Chemotherapy

Some chemotherapy drugs affect your fertility (the ability to get pregnant or make someone pregnant). If this is a concern for you, it is very important to talk to your cancer doctor before treatment starts. Sometimes your fertility can be preserved by storing sperm or storing eggs before chemotherapy begins.

If the chemotherapy drugs cause hair loss or thinning you might decide to have a wig fitted. You can have the wig fitted before your hair falls out. We have more information about wigs for cancer treatment.

Your doctor or nurse may advise you to have a dental check-up before starting chemotherapy. If your teeth or dentures are in good condition, this reduces the risk of problems with your mouth during treatment.

You may need to have a test to check for coronavirus before each treatment. The test is called a covid swab test.

Always tell your cancer doctor about any prescription and other drugs, vitamins, herbal remedies or supplements you are taking or plan to take. Some drugs may interact with chemotherapy drugs or make treatment less effective.

Vaccinations can reduce your risk of getting certain infections. Your doctor or nurse may talk to you about having vaccinations. Doctors usually recommend that people with cancer have a flu vaccination and a coronavirus vaccination.

Vaccines can be given before, during or after cancer treatment. You can talk to your healthcare team about possibly getting a coronavirus vaccine before chemotherapy treatment starts. This may improve the vaccine’s effectiveness. But some people may need to start treatment before having the vaccine.

Before starting chemotherapy, it is a good idea to think about your work or education. This means you can make arrangements for time off during treatment.

Chemotherapy makes you tired, so you may need help with day-to-day tasks. Although you may find it hard to ask, family and friends often want to help. If you live alone or are caring for someone else, you can ask to talk to the hospital social worker about getting help.

If you have children, you may need help with taking and collecting them from school or clubs. Family and friends usually want to help, so accept their offers or ask for any help you need. It is also useful to know who you can contact at short notice to look after your children. We have more information about childcare when you have cancer.

Some chemotherapy drugs can affect organs, such as the heart or the kidneys. You may need tests to measure how well these organs are working before you have chemotherapy. For example, if you are having drugs that can affect the heart, you may have an electrocardiogram (ECG). This measures how well your heart is working. Or you may have an echocardiogram (ECHO), which uses soundwaves to create a picture of the heart. We have more information about heart tests.

Some people may need further scans or x-rays to find out more about the extent of the cancer (its stage) before chemotherapy. We have more information about tests and scans.

A nurse will check your height and weight. Your cancer doctor and pharmacist use this information to work out the right dose of chemotherapy for you.

You will have a blood test before each cycle of chemotherapy. Sometimes your blood may be checked 1 to 2 days before chemotherapy. This can be done:

• at the hospital where you are having chemotherapy
• at your GP surgery or with a practice nurse
• at a hospital closer to your home.

The results will be ready for you when you go to have your chemotherapy.

You may have a pregnancy test before starting treatment.

If your doctor can see or feel the cancer, they will be able to tell if it is responding to chemotherapy by doing a physical examination.

If the cancer can be seen on a scan, you may have a scan after a few cycles of chemotherapy. This is done to see if the cancer is getting smaller. Chemotherapy to reduce the risk of cancer coming back after surgery (adjuvant chemotherapy) will not usually need scans to check if it is working.

With some cancers, blood tests can be used to check if treatment is working. These cancers release proteins into the blood (tumour markers) that can be measured with a blood test. If the tumour markers are reducing, it usually means the chemotherapy is working.

Depending on how you feel, there is no reason to stop going out or visiting friends if you plan ahead. If you are going out for the evening, try to rest during the day so you have more energy at night. If you are going out for a meal, take anti-sickness tablets, if you need to, before you go.

For most people, having an occasional drink should not affect your chemotherapy treatment. But it is best to check with your cancer doctor or specialist nurse first.

Vaccinations can reduce your chance of getting certain infections. If you have had chemotherapy, you may not be able to have some vaccinations as your immune system may be weakened. These include live vaccinations, which use tiny amounts of a live virus or bacteria. Doctors usually recommend that you have a flu vaccination and a coronavirus vaccination. These are both inactivated vaccines, which help reduce the risk of infection. People with weak immune systems can have this type of vaccination. Before going abroad, ask your doctor if you need any vaccines and whether it is safe for you to have them.

Sometimes people who have cancer can find it difficult to get travel insurance. It is best to look for travel insurance as early as possible. If you are planning a holiday it is important to speak to your cancer doctor or nurse before you make any plans.

Below is a sample of the sources used in our chemotherapy information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Brighton, D. Wood, M. The Royal Marsden Hospital Handbook of Cancer Chemotherapy. Elsevier Churchill Livingstone. 2005.

National Institute for Health and Care Excellence (NICE) Neutropenic Sepsis Guideline CG151. 2012.

Perry, MC. The Chemotherapy Source Book (5th ed.) Philadelphia: Lippincott, Williams & Wilkins. 2012.

UKONS Acute Oncology Initial Management Guidelines Version 3, March 2018. Available from www.ukons.org (accessed June 2021).

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.