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Navigating chemotherapy: How to prepare and what to expect during chemo

When you need chemotherapy as a part of your cancer treatment, it’s normal to have many questions and fears. What will my treatment entail? Will I lose my hair? How will it make me feel?

You may have heard about someone who had a serious side effect from chemotherapy, or maybe you’ve seen chemo portrayed on TV. However, when people talk with others who have actually gone through chemo, they feel better. Having realistic expectations eases some of their anxieties.

Every chemo drug has its own set of side effects, but many of these are expected and manageable. You may be surprised how well your care team is able to help you cope with chemo side effects and how many resources are available to support you before, during and after your treatment.

What to know before chemo

When you understand what’s going to happen with your body, you can ask the right questions and make informed choices. This helps you be a part of shared decision making about your care. Before your first treatment, make sure you know the answers to these common questions:

  • How the medications will be administered—by infusion, orally?
  • What is the frequency—daily, weekly, monthly?
  • Will I require surgery to receive chemotherapy, such as chemo port placement?
  • Will I require additional therapies at the same time as chemo?
  • What side effects are expected?
  • What side effects mean I should call my doctor?

It also helps to plan for practical matters before treatment. Allow people to help you, such as setting up a calendar to deliver meals. Join a support group to connect with someone who has been through chemo. Finally, anticipate items you may need ahead of time. Some practical items to gather include:

  • Get a wig, scarf or other head covering if desired.
  • Pick loose, comfortable clothing for treatment days.
  • Stock up on puzzles to help combat chemo brain, for example, crosswords or Sudoku.
  • Find or buy a thermometer for temperature tracking.
  • Purchase personal items that help ease side effects, such as lip balm, plenty of scent-free moisturizers and alcohol-free mouth care.

Related: How to tell people about your cancer diagnosis

What to expect during chemo treatment

Each treatment is different, but the most common side effects of chemotherapy are hair loss, gastrointestinal effects and bone marrow suppression. Some of the symptoms of these side effects are expected and accepted, but others signal a need for immediate care.  

Hair loss

Not all chemotherapies cause hair loss, but most of them do. Because the hair on your head grows very quickly, it’s one of the parts of the body commonly affected by chemotherapy. There’s not a lot you can do to prevent it, but there are things you can do to deal with hair loss—such as wearing a wig, learning to tie scarves or wearing hats. Some centers also have programs like Look Good, Feel Better that help you care for your appearance during treatment.

Gastrointestinal effects

We have fantastic medications today that work well to prevent or minimize nausea and vomiting associated with chemo. Diarrhea and constipation may happen as well, and these need to be reported to your doctor to make sure you’re still getting the right nutrients. Additionally, some chemotherapies can make your mouth very sore—called stomatitis. At the first sign of any soreness, notify your physician and get care before it progresses.

Bone marrow suppression

Chemotherapy affects your body’s ability to make blood cells in the bone marrow. If this lowers your platelet count, it can lead to a higher risk of bleeding. Signs like tiny pinpoint red spots called TKI or blood in the stool or urine need immediate attention. The effects on red blood cells may cause anemia, and the effects on white blood cells put you at risk for infection. If you have a fever of 100.5 degrees or greater, contact your physician immediately.

When possible, it helps to maintain exercise during chemo to keep your stamina up. However, people often underestimate the amount of fatigue they’ll feel. Be compassionate with yourself and seek support if you need it. Don’t just try to tough it out. Your care team is there to help you navigate your side effects.

Caring for yourself after chemo

After treatment, expect that you’ll need time to recover and know that you won’t bounce back immediately. You’ll gradually get back into a regular routine following treatment, but it’s OK to acknowledge that your life has changed.

Life after chemo sometimes comes with a lot of worries and “what ifs.” How many days until my next appointment? What if my cancer comes back? I’m cancer-free, but now what do I do? That’s why support needs to continue long after your final treatment.

Cancer centers like the ones found at Baylor Scott & White Health offer numerous services—often at no cost to you—before, during and after treatment. Consider connecting with resources like:

Staying involved with other cancer survivors through a support group is also essential. Above all, continue to lean on the relationships you’ve developed with your doctors and nurses. You’ve made it through chemo, and these trusted medical professionals will continue to watch over you and care for you. As “what ifs” and fears pop up, they can advocate for you and help address any worries.

Going through chemotherapy treatment isn’t easy. But know that you are not alone. The more you educate yourself, understand what to expect and surround yourself with support, the better prepared you’ll be to cope with life during and after treatment.

Find cancer support near you.

About the author

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Eron Flemens is the program coordinator at the Cvetko Patient Resource Center at Baylor University Medical Center. She has been a nurse for 39 years and certified in oncology nursing since 1993. Her passions are patient education and advocacy.

Navigating chemotherapy: How to prepare and what to expect during chemo