Chemotherapy
Medicines that kill or slow down cancer cells, used in blood cancers and many other conditions, given as a drip, injection or tablets.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Chemotherapy uses medicines to kill or slow cancer cells; in blood cancers it is a core treatment, often combined with other drugs.
- It cannot promise a cure: ask your consultant whether the aim for you is to cure, control or relieve symptoms.
- A high temperature, feeling very unwell or shivering after chemotherapy can mean neutropenic sepsis, a medical emergency — call your 24-hour chemotherapy line or 999 straight away.
- Treatment runs in cycles over weeks to months, with regular blood tests to check your blood counts and adjust doses.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can shrink or control many blood cancers and other cancers, and in some it is given with the aim of cure
When the likely harm of chemotherapy outweighs the likely benefit, for example in someone too frail to tolerate it safely.
You may feel sick or very tired and need to rest. Anti-sickness and other medicines help. Take your temperature if you feel unwell and follow your...
A 24-hour emergency contact number and a clear, written plan for fever and feeling unwell.
You may feel sick or very tired and need to rest. Anti-sickness and other medicines help. Take your temperature if...
Blood counts often reach their lowest point, so infection risk is highest. Be especially alert for fever or...
A blood test checks your counts have recovered enough to continue safely. Treatment may be delayed or the dose...
Your response is monitored with blood tests, scans or bone marrow tests, depending on your cancer. The plan can...
What it is
Chemotherapy is treatment with medicines that kill cancer cells or stop them dividing. In blood cancers such as leukaemia, lymphoma and myeloma it is one of the main treatments, and it is also used for many other cancers. It can be given through a drip into a vein, as an injection, as tablets you take at home, or sometimes into the fluid around the spine.
Because these medicines travel around the whole body, they can reach cancer cells in many places at once. But they also affect some healthy cells that divide quickly, such as those in your bone marrow, mouth, gut and hair. This is why chemotherapy causes side effects, and why you have regular blood tests during treatment.
Chemotherapy is usually given as a planned course of several 'cycles', with rest gaps in between to let your body recover. Your team will explain whether the aim is to try to cure the cancer, to control it, or to relieve symptoms. These aims are different, and it is fair to ask your consultant directly which one applies to you.
Chemotherapy is one part of a wider plan. It is often combined with targeted drugs, immunotherapy, steroids, radiotherapy, surgery or a stem cell transplant, and your case should be discussed by a multidisciplinary team (MDT) of specialists.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Chemotherapy compared with some other cancer drug treatments
| Approach | How it works | Key point |
|---|---|---|
| Chemotherapy | Kills or slows fast-dividing cells throughout the body | Affects some healthy cells too, so side effects are common |
| Targeted therapy | Blocks a specific feature inside cancer cells | Needs the right target to be present; has its own side effects |
| Immunotherapy | Helps the immune system attack the cancer | Different side effects, including immune-related ones |
| Steroids | Used with chemo to kill some cancer cells and reduce reactions | Often part of blood cancer regimens |
Many people have more than one of these together. Your team will explain why a particular combination is chosen for your cancer.
Preparing for your treatment
- Make sure you understand the aim of treatment (cure, control or symptom relief), the drugs involved, and how many cycles are planned.
- Tell your team about all your medicines, supplements and herbal remedies, as some interact with chemotherapy.
- Mention any infections, recent vaccinations, heart, kidney or liver problems, and whether you could be pregnant or are breastfeeding.
- Ask about fertility: some chemotherapy can affect fertility, and sperm, egg or embryo storage may be possible if discussed before starting.
- You will usually have blood tests, and sometimes heart or kidney tests, before treatment starts and before many cycles.
- Plan practical support: someone to help at home, time to rest, and a thermometer to check your temperature.
- Make sure you are given a 24-hour emergency contact number and written advice on warning signs before your first treatment.
- Ask about dental checks and good mouth care, as chemotherapy can cause mouth soreness and infections.
What happens
Before each treatment you usually have a blood test to check your blood counts are safe, and you see a nurse or doctor. If your counts are too low or you are unwell, treatment may be delayed — this is a normal safety step, not a failure.
