What to Expect on Your First Day of Chemo

Receiving a cancer diagnosis can be one of the most devastating experiences of a person’s life. Being told you may need weeks or months of chemotherapy can be extremely overwhelming. Not knowing what to expect on your first day of treatment can increase the feelings of anxiety and loss of control. As an oncology infusion nurse with over 15 years of experience, I will give you an insider’s look into what a day in the chemo infusion suite is like and will aim to answer the most frequently asked questions.

How long will I be here?

This question is the one I am asked most frequently by just about every new patient that sits in my chair. It’s understandable! You may need to coordinate rides, child-care, have someone walk the dog, and the list goes on. You have a life outside of chemo and making room in your schedule for treatments can be hard.

Every chemo regimen is different depending on your specific diagnosis so treatment times will vary greatly, but my best advice is this: plan to be unavailable for the day. You will likely need to arrive early for your appointment to have bloodwork drawn, see the doctor or nurse practitioner, and make sure everything is in order to begin your treatment.

Once you’re in the infusion chair, you’ll likely receive multiple medications in addition to your chemotherapy. These could include anti-nausea medications, steroids, and IV fluids, to name a few. The pharmacist will then mix your chemotherapy based on the specific dose ordered by your doctor and this can take time as well.

Chances are, you will not be spending your entire day in the chemo suite but it is better to be prepared and pleasantly surprised when you finish early, rather than having to scramble at the last minute to find someone to pick up the kids from school.

What should I bring and what should I wear?

We want you to be completely comfortable during your infusion so the answer to this is simple. Bring and wear whatever you need to accomplish that! Some of the most common items people like to bring are:

Wear comfortable clothes that allow easy access to your port (if you have one) or your arms (if you don’t). Your nurse will thank you!

What does getting chemo feel like?

The answer to this question is often surprising to new patients. Most people don’t feel anything abnormal during their chemo infusions. You will probably experience some mild discomfort while having your port accessed or an IV started and you may be given medication (such as Benadryl) that can make some people sleepy, but for the most part, it should be uneventful. Once your medications are up and running, you will be able to relax and pass the time however you choose.

In rare cases, there may be complications such as an allergic reaction to a medication or irritation at your IV site. If these do occur, it is important to alert your nurse immediately so that measures can be taken to reverse these effects.

Many new patients worry about nausea and vomiting during their treatment, but these side effects usually take a few days to manifest. It is unusual for a patient to feel sick and/or vomit during their infusion.

What can I expect after chemo?

Once your infusion is over and you are discharged home, what can you expect over the next few days and weeks? Each chemotherapy medication has its own unique side effects but in general, here are some things you can expect:

Hair loss

Hair loss will usually begin about 14 days after your first infusion. It may be a slow, gradual process or it may happen all at once. Some patients prefer to shave their heads and others choose to let it happen naturally. This is a very personal decision. Hair loss can also be painful, similar to the feeling of taking out your ponytail after a long day.

Nausea, vomiting, and loss of appetite

Nausea usually starts to kick in about 2-3 days after chemo and may last for a few days. Your doctor will give you a prescription for anti-nausea medications to take at home and you should not hesitate to use them. Eating small, frequent snacks/meals can help to minimize nausea. Some people experience taste changes (such as a metallic taste) that can make eating difficult. If you are unable to keep food, water, or medications down, let your doctor or nurse know right away.

Fatigue

Feeling unusually tired and run-down is common after chemo and can become more intense with every treatment cycle. Listening to your body and getting the rest you need is very important. If possible, arrange for friends and family to help with daily activities if you are feeling unwell.

Risk of infection

Chemotherapy attacks rapidly growing cells in your body. This includes your infection-fighting white blood cells. In the weeks after chemo, you may be at a greater risk of infection due to a low white blood cell count (neutropenia). During this time, it is important to wash your hands frequently and stay away from anyone who is sick. You may also be required to return to the infusion center 24-48 hours after your chemo for an injection that will stimulate white blood cell growth.

Take a deep breath and trust your team!

Chemo can be a scary and overwhelming experience for new patients, and I hope these tips will help ease some of the fear of your first day of treatment. Your infusion nurses are a wealth of knowledge when it comes to chemo so don’t hesitate to ask questions. It’s your body and your journey and we are here to help you along the way!