Chemotherapy For Cancer: What it is, how it works, and chemo side effects
Introduction
Chemotherapy is a common cancer treatment in which drugs travel through the bloodstream to destroy cancer cells at the original location of the tumour and also in parts of the body where it has metastasised.
Different chemotherapy treatments differ in their mechanisms of action and are used to treat various types of cancer. They can be administered intravenously or as tablets.
Chemotherapy cannot differentiate between cancer cells and normal cells. Thus, some cells, such as those of the hair, skin, or digestive system lining, that grow rapidly compared to other cells in the body, are also affected by chemotherapy, producing side effects such as hair loss, diarrhoea, skin bruises, appetite change, nausea and vomiting.
Patients must discuss the treatment goals and understand the side effects and their management with the oncologist to make an informed decision about their care.
What is the goal of chemotherapy?
The goal of chemotherapy depends on the type, size, location and stage of cancer, in addition to how far it has metastasised. Thus, the goal of chemotherapy can be for the following reasons:
* Curative Chemotherapy: Usually, chemotherapy is used to cure cancer, where it, hopefully, destroys cancer cells, and prevent recurrence
* Palliative chemotherapy: To reduce symptoms and to improve survival. When cancer cannot be controlled or has metastasised, palliative chemotherapy is recommended to provide comfort to the patient. For example, palliative chemotherapy can be used to shrink a tumour that is causing pain.
Mechanism of action of chemotherapy
During the cell cycle, cells grow in size, DNA replicates and cells divide to produce new cells. Cancer cells grow and pass through the cell cycle rapidly. Chemotherapy drugs work on different stages of the cell cycle. Thus, some drugs work better for certain cancers, and in some cases, a combination of drugs works better in cancer treatment. Understanding the mechanism of drug action helps the oncologist plan the drug’s dosage, timing and frequency for effective cancer treatment.
Types of chemotherapy
Chemotherapy can be the primary treatment or used with other cancer treatments in the following ways:
* Neoadjuvant therapy: In this case, chemotherapy is used before surgery or radiation therapy to shrink the tumour and make surgery easier.
* Adjuvant therapy: Chemotherapy is used after surgery or radiation therapy to kill any leftover cancer cells and prevent recurrence.
* Maintenance chemotherapy: If the cancer relapses or is not eliminated from the body or metastasises, it can be used along with other cancer treatments.
Chemotherapy treatment cycles
Chemotherapy is given at regular intervals; drugs are administered for a few days, followed by a rest period of a few days or weeks. This allows normal cells to recover from the drug effects. The number of chemotherapy cycles is calculated based on the type and stage of cancer, and it can be changed during the treatment course based on the patient’s response and their overall health.
Common side effects of chemotherapy
The side effects of chemotherapy vary depending on the type, location and stage of cancer, chemotherapy type and dose and the patient’s overall health. The normal cells most commonly affected by chemotherapy are those of the hair, mouth, digestive system, and reproductive system, as well as the blood-forming cells of the bone marrow. Some drugs can damage the nervous system, kidneys, bladder, lung and heart. Although no one can predict the type and severity of side effects a patient may experience, knowledge of the possible side effects helps patients cope and manage them effectively.
Physical side effects
Fatigue: The body works hard to eliminate cancer and recover from the drug’s effects, causing fatigue. Chemotherapy also lowers the blood counts, causing anaemia, which can make a person feel tired.
Nausea and vomiting: This affects approximately 80% of patients and is known as chemotherapy-induced nausea and vomiting (CINV).
Hair loss: An unfortunate side effect of chemotherapy is hair loss, which occurs in the first three weeks of treatment initiation. Hair growth begins 2-3 months following treatment completion, although the colour and texture may differ.
Skin changes: When chemotherapy drugs are administered intravenously, the injection site might itch. Hand-foot syndrome and sunlight sensitivity (increasing sunburn risk) are common during chemotherapy. Skin colour may become dark, and nails may become brittle.
Bowel habit changes: Constipation and diarrhoea are common side effects during chemotherapy.
Appetite loss: Patients may develop a metallic taste in their mouth and will not feel like eating anything. A sore throat and mouth sores also make eating difficult, which can lead to weight loss.
Weak immune system: Chemotherapy lowers the number of white blood cells, increasing the risk of infections.
Bruising/bleeding: Chemotherapy can reduce the platelet count, making patients bleed more than expected during an injury. Small red spots can also be observed under the skin (petechiae).
Kidney and bladder issues: Burning sensation can occur during chemotherapy. Some chemotherapy agents will deteriorate the renal function.
Cognitive and emotional effects
People undergoing chemotherapy may experience anxiety, depression and mood swings.
Other side effects
Peripheral neuropathy: Patients may experience a tingling sensation, numbness or pain in their hands and feet. There may be difficulty in muscle coordination.
Infertility: Chemotherapy can reduce the oestrogen and testosterone levels, impacting sex drive and conception. It is best to avoid getting pregnant while undergoing treatment, as chemotherapy drugs can have a detrimental effect on the fetus.
Managing chemotherapy side effects
Patients must consult their cancer care team for managing the side effects. Below are some strategies that can help.
Lifestyle adjustments: Energy levels will not be the same as they were before chemotherapy. Patients must keep track of their energy levels throughout the day and plan their day accordingly. Prioritise tasks and attend to those that require immediate attention, delay other activities or delegate to family or friends. Light exercise, a nutritious and balanced diet, and adequate sleep should be a part of the daily routine. Consult a dietitian or psychologist if required to plan a wellness routine during chemotherapy.