Intravenous chemotherapy is given through a cannula in your arm or through a line such as a PICC line or port. Nurses trained in chemotherapy give the drugs and watch you for any reaction. Some sessions are short; others, or combinations, take several hours. You may also be given anti-sickness medicines, fluids and steroids around the treatment.
Most chemotherapy is given as a day case or outpatient, so you go home the same day. Some intensive blood cancer treatments need a planned hospital stay. Oral chemotherapy is taken at home, with clear instructions on timing, safe handling and what to avoid.
Treatment is given in cycles, with rest periods to let your bone marrow and body recover. Your team will tell you the schedule and when your blood counts are likely to be at their lowest, which is when infection risk is highest.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- When the likely harm of chemotherapy outweighs the likely benefit, for example in someone too frail to tolerate it safely.
- When the cancer type is unlikely to respond and a different treatment (such as targeted therapy or supportive care) is more appropriate.
- When severe active infection or very low blood counts make treatment unsafe until they improve.
- When a person decides, after honest discussion of aims and trade-offs, that they do not want chemotherapy.
- When a private setting cannot safely manage the intensity of treatment or its emergencies; some regimens need specialist inpatient cover.
Delay or rearrange if…
- You have an active infection or a temperature.
- Your blood counts have not recovered enough since the last cycle.
- You are unwell, dehydrated, or have uncontrolled sickness or diarrhoea.
- Key results, organ-function tests or staging information are missing.
- There is a chance of pregnancy that needs to be checked first.
Alternatives to discuss
- Targeted therapy or immunotherapy where the cancer has a suitable target.
- Radiotherapy, surgery or a stem cell transplant as part of the plan, depending on the cancer.
- Active monitoring (watch and wait) for some slow-growing blood cancers that do not yet need treatment.
- Best supportive and palliative care focused on symptoms and quality of life.
- A clinical trial of a newer treatment, where one is suitable and available.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can shrink or control many blood cancers and other cancers, and in some it is given with the aim of cure
- Reaches cancer cells throughout the body, including places surgery cannot
- Can relieve symptoms and improve how you feel when the aim is control rather than cure
- Often works alongside other treatments, such as targeted drugs, antibody treatments or a stem cell transplant
- Doses and timing can be adjusted to your blood counts and how you tolerate treatment
Risks & complications
- Increased risk of infection because your white blood cells fall (this can become neutropenic sepsis, which is an emergency)
- Tiredness that can build up over a course of treatment
- Feeling or being sick, usually helped by anti-sickness medicines
- Sore mouth, taste changes, and reduced appetite
- Hair thinning or loss with some drugs (not all)
- Bruising or bleeding more easily, and anaemia, if blood counts drop
- Diarrhoea or constipation needing treatment
- Numbness or tingling in hands and feet (nerve effects) with certain drugs
- Skin and nail changes
- Fertility changes, which may be temporary or permanent depending on the drug
- Allergic or infusion reactions during treatment, which the team watches for
- Severe infection (neutropenic sepsis) that can be life-threatening if not treated urgently
- Damage to the heart, lungs, kidneys or liver with certain drugs
- A second cancer developing years later with some treatments
- Tumour lysis syndrome (a chemical imbalance) when large amounts of cancer break down quickly
The single most important thing to know is that chemotherapy lowers your infection-fighting white cells, so an infection can become dangerous very quickly. A temperature, feeling very unwell, shivering or shaking is a medical emergency — do not wait, do not take paracetamol to mask it, and contact your 24-hour chemotherapy line or call 999. The exact side effects depend heavily on which drugs you have, so ask your team for written information specific to your regimen.
