Chemotherapy: myths and facts

When someone says “chemotherapy is needed”, most families remember stories they have heard from afar. Some of them are right, some are incomplete and some are wrong. Below we compare eight common beliefs with current medical knowledge, based on the US National Cancer Institute (NCI). This article does not replace the doctor’s decision.

1. “Chemotherapy means all your hair falls out”

The facts: Some types of chemotherapy cause hair loss and some do not. Ask what applies to your medicine. If hair falls out, it usually grows back about 2 to 3 months after treatment ends. It may be thin at first, or differ in texture and color.

2. “The more severe the side effects, the better the treatment works”

The facts: You cannot tell from side effects whether treatment is working. The doctor checks this with visits, blood tests and imaging. Having no side effects does not mean the treatment is useless either.

3. “Chemotherapy means you have to stay in the hospital”

The facts: Chemotherapy may be given in hospital with an overnight stay, at home, or as outpatient care in a clinic or hospital. Outpatient means you do not stay the night in hospital. Most medicines go in through a drip, but some are taken by mouth, injected or given in other forms. The place and method are decided by your type of disease and your medicine.

4. “You can’t work during chemotherapy”

The facts: Many people can work during chemotherapy, as long as they fit their work schedule to how they feel. You may need to work part-time or work from home on hard days. Tiredness is the most common side effect and, unlike ordinary tiredness, is not relieved by a good sleep, so planning helps.

5. “Chemotherapy is only for when there is no hope left”

The facts: The goal of chemotherapy differs between patients. Sometimes the aim is to cure the disease, reduce the chance of it returning or slow its growth, and sometimes to ease symptoms, for example by shrinking a painful tumor. Chemotherapy is often combined with other treatments such as surgery or radiotherapy. Ask the doctor what the goal of your own treatment is.

6. “Nausea and vomiting are unbearable and nothing can be done”

The facts: Nausea and vomiting are common side effects, but anti-nausea medicines can usually prevent or reduce them, sometimes before they start. If you have nausea or are worried about it, tell the treatment team. Smaller, more frequent meals and enough fluids help too.

7. “Targeted therapy and immunotherapy are gentle and have no side effects”

The facts: These treatments have side effects too, and some are serious. In targeted therapy, diarrhea and liver problems are the most common. In immunotherapy the immune system may become overactive and attack healthy tissue. These treatments do not cure everyone either: only some patients respond to immunotherapy, and cancer cells sometimes become resistant to targeted therapy.

8. “Supplements and herbs can remove side effects or cure cancer”

The facts: So far no study has shown that a diet, food, vitamin or supplement can cure cancer, slow it or prevent it from coming back. Herbal products may be harmful on their own or together with other medicines and can change the effect of treatment. Complementary treatment (used alongside the main treatment) differs from alternative treatment (used in its place), and the main danger is when the treatment the doctor recommended is set aside. Tell the treatment team about everything you take, even something simple.

A few honest points

• Chemotherapy has side effects, and they can be hard. They often get better after treatment ends, but tiredness may last for months or even longer.
• Chemotherapy lowers white blood cells and raises the risk of infection. A fever of 38 degrees or higher in this period means calling the treatment team at once.
• Every patient is different. The experience of people you know is not necessarily your experience.
• Do not skip a session on your own. If you have a side effect, the doctor will adjust the plan with you.

Every patient’s treatment plan is different; ask your doctor about your own situation.