About chemotherapy

What is chemotherapy?

Chemotherapy (also called “chemo”) is the use of drugs to kill or slow the growth of cancer cells. The drugs are also called cytotoxics, which means toxic to cells (cyto). Chemotherapy is one anticancer drug treatment. See Other drug therapies for others.

How does it work?

All cells in the body grow by dividing into 2 cells. Cancer cells are cells that divide rapidly and grow out of control. Chemotherapy damages the cells that are dividing rapidly.

Most chemotherapy drugs are delivered into the bloodstream and they can travel to all parts of the body to reach cancer cells in the organs and tissues. This is known as systemic treatment. Occasionally, chemotherapy is delivered directly to the cancer. This is known as local chemotherapy.

How is chemotherapy used?

There are many different types of chemotherapy drugs, and each type damages cancer cells in a different way. You might have treatment with one chemotherapy drug or several drugs.

The chemotherapy drugs you have will depend on the type of cancer. This is because different drugs work on different cancer types. Sometimes chemotherapy is the only treatment used to treat cancer, but you may also have other treatments.

Why have chemotherapy?

Chemotherapy can be used for different reasons:

As the main treatment – The aim is to reduce or stop the signs and symptoms of cancer. This is called curative chemotherapy.

Before other treatments – Chemotherapy may be given before surgery or radiation therapy to shrink the cancer so that the other treatment works better. This is called neoadjuvant therapy.

After other treatments – The aim of chemotherapy given after surgery or radiation therapy is to get rid of any remaining cancer cells and try to cure the cancer. This is called adjuvant therapy.

With other treatments – Chemotherapy may be given with radiation therapy (called chemoradiation or chemoradiotherapy) or with immunotherapy or targeted therapy.

For cancer that has spread – Chemotherapy may be used to slow the growth and stop it from spreading for a period of time. This is called palliative chemotherapy. In rare cases, palliative treatment can also achieve remission, when the signs and symptoms of cancer reduce or are no longer detected during routine tests.

To relieve symptoms – By shrinking a cancer that is causing pain and other symptoms, chemotherapy can improve quality of life. This is also called palliative chemotherapy.

To stop cancer coming back – Chemotherapy might continue for months or years after remission. This is called maintenance chemotherapy. It may be given with other drug therapies.

Which health professionals will I see?

Before, during and after treatment, you will see a range of health professionals who specialise in different aspects of your care. The main specialist doctor you will see when having chemotherapy is a medical oncologist (for tumours, also called solid cancers) or a haematologist (for blood cancers). You may be referred to a medical oncologist or a haematologist by your general practitioner (GP) or by another specialist such as a surgeon.

Treatment options will often be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. It’s also a good idea to build a relationship with a GP because they will be part of your care, particularly after your cancer treatment ends.

Health professionals you may see

• GP – helps you with treatment decisions and works in partnership with your specialists in providing ongoing care
• medical oncologist or haematologist – treats cancer with drug therapies such as chemotherapy, targeted therapy and immunotherapy (systemic treatment)
• radiation oncologist – treats cancer by prescribing and overseeing a course of radiation therapy
• surgeon – surgically removes tumours and performs some biopsies; specialist cancer surgeons are called surgical oncologists
• cancer care coordinator – coordinates your care, liaises with other members of the MDT, and supports you and your family throughout treatment; may also be a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
• nurse or nurse practitioner – administers medicines and drug therapies, including chemotherapy, targeted therapy and immunotherapy, and provides care, information and support throughout your treatment; a nurse practitioner works in an advanced nursing role and may prescribe some medicines and tests
• palliative care specialist and nurses – work closely with the GP and cancer team to help control symptoms and maintain quality of life
• dietitian – helps with nutrition concerns and recommends changes to diet during treatment and recovery
• social worker – links you to support services and helps you with emotional, practical and financial issues
• pharmacist – dispenses medicines and gives advice about dosage and side effects
• psychologist, counsellor – help you manage your emotional response to diagnosis and treatment