Important: This page is for general information only. Your oncologist will design a chemotherapy plan that is specific to your cancer type, stage, and health. Always follow your doctor’s guidance.
What is chemotherapy?
Chemotherapy — often called “chemo” — is a type of cancer treatment that uses drugs to kill cancer cells or stop them from growing and dividing. It is one of the most common cancer treatments, used alone or alongside surgery, radiation therapy, or other medications.
Chemotherapy works by targeting fast-growing cells. Because cancer cells divide more rapidly than most normal cells, chemotherapy drugs are especially damaging to them. However, some healthy cells that also divide quickly — such as those lining the mouth and gut, and the cells that produce hair — can also be affected. This is why chemotherapy causes side effects.
Why chemotherapy is used
Chemotherapy is used for several purposes depending on the stage and type of cancer:
- To cure cancer — in some cancers, such as certain lymphomas and leukaemias, chemotherapy alone can eliminate the disease entirely.
- To shrink a tumour before surgery or radiation — this is called neoadjuvant chemotherapy. Making the tumour smaller may allow less extensive surgery.
- To destroy remaining cancer cells after surgery or radiation — this is called adjuvant chemotherapy, and it lowers the risk of the cancer coming back.
- To control cancer growth — if a cure is not possible, chemotherapy can slow the cancer, prevent it from spreading, and extend life.
- To ease symptoms — shrinking a tumour can relieve pain, difficulty breathing, or other problems it is causing.
Your oncologist will explain which of these goals applies to your treatment.
How chemotherapy is given
Chemotherapy can be given in different ways. The most common methods are:
- Intravenous (IV) drip — a needle or cannula is placed into a vein in the arm or hand, and the drug flows in slowly over minutes or hours. This is the most frequent method.
- Oral tablets or capsules — some chemotherapy drugs are taken by mouth at home, like any other medicine.
- Injection — given as a shot into a muscle or under the skin.
- Via a port — a small device placed under the skin during minor surgery, connected to a large vein. The nurse inserts a needle into the port for each treatment. Ports are used when many cycles of IV chemotherapy are needed; they reduce the need to find a new vein each time.
Your medical oncologist will decide which method is right for your cancer and drug combination.
What a chemotherapy schedule looks like
Chemotherapy is usually given in cycles. A cycle is a period of treatment followed by a rest period. For example, you might receive chemotherapy drugs on day 1 and day 2 of a cycle, then have 19 days of rest before the next cycle begins. This gives your body time to recover and rebuild healthy cells.
A full course of treatment typically involves several cycles — often 4 to 8, depending on the cancer type and the drugs used. Your oncologist will tell you how many cycles are planned and how long each cycle lasts.
It is important not to skip chemotherapy sessions without talking to your doctor first. Your doctor may adjust the schedule if you are experiencing serious side effects, but missing treatment without guidance can reduce its effectiveness.
Common side effects and how to manage them
Chemotherapy affects people differently. The side effects you experience depend on the specific drugs, the dose, and your overall health. Not everyone has all of these side effects, and they often improve after treatment ends.
Fatigue is the most common side effect — a deep tiredness that rest does not always relieve. Plan ahead: ask someone to drive you to appointments, rest on the day of and after treatment, and reduce other demands on your energy during treatment weeks.
Nausea and vomiting can often be well controlled with anti-nausea medications (called antiemetics) that your doctor will prescribe. Take them as directed, even if you feel well before your session. Eating small, bland meals and avoiding strong smells can also help.
Hair loss may occur with some chemotherapy drugs, usually starting 2–3 weeks after the first treatment. Hair almost always grows back after treatment ends. Not all chemotherapy regimens cause hair loss — ask your doctor whether yours is likely to.
Mouth sores (mucositis) can develop because chemotherapy affects the cells lining the mouth. Rinse with a mild saltwater or bicarbonate mouthwash several times a day. Use a soft toothbrush and avoid hot, spicy, or acidic foods.
Low blood counts — chemotherapy can temporarily reduce the number of red blood cells, white blood cells, and platelets:
- Low white blood cells increase the risk of infection. Wash hands frequently, avoid crowds, and call your doctor immediately if you develop a fever.
