Chemotherapy

Chemotherapy can be used to treat many different types of cancer, including bowel cancer, breast cancer, prostate cancer and leukaemia. You may have it with the aim of curing your cancer, or to control it and relieve your symptoms if it can’t be cured.

What is chemotherapy and what are the potential side effects?

If you’ve been diagnosed with cancer, your doctor will discuss the type of cancer treatment you should have and may recommend you have anti-cancer drugs known as chemotherapy as part of your treatment plan. You may have it alongside other treatments such as surgery or radiotherapy, or on its own.

There are many different types of chemotherapy drugs. You can have different ones for different types of cancer. Sometimes you may have a combination of drugs together.

Chemotherapy works by stopping cancer cells from growing and dividing. This means it can stop cancer cells, which usually grow and multiply quickly. But it can also affect healthy cells in your body, which means it can lead to side effects. Your doctor will have a discussion with you about the potential benefits and side-effects of chemotherapy and help you decide whether it is the right treatment option for you.

Private vs NHS chemotherapy

You can have chemotherapy privately or on the NHS. Most of the time, you’ll have the same chemotherapy drugs whichever route you go down. You can also be assured that you will receive expert care whether you’re treated in the NHS or privately. But there may be differences in how you receive your care.

Private healthcare facilities for having chemotherapy aim to offer maximum comfort and privacy. You may be more likely to have an individual room, or to receive your treatment at home. You may also be able to start your chemotherapy treatment sooner if you’re having private care. It’s possible that you may be able to access some chemotherapy drugs that aren’t available on the NHS, privately. Your doctor will talk to you about your treatment options and can tell you if there’s anything available privately that you can’t get on the NHS, as well as informing you of the potential benefits and side-effects of these treatments.

Preparing for chemotherapy

There can be several things to think about before having chemotherapy. You can suffer from several chemotherapy side effects. Chemotherapy can affect your fertility. If this is a concern for you, you may want to talk to your doctor about what options you have for preserving your fertility before you start treatment. You should also make sure you’re taking effective contraception, as the drugs used in chemotherapy can affect a growing baby. As hair loss can be a side effect, you may want to get a wig fitted before you begin chemotherapy.

You’ll normally need several sessions of chemotherapy, with rest periods in between to recover. Your doctor, cancer nurse or care team will tell you more about what to expect, including how your course of treatment - including how many treatment cycles this will involve. You may need to make plans for taking time off work, and for any help you you’ll need at home while you’re having treatment.

What happens during chemotherapy?

You usually have chemotherapy in a special day unit or outpatient clinic. Sometimes, you may need to go into hospital, and occasionally, for some types of chemotherapy, you may be able to have it at home.

Specialist chemotherapy nurses will look after you and administer the dose of chemotherapy medicine. There are a number of different ways of having chemotherapy. These include the following:

• Intravenous chemotherapy (by injection or drip into a vein)
• Oral chemotherapy (by mouth, as tablets or capsules)
• Injection into a muscle (intramuscular) or under the skin (subcutaneous)
• Intrathecal chemotherapy (injection into the fluid that surrounds your brain and spinal cord)
• Chemotherapy cream (applied directly onto your skin – this may be used for skin cancers).

Common side effects of chemotherapy drugs

Chemotherapy can affect healthy cells in your body, as well as cancer cells. Because of this, it can cause a number of possible side effects. This depends on the type of cancer care treatment you’re having, and how you respond to it. Side effects can happen straight away, but often you get them days or weeks later. Some of the most common ones include the following:

• Digestive problems, including feeling sick and vomiting, diarrhoea, constipation and losing your appetite
• Losing or thinning of your hair
• A sore mouth
• Fatigue – feeling extremely tired
• Increased risk of infections
• Anaemia (this can make you feel very tired and like you have no energy)
• Skin changes, including increased sensitivity to sunlight

You may have longer-term side effects too. Certain chemotherapy drugs may affect your fertility or cause an early menopause. They may increase risk of heart or lung problems later in life.

Much of the time, any potential side effects of chemotherapy will be outweighed by the benefits, but this may not always be the case. Your doctor will help you to weigh up the benefits and risks involved when planning your treatment. Sometimes, you may be offered a choice between different chemotherapy drugs or alternative treatments and again, your doctor can help you to decide what’s best for you.

Your doctor or nurse will also talk to you about how to manage potential side effects before you start treatment. In some cases, you may be able to take other medicines to help prevent or manage side effects.

Recovery and what to expect after chemotherapy

Cancer treatments such as chemotherapy can be both physically and mentally demanding. It will take a while to recover from chemotherapy as well as from the cancer itself. It’s important to give yourself time. Your cancer nurses will talk to you about any support you need.

You’re likely to have several follow-up appointments with your cancer team once you finish chemotherapy. These are a good opportunity to bring up any problems or concerns that you have.

Chemotherapy costs and fees

If you have private medical insurance, you should check with your insurer whether they will cover the chemotherapy treatment your doctor is recommending. Health insurance doesn’t always cover all cancer treatments.

If you don’t have insurance, sometimes you can arrange with your doctor to fund treatments yourself. Because each chemotherapy treatment needs to be tailored to the patient’s need, the cost will vary. It may also vary depending on where you live. It’s best to speak with your consultant and ask for a clear indication of the costs, including any private tests you might need.

Helpful websites

• Macmillan Cancer Support www.macmillan.org.uk 0808 808 0000

References

• Amjad MT, Chidharla A Kasi A. Cancer chemotherapy. StatPearls. www.ncbi.nlm.nih.gov, last updated 7 September 2021.
• Chemotherapy. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 30 September 2018.
• Cytotoxic drugs. British National Formulary. National Institute for Health and Care Excellence (NICE). bnf.nice.org.uk, last updated 10 November 2021.
• Comparing NHS with private cancer treatment. Cancer Research UK. www.cancerresearchuk.org, last reviewed 27 September 2019.
• What you can do if a treatment is not available. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 31 July 2018.
• How chemotherapy is given. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 30 March 2018.
• Side effects of chemotherapy. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 30 September 2018.
• Chemotherapy for breast cancer. Macmillan Cancer Support. www.macmillan.org.uk, reviewed 31 October 2018.

The original publication date for this page was on 17 August 2022. This page was last updated on 5 September 2023 to fix a website link.