Chemotherapy

Chemotherapy uses drugs that damage cells while they are dividing. Cancer cells divide faster than most normal cells and take the brunt of it, but healthy tissues that also turn over quickly are affected too: the bone marrow, the lining of the mouth and gut, and the hair roots. That is where the side effects come from.

It is used in several different situations. Before surgery to shrink a tumour, after surgery to deal with cells that may have escaped, alongside radiotherapy to make it work better, and on its own when a cancer has spread. Your oncologist chooses the drugs and the number of cycles from the cancer type, what the biopsy showed and your general health.

Most regimens are given into a vein in a Day Care unit. A cannula is placed, or blood is drawn from a port or a PICC line if you have one, and medication to prevent sickness goes in first. The drugs themselves run over anything from thirty minutes to several hours.

Your blood counts are checked before every cycle and a session is postponed if they are too low. Some drugs are tablets taken at home instead. You are awake throughout, you can eat normally, and you go home the same day.

The pattern repeats: the few days after a cycle are the hardest, then you pick up before the next one. Sickness is well controlled with modern anti-sickness drugs. Fatigue, taste changes, mouth ulcers and hair thinning or loss are common, and hair grows back once treatment ends.

Your blood counts dip about seven to fourteen days after each cycle, and that is the window when infection is dangerous. A temperature of 38 degrees or above, shivering, or feeling suddenly unwell during that window is an emergency: go to hospital the same day and tell them you are on chemotherapy.