The purpose of chemotherapy is to kill cancer cells wherever in the body they may be hiding. It is usually administered intravenously or orally in pill form. There are many types of chemotherapies that have differing activities on the many types of cancer. They differ not only in the spectrum of activity but in the spectrum of their potential side effects. In general chemotherapy kills actively dividing cells which is why cancer cells are susceptible to its effects. However, blood cells, the lining of the gastrointestinal tract, and hair are all composed of rapidly dividing cells which are potentially affected
by chemotherapy. That is why nausea, vomiting, lowering of the blood counts, hair loss, and fatigue are the most common side-effects. However, these side-effects are minimized by new supportive care medications which make undergoing chemotherapy much more tolerable than it was years ago.
There are many different chemotherapy regimens for the many types of cancer. Most chemotherapy can be given on an outpatient basis where you come in to the Cancer Center, get your chemotherapy, and go home. Occasionally chemotherapy must be given in the hospital. Chemotherapy is given on many different schedules. Usually it is given either weekly or every 3 weeks. As a rule of thumb, each 3 to 4 weeks is considered 1 cycle of chemotherapy. The type of cancer and the stage of the cancer will determine the recommended number of cycles of chemotherapy.
When coming for your chemotherapy the first time, it is best to have someone drive you. It is a good idea to eat beforehand, but don’t have anything too heavy. Depending on the chemotherapy regimen, 
the infusion can be anywhere from 30 minutes to 6 hours or longer. You can bring food to snack on, or our nutritionists will be happy to supply you with snacks at the Cancer Center. The Cancer Center is open 24 hours-a-day, 7 days-a-week, and your chemotherapy can be arranged around your schedule.
Before you can get your chemotherapy, we will have to run some blood tests to ensure that your body is strong enough for the chemotherapy. This usually takes 10-30 minutes. Once we have the go-ahead to start, you will receive some pre-medications both by mouth and through the IV. The medications will help to relax you and help to prevent reactions to the chemotherapy. This can take from 10-60 minutes depending upon the number and type of pre-medications required for your chemotherapy. Then your chemotherapy will begin and can last anywhere between 30 minutes to many hours, depending on your regimen. Should you experience any side-effects while your chemotherapy is infusing, let us know right away. Most side-effects can be managed by altering the rate of the infusion and/or giving additional medications, but occasionally people experience allergic reactions to chemotherapy and the infusion must be stopped. This is rare, but it is important to tell us anything different that you are feeling while undergoing your treatment.
When you go home after your treatment, you will have medications to take on an as needed basis. If these medications do 
not work, or you have any new symptoms, you should call our office at anytime day-or-night and we can discuss what you are experiencing. If need-be, after talking with you, we may ask you to return to the Cancer Center to be evaluated, as it also functions as an urgent care for our patients.
Depending on your chemotherapy regimen, you may need to be on medications to support your white and/or red blood cell counts. These can be taken at home, or administered in the Cancer Center. For some regimens, your white blood cells may drop low enough that you become neutropenic. This means that you are especially susceptible to infection. During this period (usual days) you should avoid crowds, people who are sick, children who may be sick, and be attentive of the food you eat. A neutropenic diet consists of well-cooked foods, no raw/rare meats, no tap water, no uncooked fresh fruits or vegetables, and no unpasteurized dairy products. If you become 
neutropenic it is important that you take your temperature periodically at home (even if you do not feel feverish), and if your temperature is greater than 100.4°F you should call our office immediately. Infections while neutropenic can be very serious and can require hospitalization for IV antibiotics and monitoring.
Having cancer and undergoing chemotherapy can be a challenge. But it is a challenge that you don’t have to face alone. All of us at Dr. Gould’s office will be here with you every step of the way. Your family and friends can be there for you as well, if you let them. Everybody copes differently, and there is no right way, but letting your loved one's be there for you, can make you and them feel less alone.