Published figures to discuss
Side-effect and response rates vary enormously between different drugs, regimens and cancers, and between individuals. Published figures from one study often do not apply to another regimen, so exact percentages can mislead. The most important point is not a single number but recognising that infection while neutropenic is common enough, and serious enough, to be treated as an emergency every time.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Neutropenic sepsis | Oncological emergency | Fever, shivering, feeling suddenly unwell or low temperature during chemotherapy needs urgent assessment, even if symptoms seem mild. | Guide sourcesClinical context |
| Treatment benefit varies by cancer type and genetics | Highly diagnosis-specific | Chemotherapy may be curative, disease-controlling or palliative depending on diagnosis, stage and treatment intent. | Guide sourcesClinical context |
| Nausea, fatigue, hair loss, mouth ulcers or diarrhoea | Regimen-dependent | Supportive medicines reduce many side effects, but expected risks should be explained for the exact regimen. | NHS — Chemotherapynhs.ukSource-linked context |
| Fertility, heart, nerve or second-cancer risk | Drug- and dose-dependent | Consent should cover late effects and fertility preservation where relevant before treatment starts. | NHS — Chemotherapynhs.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Chemotherapy is not a one-off event but a course over weeks or months, so 'afterwards' means both how you feel between cycles and how you recover once treatment finishes. Many side effects ease in the gaps between cycles and improve after the course ends, though tiredness can linger.
- Tiredness that comes and goes, often worse in the days after each cycle
- Some nausea, taste changes or a sore mouth that settle between cycles
- Hair thinning or loss with certain drugs, usually regrowing after treatment
- Needing to rest more than usual and pace your activities
- Ups and downs in mood — cancer treatment is demanding, and support is available
Aftercare
- Always carry your 24-hour chemotherapy emergency number and your treatment record or alert card.
- Check your temperature if you feel unwell, hot, cold or shivery, and act on your warning-sign advice straight away.
- Look after your mouth with gentle brushing and any recommended mouthwash to reduce soreness and infection.
- Drink enough fluids, eat as well as you can, and report ongoing sickness or diarrhoea so it can be treated.
- Avoid live vaccines unless your team agrees, and ask before starting any new medicines or supplements.
- Use reliable contraception if there is any chance of pregnancy, as chemotherapy can harm a developing baby.
- Handle oral chemotherapy and body fluids safely at home as instructed, to protect others.
- Keep all blood tests and appointments so doses can be kept safe and effective.
- 24-hour chemotherapy emergency number saved in your phone
- A working thermometer at home and knowing your team's temperature advice
- Written information about your specific drugs and their side effects
- Anti-sickness and other supportive medicines collected and understood
- A list of all your current medicines and supplements
- Someone who can help at home and drive you if needed
- Contraception arranged if pregnancy is possible
- Mouth care items (soft toothbrush, recommended mouthwash)
⚠ Get urgent help if…
- A high temperature, or feeling hot, cold, shivery or shaking — this can mean neutropenic sepsis and needs emergency help now
- Feeling generally very unwell, even with a normal temperature
- Severe breathlessness, chest pain, confusion or passing little or no urine — call 999
- Uncontrolled bleeding, lots of new bruising, or blood in vomit, urine or stools
- Persistent vomiting or diarrhoea so you cannot keep fluids down
- Signs of infection such as a cough, burning when passing urine, or redness around a line site
- A new rash, swelling, or difficulty breathing during or soon after treatment (possible reaction)
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
What a 'good result' means depends on the aim of treatment. When the aim is cure, the hope is to clear the cancer and reduce the chance of it coming back, but no team can guarantee this in advance. When the aim is control, success means shrinking the cancer, keeping it stable, or easing symptoms for as long as possible. Your response is judged over weeks to months using blood tests, scans or bone marrow tests, not from how you feel alone.
Response rates and outcomes vary widely by the type of blood cancer, its genetics, your age and general health, so be cautious about figures you read online. Ask your own consultant what response they are aiming for, how they will measure it, and what the options are if the cancer does not respond as hoped.
Some people are treated with the aim of long-term remission or cure, while others have chemotherapy on and off over time to keep a cancer controlled. Even after successful treatment, you will usually have follow-up to watch for the cancer returning and for any late effects of treatment. How durable the result is depends on the specific cancer and treatment, which your haematologist can discuss for your situation.
Related tests, treatments or support
Chemotherapy is frequently combined with targeted therapy, immunotherapy, antibody treatments such as rituximab, steroids, radiotherapy or a stem cell transplant. Supportive treatments — anti-sickness medicines, antibiotics, growth-factor injections to help white cells recover, and sometimes blood or platelet transfusions — are also part of the plan. Your MDT decides the combination based on your diagnosis.
