8 Things to Know Before Your First Chemo Treatment

If you're about to go for your first round of chemotherapy, you may have lots of questions along with some fears. Your oncologist will talk about the drugs you will receive and potential side effects, as well as how often you will need to be seen.

Yet there are many tips that don't often make their way into those conversations, and if they do, you'll likely have more questions when you get back home. Here are some tips on how to be as prepared as possible to have a good experience during your chemotherapy infusions and prevent problems and complications later on.


Eat Light

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Two to three hours before an infusion, eat light and make your choices high-fiber. Chemo drugs tend to slow peristalsis (digestion and bowel processes), so whatever you eat may be in your digestion for longer than usual and will dry out.

The drugs commonly used to prevent nausea and vomiting can be constipating as well. Even if it's recommended that you use medications to prevent constipation, it's necessary to be well-hydrated for these to work.

Eating a high-fiber snack helps since fiber helps retain moisture in the bowels.


Pre-Chemo Blood Tests 101

Before you have each round of chemo, you will have a blood test called a complete blood count (CBC). Your CBC provides a reading on all of the types of blood cells produced by the bone marrow which can be affected by chemotherapy.

Your red blood cell count and hemoglobin are looked at to see if you have anemia. This can lead to fatigue and lightheadedness.

Your white blood cell count will tell your healthcare provider if you have neutropenia, a deficiency of the type of white blood cells known as neutrophils. If your neutrophil level is too low, you may be at risk for infection.

With some chemotherapy regimens, your oncologist may recommend treating you with either Neulasta or Neupogen, which are medications that increase the number and activity of white blood cells in your body.

Your platelet level may also decrease, resulting in a condition called thrombocytopenia. This can lead to bruising and easy bleeding.

Depending on the results of your blood tests, your oncologist may recommend delaying your chemotherapy or using specific treatments to improve your values.

As part of being an empowered patient, ask your oncologist or her nurse to show you the CBC results and explain them to you. It's also helpful to have a copy that you can keep in your records.


Ask Questions About Each Drug

Every chemotherapy infusion includes a mix of drugs. Some are actually cancer-killing drugs, others are medications which help alleviate side effects. Ask questions about all of the drugs you receive, including:

  • What is this medication?
  • What side effects may it have?
  • What will I feel like with this drug?
  • How do I cope with this?
  • Who do I call if I have problems with this?
  • How does this help kill the cancer cells?

Post-Chemo Medications

If you've been given a prescription for post-chemo medications, get clear instructions on how and when to take these.

Medications used to control nausea and vomiting differ. Some are to be used routinely on a schedule to prevent chemotherapy-induced nausea. These medications need to be taken before you feel sick to be most effective.

Other nausea medications are used only on an as-needed basis, for example, if you are feeling very nauseous or vomiting.


Staying Hydrated by Drinking Fluids

Chemotherapy drugs are very drying to your body's tissues, and the drugs will be going to every cell you have. Right after an infusion, drink 8 ounces of water every hour until bedtime. Avoid caffeine, as it is also drying (it's a diuretic) and may cause you to feel worse.

A benefit of drinking enough water is that it will help your body to process and flush the chemo drugs out of your system sooner, so you can start to recover sooner, too.

In rare cases, such as with severe kidney disease or heart failure, it can be detrimental to drink too much water, so talk to your oncologist if you have any other serious medical conditions.


Plan on Having a Support Buddy

Some people plan on driving themselves to chemo if their first infusion goes well. Yet there are many reasons why it's beneficial to have a chemo buddy who can drive you, take notes and help ask questions, and keep you company through your infusion.

There is a lot of information to digest at each visit, and having a friend with you doubles your chance that you won't miss anything. Sometimes a chemo buddy is better able to detect if you have a reaction to the chemo drugs and can point this out to you early on.

The emotional support of having a friend can't be understated. Even if you and your friend each read a book, watch a movie, and don't talk, the presence of another person can lift your spirits. In our fast-paced world, we seldom have time to simply sit and talk with a friend for a few hours. Chemotherapy offers this opportunity.


Track Your Side Effects

If you have side effects from chemotherapy that are bothersome, such as nausea, vomiting, rash, swelling, or unusual pain around the injection site, write these down.

Your healthcare provider or nurse will need to know how often you're having problems, how severe they are, and how you're coping. If you have notes to refer to when you visit the healthcare provider it's easier to recall and bring up any concerns which you had.


Allow for Fatigue and Recovery

The day after your first treatment you may feel tired or very fatigued. Plan on resting, as this gives your body the chance to respond to the chemotherapy, and begin the recovery cycle. Remember that chemo affects every cell in your body. Stay well-hydrated by drinking lots of water or juice.

If you feel ​​fuzzy brained from the medications, try a hot tub soak. Do keep in mind that the majority of the side effects are temporary and that during recovery you will soon feel better.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. McQuade RM, Stojanovska V, Abalo R, Bornstein JC, Nurgali K. Chemotherapy-induced constipation and diarrhea: Pathophysiology, current and emerging treatmentsFront Pharmacol. 2016;7:414. doi:10.3389/fphar.2016.00414

  2. Newburger PE, Dale DC. Evaluation and management of patients with isolated neutropeniaSemin Hematol. 2013;50(3):198–206. doi:10.1053/j.seminhematol.2013.06.010

  3. Izak M, Bussel JB. Management of thrombocytopeniaF1000Prime Rep. 2014;6:45. doi:10.12703/P6-45

Additional Reading
  • American Society of Clinical Oncology. Cancer.Net. Chemotherapy