What Happens During Chemotherapy?

Hearing for the first time that you need chemotherapy inevitably leads to a host of complicated questions. How will I feel? How will my life change? How should I prepare?

Making sure those questions are answered can help patients feel more comfortable and confident walking into their first appointment, says Gineesha Abraham, APRN in the Breast Medical Oncology unit at Smilow Cancer Hospital.

“One of the phenomenal things we do at Smilow is we are able to offer education sessions for patients,” Abraham said. “These are usually done a few days prior to the start of chemotherapy where patients get to sit with the nurse, either one-on-one or in group teaching classes where they can ask questions and get all the information they need.”

This individualized approach to chemotherapy education is important because each patient has different needs, treatment plans and experiences.

What is chemotherapy?

Cancer is a disease of rapidly dividing cells and chemotherapy is a treatment used to kill those cancer cells. It is mostly administered through an IV but can also be used orally. Chemotherapy is used for most cancers and can be given in conjunction with other treatments like immunotherapy.

Before starting chemotherapy, patients will need to complete bloodwork, which sometimes happens ahead of time or may happen on the same day as treatment. Then a doctor, advanced practice provider or infusion nurse, working in collaboration with a member of the pharmacy team, will have an assessment done to make sure it is safe for the patient to receive treatment.

Chemotherapy can be administered in several settings, which may include an outpatient setting with infusion chairs. Patients can bring a book or tablet to help pass the time.

Side effects from chemotherapy

Common side effects of chemotherapy may include:

• Fatigue
• Nausea
• Rashes
• Hair loss
• Gastrointestinal issues
• Risk of infection

Some patients may only have one or two side effects, while others may experience more, depending on factors like additional medications they’re taking, underlying conditions and dosage.

Depending on the patient’s unique situation, there are different ways to address side effects. For example, “cold capping,” or using a specialized device that cools the scalp to reduce blood flow to hair follicles may reduce the risk of hair loss with certain chemotherapy agents.

While fatigue and nausea are common, Abraham says their goal is to help patients get through treatment with acceptable side effects. “We always adjust and modify,” she said.

Patients are encouraged to bring a support person with them for the first two sessions in case they need help afterwards or ride home, but Abraham said if patients are feeling good, they can drive themselves to appointments and continue with their daily activities.

“There are studies that show the benefit of exercise in women undergoing chemotherapy for breast cancer. It can help with fatigue, so we encourage patients to be as active as possible and maintain your lifestyle as normal as possible,” Abraham said.

Support for cancer patients

Helping loved ones continue the things they enjoy during chemotherapy is just one way family and friends can help. Attending doctor’s appointments and education sessions can also lift some of the burden off the patient.

“It can be overwhelming when you’re being told you need chemotherapy and it’s a lot of information coming at you. Having someone that you are comfortable with during your appointments who is also listening along with you and asking questions can be helpful,” Abraham said.

She also encourages patients to reach out to their care team at any point if they have concerns about side effects or how they’re feeling. There’s even an urgent care service at Smilow for patients undergoing chemotherapy in case they need an urgent evaluation. It allows patients to bypass the emergency department and have peace of mind knowing they are being seen by a clinician who specializes in oncology. An Extended Care Clinic at Smilow provides supportive care and symptom management for patients outside of their regular appointments.

Additional specialized programs aimed at helping patients undergoing cancer treatment are also available at Smilow. Learn more about some of the support services offered.