Tackling digestive system issues: Avoid eating immediately before or after treatment; maintain a gap. Plan to eat small, frequent meals and chew slowly, allowing the body enough time for digestion. Avoid high-fat, spicy and fried foods. Drink 1-2 litres of water to stay hydrated and prevent constipation. Doctors prescribe medications to manage vomiting, constipation or diarrhoea.
Hair loss: Patients with long hair must cut it short before chemotherapy. Wash hair every 2-4 days with a baby shampoo. Do not expose the scalp to sunlight, and cover the scalp with a scarf, hat or wig.
Improving appetite: The metallic taste in the mouth can be resolved by trying different seasonings. Sucking on ice chips or sugar-free candies keeps the mouth moist and eases swallowing. If mouth sores are present, eat a soft diet and avoid very hot foods, coffee, carbonated beverages, alcohol and acidic foods to prevent irritation of the sores.
Kidney and bladder issues management: Avoid drinking coffee or alcohol, which increases the frequency of urination. Prevent urinary tract infection by adequate water intake and genital hygiene. Urinate every few hours and empty your bladder completely before exercise or bedtime.
Preventing infections: Follow good hygiene practices, such as washing hands after using the bathroom or before eating food, staying updated on vaccinations and avoiding being around people who are ill. The doctor may recommend granulocyte-colony stimulating factor (G-CSF) shots that help the body make more white blood cells.
Minimising bruises and managing skin changes: Avoid falls and cuts; use a soft toothbrush to prevent bleeding gums, an electric razor for shaving and a lip balm to prevent chapped lips. Aspirin and ibuprofen must be avoided to minimise the risk of bruising. Use a moisturiser to keep hands and feet soft. Avoid exposure to direct sunlight and use a sunscreen with SPF 30 or more when outside. Maintain short nails with smooth edges.
Preventing nerve damage: Doctors may adjust the chemotherapy dosage and also prescribe pain medication to resolve the symptoms of peripheral neuropathy. Doctors may also advise quitting smoking, limiting alcohol consumption, and exercising regularly.
Improving mental health and memory: Consult a psychologist to address mental health issues, as the diagnosis and treatment of cancer can be stressful. Patients must ensure to get 8 hours of sleep, exercise regularly, solve puzzles to improve their memory and stay organised to find their items easily and reduce stress on their mind. Patients should consult with a psychologist for anxiety or depression during their treatment; doctors may recommend meditation and music to ease their worries and in still a positive outlook towards the treatment. Patients should discuss their worries with their family members and friends and take counselling sessions to address mood swing issues. Patients can also join support services, such as charities or people who have been diagnosed with cancer.
Fertility issues: The doctor can prescribe medication for erectile dysfunction and vaginal discomfort. If a patient plans to have children, the doctors can recommend the appropriate timing for planning the pregnancy. Patients may also discuss about storing their eggs and sperm before commencing treatment.
Why Patients Choose Kauvery for Chemotherapy Treatment
“Kauvery day care is the best place for chemotherapy treatment. Dr Santhosh and his staffs are amazing, I’m so glad I found them for my mother treatment.”
– Monashree Ramesh
“My self Mrs. Helan Mary I am taking chemotherapy in this hospital. While coming every time in the oncology OPD Good caring for oncology department staffs and we are taking the treatment to Dr Suresh Kumar sir. He was giving the best treatment for my wife. Now feel better my wife. I mention to the staffs from OPD Font office Vani, Saravanan and staffs Ashwini, Nithya very caring and their physician assistant Yogapriya. Thank you for they are care. Really I’am satisfied in their work.”
– Pious Thomson
What side effects require immediate attention?
* High fever
* Unexplained bruising or bleeding
* An allergic reaction, such as trouble swallowing, intense itching or mouth or throat swelling
* Breathing trouble
* Blood in stool or urine
* Intense headaches
* Prolonged diarrhoea or vomiting
For how long do the side effects last?
Side effects usually disappear a few months after chemotherapy. Most people are expected to regain their original energy levels within 6 months to 1 year. Some side effects, such as fatigue, peripheral neuropathy and brain fog, continue for years after chemotherapy has ended. Patients must take enough rest, eat nutritious food and follow up with their doctors to address any concerns.
Conclusion
Chemotherapy is routinely administered for cancer as a treatment. Chemotherapy harms normal cells in the process of killing cancer cells, which leads to side effects. Patients with cancer should have a detailed discussion with their oncologist about the treatment and the side effects associated with it. Patients should also enquire about the length and severity of the side effects and strategies to manage them. Although most side effects are resolved within a few months after chemotherapy, some side effects may last for many years. Keeping yourself informed will prepare you to handle the treatment better.
Frequently Asked Questions
What is chemotherapy used for in cancer treatment?
Chemotherapy is used to kill cancer cells, either to cure the cancer or relieve symptoms if the cancer has spread.
What are the most common side effects of chemotherapy?
Common side effects include fatigue, hair loss, nausea, appetite changes, infections, and skin changes.
How long do chemotherapy side effects last?
Most side effects go away a few months after treatment ends, but some may last longer like fatigue or nerve pain.
How can I manage nausea and appetite loss during chemo?
Eat small, bland meals, drink plenty of water, and avoid spicy or oily foods. Your doctor may prescribe medicines to help.
Does chemotherapy affect fertility?
Yes, chemotherapy can affect fertility. Talk to your doctor about storing eggs or sperm before starting treatment.
When should I call the doctor during chemotherapy?
Call your doctor if you have a high fever, severe bleeding, trouble breathing, or ongoing vomiting or diarrhoea.
Article Updated On June 19, 2025
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
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