How does chemotherapy work?

Because the medicines circulate in the bloodstream, they can reach cancer cells in different parts of the body. The exact drug, dose, route and schedule depend on the cancer, its extent, previous treatment and your general health. Some medicines interfere with cell division; others damage the cell's genetic material or make it harder for a cell to repair itself. Healthy cells that divide quickly can also be affected, including cells in hair follicles, the mouth and the digestive system. This helps explain possible hair loss, mouth soreness, nausea or changes in bowel habits. Blood-forming cells can also be affected, which may lower infection-fighting white cells.

Your oncology team may give treatment through a vein, by mouth, or by another route. Keep a written list of medicines and supplements, and tell the team about allergies, dental problems, pregnancy plans or a current infection before treatment begins. Ask which symptoms should be reported the same day and how to manage nausea, tiredness or appetite changes. Do not change doses or skip appointments without speaking with the treatment team. Chemotherapy may be used alone or alongside surgery, radiotherapy, hormone treatment or targeted treatment; its purpose may be to shrink a tumour, reduce the chance of return, or control cancer and its symptoms.

Contact your oncology team promptly for a fever, chills, a new cough, breathlessness, persistent vomiting, severe diarrhoea, unusual bleeding or a rapidly worsening condition. Chemotherapy can reduce infection-fighting cells, and fever with a low white-cell count can become febrile neutropenia. Do not wait for the next appointment if you have been given an urgent-care number. Emergency help is appropriate for severe breathing difficulty, confusion, collapse or uncontrolled bleeding.

Which medicines will I receive, and what is each one intended to do? How will treatment be given and monitored? Which side effects need an urgent call? What should I do if I miss a dose or develop a fever?