Follow-up & long-term care
You will be reviewed regularly during treatment, with blood tests before most cycles and scans or marrow tests at set points to check response. After treatment, follow-up appointments continue to monitor for the cancer returning and for late side effects. You should always have a clear route to contact the team urgently between appointments if you feel unwell.
- Regular blood tests during and after treatment to monitor counts and organ function
- Ongoing infection precautions while your immune system recovers
- Monitoring for late effects on the heart, lungs, fertility or risk of a second cancer with certain drugs
- Keeping vaccinations up to date as advised by your team after treatment
- Long-term follow-up appointments to check for the cancer returning
Repeat, follow-on and what comes next
- Doses are often reduced, delayed or switched if side effects or low blood counts make full-dose treatment unsafe.
- If a cancer does not respond, the team may change to a different regimen or treatment type.
- Treatment plans are reviewed at set points and can change based on response, tolerance and your wishes.
- Some people need supportive treatments, such as transfusions or growth-factor injections, to get through a course.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A 24-hour emergency contact number and a clear, written plan for fever and feeling unwell.
- Regular blood tests and review before cycles, with doses adjusted for safety.
- A named team and clear route to urgent assessment, including a hospital that can admit you.
- Written, regimen-specific side-effect information and access to specialist nurses.
- Coordination between private and NHS care so records, scans and emergencies are joined up.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The specific drugs used and how many cycles are planned
- Whether treatment is given as a day case, outpatient or with a hospital stay
- The cost of a long-term line (such as a PICC line or port) and its care
- Supportive medicines, anti-sickness drugs, growth-factor injections and any transfusions
- Blood tests, scans and bone marrow tests to monitor response and safety
- Consultant and specialist nurse time, and access to a 24-hour emergency service
- How complications or hospital admissions are covered and coordinated with the NHS
- The consultant haematologist or oncologist fee and who leads your care
- Drug costs per cycle and the total expected number of cycles
- Facility, day-unit or inpatient fees, and line insertion and care
- Cost of monitoring blood tests, scans and any bone marrow tests
- What 24-hour emergency cover is provided and where you would be admitted if unwell
- How treatment of complications, such as neutropenic sepsis, is covered
- What happens, and what it costs, if the plan changes or treatment is extended
On the NHS? Chemotherapy is widely available on the NHS when it is clinically needed; private care is used mainly for speed of access, choice of consultant or a second opinion, usually working alongside NHS services.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being clear whether the aim is cure, control or symptom relief.
- Not being given a 24-hour emergency number and written warning signs before the first treatment.
- Fertility risks not discussed before starting, when storage options still exist.
- Side effects described only in general terms rather than for your specific drugs.
- No clear plan for how complications and emergencies will be handled, especially in private care.
Marketing red flags
- Any clinic offering a 'miracle cure' or guaranteeing chemotherapy will cure your cancer.
- Unproven 'alternative' or 'natural' chemotherapy alternatives sold instead of evidence-based treatment.
- Pressure to start expensive treatment quickly without MDT discussion or a second opinion.
- Downplaying the risk of infection and serious side effects to make treatment sound easy.
- No clear arrangements for 24-hour emergency cover or for working with the NHS.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is the aim of my chemotherapy to cure the cancer, to control it, or to relieve symptoms?
- Which drugs will I have, how many cycles, and how will you check if it is working?
- What are the main side effects of my specific drugs, and which ones are emergencies?
- What exactly should I do, and who should I call, if I get a temperature or feel unwell?
- Could this treatment affect my fertility, and can I store sperm, eggs or embryos first?
- What happens if the cancer does not respond, or if I cannot tolerate the treatment?
- How will my private and NHS care be coordinated, and who holds overall responsibility?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will chemotherapy cure my cancer?
Will I lose my hair?
What should I do if I get a temperature?
Can I have chemotherapy privately?
Will it affect my fertility?
Can I be around my family and friends?
Is oral chemotherapy gentler than the drip?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Chemotherapy Blood Cancer UK — Neutropenic sepsis NICE CG151 — Neutropenic sepsis: prevention and management Cancer Research UK — Chemotherapy Blood Cancer UK — Blood cancer treatment types
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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