- Low red blood cells (anaemia) can cause tiredness and breathlessness. Your doctor may recommend iron supplements or, in some cases, a blood transfusion.
- Low platelets can cause easy bruising or bleeding. Report unusual bleeding to your care team.
Appetite changes and weight loss are common. Tell your doctor or nurse if you struggle to eat — a dietitian can suggest ways to maintain nutrition during treatment.
Numbness or tingling in hands or feet (peripheral neuropathy) can occur with certain drugs. Tell your care team if you notice this, as it may affect which drugs are used.
When to call your care team immediately
Some side effects are medical emergencies. Call your oncologist or go to the nearest emergency department immediately if you notice:
- Fever of 38°C (100.4°F) or higher — this can indicate a serious infection when blood counts are low, and must be treated urgently.
- Shaking chills, rapid breathing, or confusion.
- Unusual or heavy bleeding that does not stop.
- Severe chest pain or difficulty breathing.
- Sudden swelling of the face, throat, or tongue (possible allergic reaction).
- Severe vomiting that prevents you from keeping down fluids for more than 24 hours.
In India, the emergency ambulance number is 108 (general emergencies) or 112. Save your oncology team’s contact number and know which hospital you should go to in an out-of-hours emergency.
Chemotherapy and daily life
Many people continue some normal activities during chemotherapy, particularly on days when they feel well. A few practical points:
- Work — whether you can work depends on your job and how you feel. If possible, plan lighter schedules around treatment days. Employers in India are generally required to accommodate medical needs under applicable labour laws.
- Diet — chemotherapy can affect your appetite and digestion. Eat small, frequent meals. Focus on nutrient-rich foods. Avoid raw or undercooked food if your white cell count is low, as this raises infection risk.
- Exercise — light walking or gentle activity, if you feel up to it, can reduce fatigue. Do not push yourself on bad days.
- Alcohol — avoid alcohol during chemotherapy, as it can interact with some drugs and worsen side effects.
- Other medications and supplements — always tell your oncologist about every drug, herbal remedy, or supplement you take. Some can interfere with chemotherapy.
Knowing if chemotherapy is working
You will have regular check-ups during chemotherapy. Your doctor will order blood tests and scans (such as CT, PET, or MRI) to monitor your response to treatment. The severity of your side effects is not a guide to whether chemotherapy is working — serious side effects do not mean the treatment is more effective, and mild side effects do not mean it is failing.
If the chemotherapy is not working as hoped, your oncologist may adjust the drugs, the dose, or the schedule, or may recommend a different treatment approach.
Cost and financial support in India
The cost of chemotherapy varies significantly depending on the drugs used, the number of cycles, and where treatment is given. Government cancer hospitals and medical college hospitals generally provide chemotherapy at significantly lower cost than private hospitals — and some offer subsidised or free treatment for patients who cannot afford care.
Ayushman Bharat PM-JAY may cover chemotherapy for eligible families at empanelled hospitals. Eligibility depends on your household income and state. Before starting treatment, ask the hospital’s help desk whether your regimen is covered under PM-JAY or any state government scheme, and what documentation you will need.
If cost is a concern, ask your oncologist or the hospital’s social worker about:
- Government or trust-run hospitals in your area that offer subsidised chemotherapy
- State government cancer assistance schemes
- NGO support programmes for cancer patients
Your hospital’s patient services department is the best starting point — they can advise on what financial support is available locally.
Questions to ask your oncologist
Before starting chemotherapy, you may want to ask:
- Which chemotherapy drugs will I receive, and why these ones?
- How many cycles will I need, and how long is each cycle?
- How will the chemotherapy be given — IV, tablets, or port?
- What side effects are most likely with my regimen, and how should I manage them?
- What symptoms should I treat as an emergency and call you about immediately?
- Will chemotherapy affect my ability to work or care for my family?
- Are there any foods, supplements, or medications I should avoid?
- How will we know if the treatment is working?
- Is this covered under PM-JAY, and what steps do I need to take?
- Are there clinical trials that may be relevant for my cancer type?
Bring a family member or trusted person to your first oncology appointment to help you remember the answers.
