If you have been diagnosed with cancer, your doctor may recommend chemotherapy as part of your treatment plan. Chemotherapy involves the use of powerful drugs to destroy cancer cells and prevent them from growing and spreading. It can be used to treat a wide range of cancers, and it may be given alone or in combination with other treatments such as surgery or radiation therapy. While chemotherapy can have side effects, it can also be a highly effective way to help you fight cancer and improve your quality of life. Your care team will work closely with you to help manage any side effects you experience and ensure that you receive the best possible care throughout your treatment.
At Blackrock Health, our three hospitals have a history of providing fast and easy access to extensive diagnostic facilities and expert medical or surgical care for patients with cancer. We have invested heavily, both in technology, and in an expert oncology team. This ensures that we can deliver cancer care, tailored to the needs of each individual patient. Our expert consultants and dedicated multidisciplinary teams are here for you. We aim to provide the most comprehensive and compassionate treatment possible in your cancer journey. We are committed to the highest standards of care and have earned a reputation as one of the leaders in the field of private oncology care in Ireland.
Chemotherapy is a type of medication used to treat cancer cells. The ultimate goal of chemotherapy is to kill cancer cells. There are many chemotherapy medications used in cancer treatment. The choice of chemotherapy will depend on the type of cancer you have. Chemotherapy can be given in tablet form or by an intravenous drip. It can also be given as a outpatient or an inpatient and this will depend on what type of chemotherapy you are prescribed.
We are always available to offer you more information, we provide all our patients with an education pack on admission to our inpatient or outpatient departments.
What is Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. As cancer cells are constantly changing, the chemotherapy finds all the cells in your body that change quickly, and destroys them.
Unfortunately chemotherapy cannot tell the difference between your good cells that constantly change, and the cancer cells. Examples of good healthy cells that constantly change are blood cells (for example your white cells that fight infection), your hair follicles and the lining of your mouth. This leads to side effects such as increased risk of infection, hair loss and feeling sick.
Unlike cancer cells these cells usually repair themselves. Most side effects improve when treatment is finished.
A course of chemotherapy consists of a number of treatments, which are given at regular intervals; this allows normal cells time to recover. Your individual treatment plan will be discussed with you.
Chemotherapy can be given as a main treatment or after other treatments to reduce the risk of the cancer coming back. Or, you may have it to shrink a cancer before surgery or radiotherapy. It is sometimes used at the same time as radiotherapy (chemo radiation). Chemotherapy is also given to control and to relieve symptoms.
Where will I receive my treatment?
Some chemotherapy is given over a short time period and so may be administered as a day case treatment, either all in one day, or on several days. Alternatively you may require to have chemotherapy as an inpatient and in those circumstances you will be admitted to the ward.
How is the chemotherapy given?
You usually have chemotherapy by injection or a ‘drip’ into a vein, or as tablets. Sometimes, it’s given in other ways, such as a pump you can take home.
How will I know if the treatment is working?
Your doctor will monitor your progress throughout your treatment. This may include scans, x-rays, blood tests and examinations. All the tests check on your health and the way chemotherapy is affecting you. They will vary person to person and will be discussed with you on an individual basis.
What are the side-effects?
Not everyone will have side-effects from their treatment, and most side-effects can be managed or mitigated to minimise their impact.
There are several general side-effects associated with chemotherapy. The main areas that can be affected are those areas where cells divide and grow quickly, such as your skin, hair, mouth, digestive system and your bone marrow (where your new blood cells are made)
In addition there are specific side-effects related to the individual drugs you will receive.
Whether or not you have side-effects from chemotherapy is not an indication of how well the treatment is working.
Remember, some of these side effects may not apply to your treatment, and there may also be some specific side effects related to your treatment that are not listed. The consultant and nurse will discuss which side effects are applicable to your treatment, and how we can help you manage them.
Some people experience a change in their sense of taste or smell.
You may find that food may taste more salty, bitter or metallic. This is only temporary; normal taste and smell usually returns two or three months after the end of treatment.
Taste changes may also be caused by infection in your mouth. Please inform your medical team of any changes you may have eg. sore mouth.
Hair loss from chemotherapy
Hair loss can be distressing. But not all chemo drugs will make you lose your hair. Some people have mild thinning that only they notice. Your doctor/nurse will be able to tell you if your chemo is likely to cause hair loss.
If you do lose your hair, it will almost always grow back after the treatments are over. But it might be a different colour or texture.
You can lose hair on all parts of your body, not just your scalp. Eyelashes and eyebrows, arm and leg hair, underarm hair, and pubic hair all may be affected.
Hair loss usually doesn’t happen right away. More often, it starts within a few weeks of treatment.
Things that may help with hair loss:
- Use mild shampoos.
- Use soft-bristle hair brushes.
- Use low heat if you use a hair dryer.
- Don’t dye your hair or get a perm.
- You might like to have your hair cut short. A shorter style will make your hair look thicker and fuller. It also will make hair loss easier to deal with if it does happen.
- Use a sunscreen, hat, scarf, or wig to protect your scalp from the sun.
Sometimes, either during the re-growth of your hair, your scalp may feel extra tender, dry, and itchy. It may help to keep your scalp clean by using a moisturising shampoo and conditioner. Also, use gentle creams or lotions on your scalp as needed. Even a gentle scalp massage may make your scalp feel better.
