurance pay for?
- Do I or does the doctor’s office need to call my insurance company before each treatment for it to be paid for?
- What do I have to pay for?
- Can I see any doctor I want or do I need to choose from a list of preferred providers?
- Do I need a written referral to see a specialist?
- Is there a co-pay (money I have to pay) each time I have an appointment?
- Is there a deductible (certain amount I need to pay) before my insurance pays?
- Where should I get my prescription drugs?
- Does my insurance pay for all my tests and treatments, whether I am an inpatient or outpatient?
Tips For Working With Your Insurance Company:
• Read your insurance policy before treatment starts to find out what your plan will and will not pay for.
• Keep records of all your treatment costs and insurance claims.
• Send your insurance company all the paperwork it asks for. This may include receipts from doctors’ visits, prescriptions, and lab work. Be sure to also keep copies for your own records.
• As needed, ask for help with the insurance paperwork. You can ask a friend, family member, social worker, or local group such as a senior center.
• If your insurance does not pay for something you think it should, find out why the plan refused to pay. Then talk with your doctor or nurse about what to do next. He or she may suggest ways to appeal the decision or other actions to take.
Cancer clinical trials (also called cancer treatment studies or research studies) test new treatments for people with cancer. These can be studies of new types of chemotherapy, other types of treatment, or new ways to combine treatments. The goal of all these clinical trials is to find better ways to help people with cancer. Your doctor or nurse may suggest you take part in a clinical trial. You can also suggest the idea. Before you agree to be in a clinical trial, learn about:
• Benefits. All clinical trials offer quality cancer care. Ask how this clinical trial could help you or others. For instance, you may be one of the first people to get a new treatment or drug.
• Risks. New treatments are not always better or even as good as standard treatments. And even if this new treatment is good, it may not work well for you.
• Payment. Your insurance company may or may not pay for treatment that is part of a clinical trial. Before you agree to be in a trial, check with your insurance company to make sure it will pay for this treatment.
Your Feelings During Chemotherapy
At some point during chemotherapy, you may feel:
It is normal to have these kinds of feelings. Living with cancer and going through treatment is stressful. You may also feel fatigue, which can make it harder to cope with these feelings.
There are many things you can do to cope with your feelings during treatment. Here are some things that have worked for other people:
- Relax and meditate. You might try thinking of yourself in a favorite place, breathing slowly while paying attention to each breath, or listening to soothing music. These kinds of activities can help you feel calmer and less stressed.
- Exercise. Many people find that light exercise (such as walking, biking, yoga, or water aerobics) helps them feel better. Talk with your doctor or nurse about types of exercise that you can do.
- Talk with others. Talk about your feelings with someone you trust. You may choose a close friend, family member, chaplain, nurse, social worker, or psychologist. You may also find it helpful to talk to someone else who is going through chemotherapy.
- Join a support group. Cancer support groups are meetings for people with cancer. These groups allow you to meet others facing the same problems. You will have a chance to talk about your feelings and listen to other people talk about theirs. You can learn how others cope with cancer, chemotherapy, and side effects. Your doctor, nurse, or social worker can tell you about support groups near where you live. Some support groups also meet over the Internet, which can be helpful if you cannot travel or find a meeting in your area.
- Talk to your doctor or nurse about things that worry or upset you. You may want to ask about seeing a counselor. Your doctor may also suggest that you take medicine if you find it very hard to cope with these feelings.
Remember, you are not alone! We are here to help! Please do not hesitate to contact us regarding any questions or concerns you may have on chemotherapy.
Chemotherapy Side Effects
Side effects are problems caused by cancer treatment. Some common side effects from chemotherapy are fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores, and pain.
Chemotherapy is designed to kill fast-growing cancer cells. But it can also affect healthy cells that grow quickly. These include cells that line your mouth and intestines, cells in your bone marrow that make blood cells, and cells that make your hair grow. Chemotherapy causes side effects when it harms these healthy cells.
Will I definitely get side effects? You may have a lot of side effects, some, or none at all. This depends on the type and amount of chemotherapy you get and how your body reacts. Before you start chemotherapy, talk with your doctor or nurse about which side effects to expect.
How long will side effects last? How long side effects last depends on your health and the kind of chemotherapy you get. Most side effects go away after chemotherapy is over. But sometimes it can take months or even years for them to go away.
Sometimes, chemotherapy causes long-term side effects that do not go away. These may include damage to your heart, lungs, nerves, kidneys, or reproductive organs. Some types of chemotherapy may cause a second cancer years later. Ask your doctor or nurse about your chance of having long-term side effects.
What can be done about side effects? Doctors have many ways to prevent or treat chemotherapy side effects and help you heal after each treatment session. Talk with your doctor or nurse about which ones to expect and what to do about them. Make sure to let your doctor or nurse know about any changes you notice – they may be signs of a side effect.