Chemotherapy

Overview What to Expect Our Expertise & Doctors FAQ

What is chemotherapy?

Together with surgery and radiotherapy, chemotherapy is one of the 3 main ways in which cancer is treated. Often known simply as ‘chemo’, they are medicines used to destroy or stop the growth of cancer cells.

Types of chemotherapy

There are various ways in which chemotherapy can be given.

Purpose of chemotherapy:

Curative chemotherapy in the treatment of chemo-sensitive, curable cancers such as lymphoma, germ cell tumours and leukemia
Palliative chemotherapy for advanced cancers aimed at killing the cancer cells, controlling disease, preserving quality of life and prolonging overall survival
High-dose chemotherapy and stem cell rescue

Timing of chemotherapy:

Upfront or induction chemotherapy to shrink the tumour size before definitive local treatment with either surgery or radiotherapy
Concurrent chemo-radiation where the drugs are used together with radiation to improve the effectiveness of radiotherapy
Adjuvant chemotherapy (therapy after the initial treatment of cancer to prevent recurrence of the tumour) where the drugs are given after surgery or radiotherapy to treat micro-metastases (tumours) which cannot be seen, so that patients will have a higher chance of cure

Your doctor may recommend the strategic use of chemotherapy treatment to kill cancer cells or a combination of one or more other treatments, depending on how far the cancer has spread.

Why do you need chemotherapy?

The goal of chemotherapy is to cure your cancer and prolong your life span. If a cure is not possible, chemotherapy may help to shrink the cancer or slow its growth. This is to allow you to live symptom-free for as long as possible.

Chemotherapy can:

Eliminate any remaining cancer cells in the body after surgery and radiotherapy
Reduce the risk of cancer relapse to a different part of your body
Kill the cancer cells and slow down its growth

An ideal treatment option will be selected based on the type of cancer, its location, stage of the cancer and other patient factors.

What are the risks and complications of chemotherapy?

Chemotherapy is often maligned due to its range of possible side effects, which may affect a patient’s quality of life. Nowadays, the newer chemotherapy agents, as well as supportive medicines used, are very effective in reducing side effects for the patient.

Common side effects of chemotherapy include:

Loss of appetite
Nausea
Mouth ulcers
Fatigue
Hair loss
Diarrhoea
Nerve damage

With advances in cancer treatment, newer chemotherapies are more effective and offer improved overall results with fewer side effects.

How do you prepare for chemotherapy?

Chemotherapy usually takes place over a period of time. Your preparation will depend on which drugs you receive and how they may be administered.

Some ways to prepare for your chemotherapy include:

Undergoing blood tests and procedures to ensure that your body is ready to receive chemotherapy
Visiting a dentist to check your teeth for signs of infection to reduce any risks or complications
Making arrangements for help at home and for work, children, pets or other commitments
Planning ahead for side effects such as infertility or hair loss
Getting a close contact to drive you to your first treatment, as some side effects can make driving difficult
Being well-rested and eating a light meal before your chemotherapy in case of nausea
Keeping well-hydrated

What can you expect with chemotherapy

Your chemotherapy treatment – the drugs you will receive and how they will be administered – is based on several factors, including:

Type of cancer
Stage of cancer
Previous cancer treatments
Goals and preferences
Overall health

How chemotherapy drugs are administered

Chemotherapy drugs can be administered via:

Tablets
Injection shot
Topical cream or gel
Intravenous infusion
Direct application to one area of the body. For example, intraperitoneal chemotherapy is applied directly to the abdomen.
Direct application on the cancer or treatment area. For example, thin disk-shaped wafers containing chemotherapy drugs can be placed near a tumour during surgery. These wafers break down over time, releasing chemotherapy drugs.

Estimated duration

Chemotherapy treatment schedules vary depending on your cancer condition. Treatment can be continuous, or it may include rest periods to let you recover between treatments.

Care and recovery after chemotherapy

Rehabilitation services will be provided to aid you in your recovery. Parkway Cancer Centre has a support programme – CanHOPE – that provides patients with support and personalised care, working closely with medical and allied health professionals, to help patients and caregivers make more informed decisions in their treatment.

