What should you know about systemic chemotherapy?

Chemotherapy may be used before surgery to shrink a tumour, after local treatment to reduce the chance of remaining disease, or when cancer has spread. The drugs affect cells that divide quickly, which can also affect healthy cells in the hair follicles, mouth, gut and bone marrow. The exact effects depend on the medicines and your health.

Systemic chemotherapy is used in different settings, including [Acute Myeloid Leukaemia](/conditions/acute-myeloid-leukaemia/), [Bladder Cancer](/conditions/bladder-cancer/), [Breast Cancer](/conditions/breast-cancer/) and [Childhood Cancer](/conditions/childhood-cancer/). A treatment plan may involve one medicine or a combination, given by infusion, injection or tablets.

Before each cycle, the team may check blood counts, kidney and liver function, weight and symptoms. Tell them about all medicines, supplements, allergies, dental problems and any chance of pregnancy. Arrange practical help for travel, meals and rest, especially after the first treatment when you are learning how your body responds.

Possible effects include tiredness, nausea, appetite changes, mouth soreness, bowel changes, hair loss and a lower infection-fighting cell count. Ask about anti-sickness medicines, mouth care, activity and food safety. Do not stop prescribed treatment or use a supplement without discussing it with the oncology team.

Call the oncology service urgently for fever or chills, feeling suddenly unwell, breathing difficulty, chest pain, uncontrolled vomiting or diarrhoea, confusion, heavy bleeding, or a new rash with swelling. Ask for the service's own fever threshold and out-of-hours number before treatment starts, because infection can become serious when blood counts are low.

Ask: What is the aim of this chemotherapy? How will it be given and how often? Which blood tests are needed? Which side effects need a same-day call? Can I work, exercise or travel? How will other conditions and medicines be managed? What happens if treatment needs to be delayed?