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Questions and Answers About Chemotherapy
What is
chemotherapy? | Chemotherapy (also called chemo) is a type of cancer
treatment that uses drugs to destroy cancer cells.
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How does
chemotherapy
work? | Chemotherapy works by stopping or slowing the growth of
cancer cells, which grow and divide quickly. But it can also
harm healthy cells 1 that divide quickly, such as those that line
your mouth and intestines or cause your hair to grow. Damage
to healthy cells may cause side effects. Often, side effects get
better or go away after chemotherapy is over.
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What does
chemotherapy do? | 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.
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How is
chemotherapy
used? | 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 2.
- 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).
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How does my doctor
decide which
chemotherapy
drugs to use? | 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
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Where do I go for
chemotherapy? | 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.
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How often
will I receive
chemotherapy? | 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.
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Can I miss a dose
of chemotherapy? | 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.
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How is chemotherapy
given?
| 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) 3. 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.
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Things to know about getting chemotherapy through an IV
Chemotherapy is often given through a thin needle that is placed in a vein on your hand or
lower arm. Your nurse will put the needle in at the start of each treatment and remove it
when treatment is over. Let your doctor or nurse know right away if you feel pain or
burning while you are getting IV chemotherapy.
IV chemotherapy is often given through catheters or ports, sometimes with the help of
a pump.
- Catheters. A catheter is a soft, thin tube. A surgeon places one end of the catheter in a
large vein, often in your chest area. The other end of the catheter stays outside your
body. Most catheters stay in place until all your chemotherapy treatments are done.
Catheters can also be used for drugs other than chemotherapy and to draw blood. Be
sure to watch for signs of infection around your catheter. For more information on
infection, see Infection 4.
- Ports.
A port is a small, round disc made of plastic or metal that is placed under your
skin. A catheter connects the port to a large vein, most often in your chest. Your nurse
can insert a needle into your port to give you chemotherapy
or draw blood. This needle can be left in place for
chemotherapy treatments that are given for more than 1
day. Be sure to watch for signs of infection around your
port. For more information on infection, see Infection 4.
- Pumps.
Pumps are often attached to catheters or ports. They control how much and
how fast chemotherapy goes into a catheter or port. Pumps can be internal or external.
External pumps remain outside your body. Most people can
carry these pumps with them. Internal pumps are placed under
your skin during surgery.
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How will I feel
during
chemotherapy?
| 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
There are many ways you can help manage chemotherapy side
effects. For more information, see the
Side Effects At-A-Glance 5
section.
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Can I work during
chemotherapy? | 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.
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Can I take
over-the-counter
and prescription
drugs while I get
chemotherapy?
| 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
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Talk to your doctor or nurse before you take any
over-the-counter or prescription drugs, vitamins,
minerals, dietary supplements, or herbs.
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Can I take vitamins,
minerals, dietary
supplements, or
herbs while I get
chemotherapy? | 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.
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How will I know
if my chemotherapy
is working? | 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.
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How much does
chemotherapy cost? | 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
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Does my health
insurance pay for
chemotherapy? | 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?
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How can I best
work with my
insurance plan? |
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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.
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What are clinical
trials and are they
an option for me? | 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.
Contact the NCI's Cancer Information Service if you are
interested in learning more about clinical trials. See Ways To
Learn More 6 for ways to contact them.
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Glossary Terms
adjuvant therapy (A-joo-vant THAYR-uh-pee)
Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.
biological therapy (BY-oh-LAH-jih-kul THAYR-uh-pee)
Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called immunotherapy, biotherapy, biological response modifier therapy, and BRM therapy.
catheter (KA-theh-ter)
A flexible tube used to deliver fluids into or withdraw fluids from the body.
clinical trial
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.
fatigue
A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.
injection
Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
intraperitoneal (IN-truh-PAYR-ih-toh-NEE-ul)
IP. Within the peritoneal cavity (the area that contains the abdominal organs). Also called IP.
intravenous (IN-truh-VEE-nus)
Into or within a vein. Intravenous usually refers to a way of giving a drug or other substance through a needle or tube inserted into a vein. Also called I.V.
metastatic cancer (meh-tuh-STA-tik KAN-ser)
Cancer that has spread from the place in which it started to other parts of the body.
outpatient
A patient who visits a health care facility for diagnosis or treatment without spending the night. Sometimes called a day patient.
palliative care (PA-lee-uh-tiv...)
Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of palliative care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, supportive care, and symptom management.
peritoneal cavity (PAYR-ih-toh-NEE-ul KA-vuh-tee)
The space within the abdomen that contains the intestines, the stomach, and the liver. It is bound by thin membranes.
port
An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath.
pump (pump)
A device that is used to give a controlled amount of a liquid at a specific rate. For example, pumps are used to give drugs (such as chemotherapy or pain medicine) or nutrients.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.
recurrent cancer (ree-KER-ent KAN-ser)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.
standard therapy (...THAYR-uh-pee)
In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.
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Table of Links
1 | http://cancer.gov/cancertopics/chemotherapy-and-you/page10#g17 |
2 | http://cancer.gov/cancertopics/chemotherapy-and-you/page10#g29 |
3 | http://cancer.gov/cancertopics/chemotherapy-and-you/page10#g23 |
4 | http://cancer.gov/cancertopics/chemotherapy-and-you/page7#SE8 |
5 | http://cancer.gov/cancertopics/chemotherapy-and-you/page6 |
6 | http://cancer.gov/cancertopics/chemotherapy-and-you/page9 |
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