CanHOPE's core activities include:

Cancer counselling
Nutritional advice
Rehabilitation
Education
Care coordination
Support group activities

Frequently asked questions

A: You may have finished your last round of chemotherapy, but your self-care journey is not over. You may continue to experience side effects and are at risk of infections, bleeding and skin problems.

Your doctor will advise you on how to take care of yourself after chemotherapy, including:

Avoiding undercooked or raw food
Avoiding crowds and stray animals
Good hygiene practices such as frequent hand-washing to prevent infection
Mouth care to prevent mouth sores and bacterial infection
Staying active
Keeping well-hydrated
Monitoring for fevers.

A: High-dose chemotherapy is treatment using conventional chemotherapy drugs but given at much higher doses. It is usually indicated in patients with blood cancers and some relapsed solid tumours. Use of higher doses of chemotherapy overcomes drug resistance and improves outcomes.

A: Nausea and vomiting are common side effects of chemotherapy drugs. These side effects occur due to chemotherapy agents circulating in your blood that trigger signals to the vomiting centre in your brain.

The severity of such side effects depend on factors such as:

Other ongoing cancer treatments such as radiation
Personal susceptibility to nausea and vomiting such as during pregnancy or when on a plane
Type of chemotherapy drugs and dosage.

A: It is generally not recommended to drink alcohol while undergoing chemotherapy, as the alcohol may interact with your current medication while worsening some side effects of chemotherapy such as dehydration, nausea and vomiting.

Do speak to your doctor for further advice.

A: Low platelet count is a common side effect of chemotherapy that puts you at risk of uncontrollable bleeding.

To increase your platelet count during chemotherapy, your doctor may recommend the following:

A platelet transfusion from donors
In some cases, medication to prevent your platelet count from dropping too low.

A: No, trastuzumab is not a form of chemotherapy. It is an anti-cancer targeted therapy drug used to treat cancers that express large amounts of HER2 protein (human epidermal growth factor receptor 2) such as early breast cancer, metastatic (stage 4) breast cancer and metastatic gastric cancer.

Trastuzumab may be used in conjunction with chemotherapy.

A: Chemotherapy does not wipe out your immune memory. However, if you are undergoing chemotherapy, your immune system can be weakened, making you susceptible to infections.

Speak to your doctor to ensure that you and those whom you interact closely with are up-to-date with all immunisations recommended for your cancer type.

A: Some side effects of chemotherapy such as hair loss, nausea or vomiting may last only during your treatment period. Others, such as dental problems, infertility and an increased risk of other cancers, will be effects that you will have to manage for the rest of your life.

A: Chemotherapy and radiotherapy are 2 common but different forms of anti-cancer treatment.

Chemotherapy is a form of systemic therapy. It involves the use of medications either given orally or through injections. These medications, when administered, enter into the blood stream and circulate round the body to where the cancer cells are.

On the other hand, radiotherapy is the use of radiation to directly kill the cancer cells. As such, radiotherapy is a form of local or regional treatment. They tend to be used when the tumour is confined to one or a few spots.

As such, the side effects of chemotherapy and radiotherapy are different. Chemotherapy side effects tend to be more systemic and generalised and the nature of which depends on the type of drugs used. Radiotherapy side effects tend to be more localised to the location where radiation is applied.

A: There is no way to completely prevent hair loss during chemotherapy. However, scalp cooling caps (scalp hypothermia) can be used to help slow blood flow to your scalp during chemotherapy and reduce the effect of chemo drugs on your hair.

Why choose Gleneagles Hospital

Established for more than 60 years in Singapore, Gleneagles Hospital provides trusted healthcare with the needs of our patients in mind. We understand that battling cancer is emotionally, physically and psychologically challenging for both the patient and caregiver.

Our oncologists work with surgeons, radiotherapists, specialty nurses and counsellors in a multi-disciplinary care team to provide holistic care to you.

We aim to help you navigate cancer treatment with success and regain your quality of life.

Estimated cost

Private healthcare can be affordable. Use our Hospital Bill Estimator to determine the estimated cost of this procedure. If you have hospital insurance, find out how you can use your insurance.

Our medical oncologists

Our cancer specialists are skilled and sub-specialised in the treatment of a range of cancers. We will help you select a suitable combination of treatments to match your goals and support you throughout your cancer journey.