Chemo 101: What you need to know

By Agnes Beasley, MSN, RN, OCN

“What should I expect from chemotherapy?” 

I’ve heard those very words spoken by newly diagnosed cancer patients on many occasions in my extensive oncology nursing career. It’s normal for a newly diagnosed patient to try to make sense of what is happening to them. Questions swirl like a tornado in a cancer patient’s mind. You may feel that way right now. Some of the questions you may have are:

  • What can I expect on the day of chemotherapy (chemo)?
  • What can I expect when I go home after chemo?
  • What happens in the “chemo room?”
  • How long will it take to get my chemo?
  • Can I have someone with me during chemo to keep me company?
  • What am I allowed to bring with me to keep me busy?
  • Is it okay to sleep?
  • Will there be other people getting treatment around me or can I be in a private room?
  • I’m feeling anxious, overwhelmed, upset, and angry. Is what I’m feeling normal?
  • If I have questions, who do I call for the answers? [more]

Oncology nurses in the chemotherapy suite get these types of questions on a daily basis. You may be thinking we’re too busy to answer your questions, but don’t worry, ask. Even though we’re helping other patients receiving treatment, we will make time for you. In fact, we want to give you the answers you need. To the newly diagnosed patient, answers to these questions, and many more, can make a huge difference in what can be a terrifying and isolated road to survivorship.

You can also read more anytime in our Guide to Chemotherapy.

Getting good information is key


Each person is different and has different needs, and an oncology nurse can be an excellent resource to a patient facing their first experience with chemotherapy. Even though these nurses deal with chemo every day, they know what it’s like to be “in the chemo chair” for the first time and can help you know what to expect. Let me explain.

Thirteen months ago, a close friend was diagnosed with breast cancer and these same questions were swirling in her mind. Chemotherapy was staring her in the face. She reached out to me for guidance, knowing that I had worked in the field for many years. She was looking to me to provide some clarity to her situation and help her understand what to expect.

Like many newly diagnosed cancer patients, she was fearful of nausea among other things. Would she experience the dreaded nausea? What about hair loss? Also, like many newly diagnosed patients she sought out information on the internet as a way to eliminate her fears, but as she later confided in me, sometimes reading information online can just heighten that fear. Instead she needed a person she could trust who would tell her the truth.

Now, not all newly diagnosed patients personally know an oncology nurse to help them through the journey. But what all cancer patients do have at their disposal are oncology nurses who work in the offices of their oncologists. These nurses are typically the healthcare professional that you will spend the most time with and who will be there to answer your questions. They want you to take advantage of their expertise.

Chemo 101

The road to answering your questions typically begins with a “chemo 101” class. Although the class may have a different name in cancer centers throughout the US, many oncology practices offer them to new patients facing chemotherapy. Most often it’s the nurses who will be giving the chemo who deliver the ins and outs of what to expect at your particular oncology center.

The goal of these classes is to empower you to become an active participant in the cancer journey and be less anxious moving forward. They are generally delivered in a small group setting. This dedicated teaching session is when the chemo nurse explains the particular drugs you’ll be getting and the expected side effects. They also tell you more about the process of getting chemo, which can include topics such as: ­

  • How will the chemo be put into your body?
  • How long will it take to get chemo?
  • Will there be an IV?
  • Who will start the IV?
  • What are the common side effects?
  • What are the less expected side effects?
  • Are there any precautions to take during or after chemo?
  • When should you call the doctor or nurse, and what numbers do you call?

Proper treatment takes time

One question that my friend asked about was why treatment took so long. Each chemo drug must be given over its own set period of time. Intravenous (IV) chemo is given over different amounts of time, depending on the drug and the type of cancer it is treating.  This can range from a few minutes to hours depending on the drug. These clinical standards are important, and we nurses must follow them in order to safely give chemo.

Another question that has come up is, “Why does my infusion neighbor have their chemo going and I’m still waiting?” As I explained to my friend, your chemo nurse has your safety in the forefront of their mind and wants to give your chemo appropriately and with accuracy. Your chemo is prepared for you after you get to the clinic, you’ve been examined by the doctor and/or nurse, and your blood counts have been checked – all these steps take time. The evidence-based steps oncology nurses follow in order to avoid mistakes are important to you as a patient and to your team of nurses.

In fact, receiving chemo is one of the last steps. Here are some of the steps which you may not see:

  • Verifying your full name and a second identifier like date of birth
  • Confirming the diagnosis
  • Reviewing relevant blood (laboratory) results
  • Reviewing a your height, weight, and any other variables that might be needed to accurately calculate the dose 
  • Reviewing and verifying the written chemotherapy orders that were provided by the oncologist
  • Reviewing supportive care treatments ordered and giving them as needed, like medications for nausea or anxiety
  • Reviewing the order of drug administration

Because every person and treatment plan is different, ask your nurse for details about your specific treatment. 

People also wonder what happens during the infusion time. During this time your oncology nurse will keep you informed of what they’re doing and why they’re doing it. My friend told me her particular chemo nurse was proactive throughout her infusions by relaying to her what to expect throughout the day. It’s okay to ask your chemo nurse questions, even though they may have already answered some of these questions in the past.

My friend now is nearing completion of her treatments, and what she’s learned is everyone experiences chemotherapy differently and it’s normal to fear the unknown and have lots of questions. She also learned that she was not traveling an isolated, lonely road; there were rest areas where she could stop to gather knowledge and emotional support. Little did she know that this figurative rest area for her was her oncology office’s chemotherapy suite. Her oncology nurses were there to her hold her hand, answer her questions, and educate her along the road to cancer survivorship!

Beasley is an oncology nurse educator for the American Cancer Society.

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