Typically, they’ll go to a hospital or doctor’s office to get treatment (though, in some cases, the dose can be administered at home). “You show up on your day of infusion, where an infusion nurse then guides you through the process of hanging and connecting you to the IV bag,” Dr. Avila explains. “Then, the liquid flows into your veins and goes all throughout the body, including the cancer cells.” (Yep, the chemo goes everywhere, not just the problem spots—more on that in a minute.)
Dr. Avila notes that a person might get chemo from an IV alone, or they might take a pill, receive injections, or apply topical creams alongside it—it really depends on the type of cancer, where it’s been detected, its stage, and what their overall health looks like. And all of this might happen in tandem with other cancer treatments, like radiation therapy or surgery.
Chemotherapy sessions can last anywhere from 30 minutes to several hours. But this isn’t a one-and-done scenario—Dr. Avila most often treats her cancer patients with four to six cycles. “After that point, we might shift to something called a maintenance phase where we give a different type of medication that’s more easily tolerated, either oral or IV, to be able to prevent the cancer from coming back.” (And despite what you might’ve heard in the news as of late, there is “no such thing as ‘preventative’ chemotherapy,” she says.)
Why chemo can be so brutal on a person’s body
Getting rid of dangerous, rapid-growing cells is chemo’s number-one priority—even if the drugs need to strike down noncancerous cells along the way. “Unfortunately, most chemotherapies aren’t well targeted, meaning they can harm healthy portions of the body,” Dr. Landau explains. He notes that chemo tends to attack other naturally “fast-growing” (but harmless) cells too, which can be found in the reproductive system, bone marrow, hair follicles, and digestive tract, for example. This means the treatment can trigger things like constipation, pain and nerve problems, diarrhea, skin changes, mood swings, mouth sores, and bruising and bleeding throughout each cycle, Dr. Avila says. Hair loss, one of chemo’s most visible side effects, usually starts around the second cycle, she adds.
Most of these effects are short-term, but some can linger for a while or happen later once the chemo is completed, Knapp says. This could potentially include issues with fertility, early menopause, osteoporosis, nerve damage, and an increased risk of developing other cancers.
As Dr. Avila stresses, chemo can be a really turbulent process—physically and emotionally. Sometimes a person with cancer will feel comfortable disclosing their diagnosis upfront, while another might never open up about it. “It’s an evolution and a journey for every patient. A lot of people like to stay conservative [with revealing details about their condition] for long periods, particularly mothers, especially in the early stages of their treatment.” Knapp has also seen the process take a major toll on her patients’ work and family lives—anything that requires them to be energetic, engaged, and present. “The demanding treatment schedule, recovery periods, and side effects of the drugs can disrupt daily routines and responsibilities, adding strain to an already challenging situation.”