Chemotherapy (sometimes just called "chemo") is the use of drugs to kill or slow the growth of cancer cells. The drugs are called cytotoxics, which means toxic to cells (cyto).

Chemotherapy is one anticancer drug treatment.

How it works

All cells in the body grow by dividing into two cells. Cancer cells are cells that divide rapidly and grow out of control. Chemotherapy damages the cells that are dividing rapidly.

Most chemotherapy drugs are delivered into the bloodstream and they can travel to all parts of the body to reach cancer cells in the organs and tissues. This is known as systemic treatment.

Occasionally, chemotherapy is delivered directly to the cancer. This is known as local chemotherapy.

Reasons for having chemotherapy

Chemotherapy can be used for different reasons:

• As the main treatment – The aim is to reduce or stop the signs and symptoms of cancer. This is called curative chemotherapy.
• Before other treatments – The aim of chemotherapy given before surgery or radiation therapy is to shrink the cancer so that the other treatment works better. This is called neoadjuvant therapy.
• After other treatments – The aim of chemotherapy given after surgery or radiation therapy is to get rid of any remaining cancer cells and try to cure the cancer. This is called adjuvant therapy.
• With other treatments – Chemotherapy may be given with radiation therapy (called chemoradiation or chemoradiotherapy) or with immunotherapy or targeted therapy.
• For cancer that has spread – Chemotherapy may be used to slow the growth and stop it from spreading for a period of time. This is called palliative chemotherapy. In rare cases, palliative treatment can also achieve remission, when the signs and symptoms of cancer reduce or are no longer detected during routine tests.
• To relieve symptoms – By shrinking a cancer that is causing pain and other symptoms, chemotherapy can improve quality of life. This is also called palliative chemotherapy.
• Stop cancer coming back – Chemotherapy might continue for months or years after remission. This is called maintenance chemotherapy. It may be given with other drug therapies to stop or delay the cancer returning.

Frequently asked questions

How is chemotherapy used?

There are many different types of chemotherapy drugs, and each type damages cancer cells in a different way. You might have treatment with one chemotherapy drug or several drugs.

If a combination of drugs is used, each drug is chosen to attack cancer cells in a particular way. The chemotherapy drugs you have will depend on the type of cancer. This is because different drugs work on different cancer types.

Sometimes chemotherapy is the only treatment used to treat cancer, but you may also have other treatments.

How is chemotherapy given?

Chemotherapy is usually given into a vein. This is called intravenous or IV chemotherapy. It is sometimes given in other ways, such as tablets you swallow (oral chemotherapy), a cream you apply to the skin, or injections into different parts of the body.

The choice depends on the type of cancer being treated and the chemotherapy drugs being used. Your treatment team will decide the most appropriate way to give you the drugs.

Why does chemotherapy have side effects?

Chemotherapy damages cells that divide rapidly, such as cancer cells. However, some normal cells – such as blood cells, hair follicles and cells inside the mouth, bowel and reproductive organs – also divide rapidly.

When these normal cells are damaged, side effects may occur. Some people have few or mild side effects, while others may feel more unwell. As the body constantly makes new cells, most side effects are temporary.

The drugs used for chemotherapy are constantly being improved to give you the best possible results and cause fewer side effects. Many people worry about the side effects of chemotherapy but these can usually be prevented or controlled. 

How much does chemotherapy cost?

Chemotherapy drugs can be expensive. The Pharmaceutical Benefits Scheme (PBS) covers all or part of the cost of many chemotherapy drugs for people with a current Medicare card.

You usually have to pay some of the cost of oral chemotherapy drugs you take at home. This cost is known as a co-payment. You may have to contribute to the cost of some intravenous chemotherapy drugs.

This depends on which state or territory you live in, whether you have treatment in hospital (inpatient) or visit the hospital or treatment centre for treatment and then go home (outpatient), or are treated in a private or public hospital.

You may have to cover the cost of some medicines yourself. Remember to keep copies of your receipts if you are getting prescriptions filled at different pharmacies, or ask your pharmacy to collate your prescription receipts.

Once you have spent a certain amount on medicines in a year, you can get a PBS Safety Net card, making prescription medicines cheaper for the rest of the year.

You have a right to know whether you will have to pay for treatment and drugs and, if so, what the costs will be. This is called informed financial consent. You can ask for a written estimate that shows what you will have to pay, if you don’t receive one.

“My chemo infusions took about 8 hours because I had 2 drugs and a saline solution in between. It was a long day, sitting in the chair having infusions.” Cheryl

Length of treatment

How often and for how long you have chemotherapy depends on the type of cancer you have, the reason for having treatment, the drugs that are used and whether you have any side effects.

Chemotherapy before or after surgery is often given for six months, but sometimes longer. Maintenance chemotherapy (to prevent the cancer coming back) and palliative treatment (to control the cancer or relieve symptoms) may continue for many months or years.

If you feel upset or anxious about how long chemotherapy is taking or any of the side effects, let your treatment team know.

Location of treatment

Most people have chemotherapy as an outpatient during day visits to a hospital or treatment centre. In some cases, an overnight or longer hospital stay may be needed.

People who use a portable pump or have oral chemotherapy can usually have their treatment at home. Sometimes a visiting nurse can give you chemotherapy intravenously or by injection in your home.

If you need to travel a long way for chemotherapy, you may be eligible for financial assistance to help cover the cost of travel or accommodation. Your local Cancer Council may also provide transport and accommodation services.

Call Cancer Council 13 11 20 to find out if there is a transport to treatment service or accommodation service in your area and how to access a patient travel assistance scheme (PATS).

Chemotherapy and pregnancy

Being diagnosed with cancer during pregnancy is rare. Having chemotherapy in the first trimester (12 weeks) may increase the risk of miscarriage or birth defects, but there seems to be a lower risk in the second and third trimesters (13 to 40 weeks).

Chemotherapy drugs may also cause premature delivery, and preterm babies can have other health issues, such as respiratory problems. If you are already pregnant, it may be possible to have some types of chemotherapy.

Talk to your oncologist or haematologist about the potential risks and benefits. If you have chemotherapy during pregnancy, you will probably be advised to stop at least 3–4 weeks before your delivery date.

This is because the side effects of chemotherapy on your blood cells increase your risk of bleeding or getting an infection during the birth. Talk to your doctor about your specific situation and what is best for you and your unborn baby.

In some cases, chemotherapy can be delayed until after the baby’s birth. The treatment recommended will be based on the type of cancer you have, its stage, other ways to treat the cancer, and protecting your developing baby.

You will be advised not to breastfeed while having chemotherapy. This is because the drugs can pass through breastmilk and may harm the baby. 

Health professionals

Before, during and after treatment, you will see a range of health professionals who specialise in different aspects of your care.

The main specialist doctor you will see when having chemotherapy is a medical oncologist (for tumours, also called solid cancers) or a haematologist (for blood cancers).

You may be referred to a medical oncologist or a haematologist by your general practitioner (GP) or by another specialist such as a surgeon.

Treatment options will often be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting.

It is also a good idea to build a relationship with a GP because they will be part of your care, particularly after your cancer treatment ends.