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Why plan chemotherapy

Nurse and patients talking about cancer

This page is about chemotherapy treatment plans and the information your doctor takes into account when planning your treatment. There is information about

 

A quick guide to what's on this page

Your treatment depends on your type of cancer, where it is in your body, if it has spread and where to, as well as on your general health. Through research, doctors find out the best way to give each type of treatment.

Chemotherapy is not usually a single treatment, but a course of treatments. A course usually lasts for between 3 and 6 months but may be shorter or longer. During this time, you will usually have between 4 and 8 cycles of treatment.

A cycle includes the time when you have your chemotherapy treatment and then the break before the next treatment. So, if your cycle lasts 4 weeks, you may have treatment on the 1st, 2nd and 3rd days and then nothing from the 4th to the 28th day. Then the cycle starts again.  The break allows your body to recover.  Giving treatment in cycles also helps to kill more cancer cells.

Depending on the drug or combination of drugs, each treatment lasts from a few hours to a few days. How often you have treatment depends on which drugs you are having, as well as on your treatment plan. So you may have the drugs continuously for a few months, for a few days each month or for a few weeks.

Before you have each cycle of treatment your doctor and nurse will check how you are. If you have cancer that can be seen on a scan, they will also check how well the treatment is working after a few cycles. This is not possible if you are having treatment after surgery to kill any cancer cells that may be left behind. Some people may need a change in their treatment plan.

PDF Download symbol You can view and print the quick guides for all the pages in the Planning Chemotherapy section.

 

Cycles and courses of treatment

Chemotherapy is not usually a single treatment, but a course of treatments. A course usually takes between 3 to 6 months, but can be more or less than that. The treatment will include one or more chemotherapy drugs that you may have through a drip, or as chemotherapy tablets or capsules.

During a course of treatment, you usually have between 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break before the next treatment, to allow your body to recover. So if your cycle lasts 4 weeks, you may have treatment on the 1st, 2nd and 3rd days and then nothing from the 4th to the 28th day. Then the cycle starts again. Or, as another example, you may have a 3 week cycle where you have treatment on the 1st and 8th days, but nothing on days 2 to 7 and days 9 to 21.

Depending on the drug or combination of drugs, each treatment can last a few hours or a few days. You may have treatments every week or every 2, 3 or 4 weeks. How often you have treatment also depends on which drugs you are having, as well as your treatment plan. Your doctor may refer to your treatment plan as your chemotherapy regimen. 

When you have chemotherapy through an infusion pump you may have the drugs

  • All the time for a few months (continuous administration)
  • For a few days each month
  • For a few weeks

Before you have each cycle of treatment your doctor and nurse will check how you are. This includes finding out how you are coping with any side effects.  After a few cycles they will also check if the treatment is working. Some people need a change in their treatment plan. This change may be a delay before your next treatment, a reduced dose of chemotherapy or a change in the type of treatment you have. You can read more about this on the page about changing your chemotherapy plan.

 

Why you have chemotherapy in cycles

All the treatment you are offered is based on years of research. The combination of drugs your doctor suggests will be the best of all those tested. The drugs aim to kill the cancer cells while causing as little as possible harm to normal, healthy cells. You have chemotherapy as a course of treatments over a few months because  

  • It allows the chemotherapy to kill more cancer cells
  • The rest between treatments allows your body to recover from any side effects

At any one time, some of the cancer cells will be resting. Chemotherapy only attacks cells that are in the process of splitting into two (dividing). So resting cells will not be killed. Some of the cancer cells that were resting during your first treatment will be dividing by the time your second comes around and so they will be killed off. Normal cells usually repair the damage from chemotherapy more effectively than cancer cells, so damage to cancer cells should progressively build up without causing permanent damage to normal cells. There is more about this in the section about how chemotherapy works.

 

How doctors choose your treatment

The exact treatment plan (regimen) that your doctor chooses depends on a number of factors

  • The type of cancer you have
  • Where it is in your body
  • If it has spread and where to

Your doctor will also take your general health and fitness and your age into account. Some drugs have more of an effect on your body than others. Your doctor has to judge that you are well enough to be able to cope with any side effects of the treatment before you start. 

How often you have each cycle, and how long your treatment course lasts, also depends on many factors including

  • The type of cancer you have
  • The drugs used
  • How the cancer cells respond to the drugs
  • Any side effects from the drugs
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Updated: 15 April 2013