Scalp Cooling to Prevent or Minimise Hair Loss
It may be possible to reduce or delay hair loss by using a ‘cold cap’ or ‘scalp cooling’. Scalp cooling is a method used to prevent or reduce the amount of hair loss for patients receiving chemotherapy. Research studies have shown that scalp cooling is often effective across a wide range of chemotherapy drugs.
Scalp cooling lowers the temperature of the scalp, by restricting the amount of blood reaching the hair follicles this protects them from the effects of the chemotherapy drugs carried in the blood stream.
Many patients have found scalp cooling very successful. The success of scalp cooling however, cannot be guaranteed as a number of factors can affect the outcome such as age, hair type and chemotherapy treatment.
Scalp cooling is not suitable for all patients so please discuss this option with your doctor or nurse.
Fatigue can be caused by cancer itself or the side effects of treatments. It is when you feel very tired or exhausted most, or all, of the time. Nine out of ten people with cancer experience fatigue and it affects everyone differently.
For some people the effects will be very mild, for others it can be very disruptive. You may get tired very quickly, and not feel better after resting and sleeping. Fatigue can affect all areas of your life. Even reading or watching television can be very tiring. This can be frustrating and overwhelming.
There are things you can do to help manage the symptoms of fatigue
- Eating well and drinking lots of fluids can help increase your energy levels. Your doctor or nurse can give you advice on your diet.
- Being physically active may also improve your energy levels and increase your appetite. Start slowly and increase the amount of activity you do over time. Try setting yourself small goals that you can achieve, such as walking to the front door. Some exercise, even a small amount, is better than no exercise at all.
- You may find that you can’t continue working due to fatigue, or that you have to reduce the amount of time you spend at work.
- It can help to talk to your employer or personnel/human resources department and let them know that you may need some time off.
- Don’t feel that you have to work if you’re too tired. If you do want to carry on working, you may be able to find ways of making your work less tiring for a while.
Following chemotherapy you may have eating problems such as a dry mouth, changes in taste and a reduced appetite. It may take a few months before your appetite is back to normal.
Try to eat a well balanced diet and to drink at least 6 - 8 glasses of fluid a day. There is no ban on alcohol unless your doctor has told you otherwise.
You need to be careful about preparing food, eg. Make sure your food is fresh and not out of date, wash all salad foods, fruit and vegetables very well and make sure your eggs are well cooked.
Some people become constipated from chemo. Others may become constipated because they are less active, eat less than usual, have diet changes, or because they are taking certain pain medicines. Tell your doctor if you haven’t had a bowel movement in 2 or more days. You may need to take a laxative or stool softener.
Things that may help you deal with constipation:
- Drink plenty of fluids to help keep your stool soft. Warm and hot fluids often work well.
- Eat a lot of high-fibre foods. High-fibre foods include bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh and dried fruit, nuts, and popcorn.
- Get some exercise. Just getting out for a walk can help, as can a planned exercise program. Be sure to check with your doctor before increasing your physical activity.
Some chemotherapy drugs may cause the urine to change to a red or blue-green colour. This occurs because the chemotherapy drug is coloured and is naturally excreted from the body in this way. This is normal and should disappear within 24 hours, but if you are at all worried please speak to one of the chemotherapy team,
Anaemia (reduced number of red blood cells)
If chemotherapy reduces the number of red blood cells in your blood, you may become very tired and feel you have no energy. You may also become breathless and feel dizzy and light-headed. These symptoms happen because the red blood cells contain haemoglobin, which carries oxygen around the body.
If your haemoglobin is low you may be offered a blood transfusion. You’ll feel more energetic and any breathlessness will be eased.
Increased bleeding and bruising
If the number of platelets in your blood is reduced you may bruise very easily, or bleed more than usual from minor cuts or grazes.
Tell your hospital doctor or nurse about this and contact them straightaway if you notice or have:
- Bleeding gums
- Tiny red or purple spots on the skin (petechiae) that sometimes cluster to make a rash.
Fertility and chemotherapy is a very complex subject, and cannot be covered here in depth. You should discuss any fertility issues with your doctors and specialist nurses before you start treatment.
Some chemotherapy drugs can damage the ovary or testis, leading to an increased risk of infertility (inability to have a child). Although chemotherapy may make you infertile during your treatment there is still a chance of getting pregnant or fathering a child.
During treatment women may experience irregular periods, or periods which are lighter or heavier than normal. Some chemotherapy drugs will stop periods completely during treatment. These effects may last for many months after treatment has finished.
Usually after treatment is over, if your periods return and are regular, you will be ovulating normally and will have normal fertility. If your periods are absent or are irregular a year after treatment you should ask your doctor to refer you to a gynaecologist for fertility studies.
There is no medical reason why you should not have a normal sex life during treatment with chemotherapy. Resuming sexual activity usually depends on how you feel, rather than any medical considerations. However, patients who have very low blood counts should ask their chemotherapy nurses for advice on resuming sexual activity.
If you have any questions/issues related to this please speak to either your clinical nurse specialist or chemotherapy nurse.
How do I get this?
You will need a referral letter from your consultant before you make an appointment.
Is this insured?
Not all services are covered by health insurance. To find out if you're covered, please check your health insurance before your visit. You can do this on our health insurance cover check page, or by contacting your health insurer.
How do I pay?
If you do not have health insurance or your health plan does not cover the full cost, you will need to pay the balance due before your treatment or procedure. You may be able to claim back some fees on your insurance. To pay an excess not covered by your insurance or any other inpatient fees, please visit our payment page. If you have any queries about paying for your care, please contact the finance team in your hospital.