Chemotherapy, also known as chemo, is a way of treating cancer using drugs. These drugs are called cytotoxic drugs. This means drugs that kill or damage cells.
Chemotherapy can be given in different ways, and often involves having more than one drug. It may also be given with other types of drugs, including corticosteroids, targeted therapy or immunotherapy.
What you need to know
Chemotherapy for myeloma
Chemotherapy is one of the main treatments for myeloma, and there are many different chemotherapy drugs that can used for this.
Chemotherapy can be given in combination with other drug treatments, such as corticosteroids, targeted therapy or immunotherapy, or before a stem cell transplant.
It is mainly given as an outpatient treatment, but some people may need to stay in hospital as an inpatient to have chemotherapy.
The more common types of chemotherapy given are cyclophosphamide and melphalan. They can be given as infusion into a vein (IV) or as tablets.
Corticosteroid treatment for blood cancers
Corticosteroids are a group of drugs that are often used to treat blood cancers. They can be given on their own or in combination with other treatments. Some commonly-used corticosteroids include:
These can be given in high doses to:
- kill blood cancer cells
- make other treatments work better, e.g., chemotherapy or targeted therapy
- reduce swelling or inflammation.
Is all chemotherapy the same?
There are many different chemotherapy treatments. These are sometimes called chemotherapy protocols or chemotherapy regimens.
Most chemotherapy treatments include one or more drugs, and are given over several weeks to months.
Your doctor will select your treatment based on the type and stage of cancer you have.
Chemotherapy team for people with blood cancers
Health professionals involved in providing chemotherapy include:
- medical oncologist
- chemotherapy nurse
- oncology pharmacist.
What to ask or talk about
Side effects of chemotherapy
Most people have some side effects during chemotherapy treatment. These depend on the drugs used, and can also vary from one person to another.
There are many possible side effects. Some of these are mild while others can be severe.
Common chemotherapy side effects can include:
- low white blood cells (neutropenia) which increases the risk of infection
- hair loss
- nausea and vomiting
- a sore mouth
- appetite and taste changes
- bleeding (low platelets)
- skin and nail changes
For more specific information about what side effects to expect and how to manage them:
- talk to your doctor, nurse or pharmacist about side effects
- see our information about managing side effects.
When do I need to get medical help during chemotherapy?
Some chemotherapy side effects can be serious and need urgent treatment. Your doctor or nurse will tell you when you need to get medical help and who to contact.
Symptoms to look out for include:
- a temperature of 38°C or higher
- chills, sweats, shivers or shakes
- a headache or stiff neck
- shortness of breath
- uncontrolled vomiting or diarrhoea
- pain, tingling or discomfort in your chest or arms
- feeling unwell in any way.
If you have any of these, follow the instructions you have been given. If you can’t get hold of anyone, go to your nearest hospital emergency department.
What tests do I need during chemotherapy?
All chemotherapy patients need regular blood tests during treatment. This is because chemotherapy can affect the number of cells in your blood which can cause problems.
Some patients also need other tests, including:
- tests to see how well the liver, kidneys or other organs are working
- scans to see if a cancer is responding to the treatment.
Your doctor will see you regularly to review your test results, and to see how you are coping with treatment. If they think changes are needed, they will discuss this with you.
Is my chemotherapy dangerous to other people?
During chemotherapy, you can have normal contact with other people. However, there are a few things you should know.
After each treatment, chemotherapy drugs can stay in your body for a few days. During this time, small amounts of these drugs can be in body fluids, such as urine, faeces or vomit. Your doctor or nurse will tell you about any precautions you need to take.
If you have oral chemotherapy at home, you should know how to store and handle your drugs safely. If you have intravenous chemotherapy at home, you should know what to do if you have any problems.
Preparing for chemotherapy
Before chemotherapy, you will need to sign a consent form. It is important you understand what you are consenting to. This includes what chemotherapy you will be having, how often you will have it, how many treatments you will have, and the possible side effects.
Some other things you should know are:
- whether you need any tests before your treatment
- whether you need to change your diet or medications
- if you need to take any premedication (tablets you take before your chemo)
- when you have to be there
- whether you need time off work
- if you can drive or catch public transport after treatment.
You may need medicines to manage side effects from your chemotherapy. It is best to get these before you start treatment, and know what they are for and how to take them. You should also have a thermometer and know how to use it.