The anxiety surrounding a first chemotherapy appointment often stems from the unknown nature of the experience. Chemotherapy is a systemic medical treatment that uses powerful drugs to destroy or inhibit the growth of fast-dividing cancer cells. Because these drugs circulate through the bloodstream, they can reach cancer wherever it has spread in the body. Understanding the steps involved in this first session can help transform fear into a manageable process. Being informed about the process is the first step in regaining control over the journey.
Preparing for Your First Chemotherapy Session
The preparation phase begins days before the scheduled infusion. A recent blood draw, typically within 24 to 48 hours of the appointment, confirms that white blood cell and platelet counts are within an acceptable range to safely receive the drugs. This pre-treatment lab work is a necessary safeguard, as chemotherapy temporarily impacts the bone marrow’s ability to produce blood cells.
Patients are often instructed to take specific anti-nausea medications (antiemetics) at home before leaving for the infusion center. Taking these prophylactic drugs before symptoms begin helps prevent nausea and makes the treatment more tolerable. Ensuring proper hydration is also important, often involving drinking plenty of water the day before and the morning of the session to aid in flushing the medication afterward.
Logistical planning includes arranging transportation, as pre-medications or chemotherapy may cause drowsiness, making driving unsafe. Wear comfortable, layered clothing since infusion rooms can be chilly and body temperature may fluctuate. If a port or central line is used, wear a top that allows easy access to the chest area, such as a button-down shirt.
Bringing a small bag with comfort items, such as a book, tablet, headphones, or a blanket, is advisable, as infusion times can sometimes last several hours. Eating a light, balanced meal before arriving is encouraged to maintain energy levels. This also prevents an empty stomach, which can sometimes worsen nausea.
The Treatment Day: Step-by-Step
The day begins with checking in at the oncology center, followed by initial assessments by the nursing staff. A nurse records baseline measurements, including vital signs and current weight. Weight measurement is important because chemotherapy dosage is precisely calculated based on the patient’s body surface area.
Next, the nurse establishes intravenous access, either by inserting a peripheral IV or by accessing a central venous access device (CVAD) like a port or PICC line. This access point delivers all fluids and medications. Once access is secured, the nurse administers pre-medications, typically including steroids to reduce inflammation and anti-nausea drugs.
The actual chemotherapy infusion begins after the pharmacy prepares the custom dose and the oncologist confirms the blood work results. The chemotherapy drugs are contained in IV bags and are often administered sequentially, with saline flushes in between to clear the line. The infusion duration can range from under an hour to several hours, depending on the specific drug regimen.
Throughout the infusion, the nursing staff regularly monitors the patient for immediate reactions, such as changes in vital signs or discomfort at the infusion site. Patients should remain seated comfortably and immediately report any unusual sensations. Once the last medication bag is complete, the IV line is flushed, the access device is removed or de-accessed, and the patient is cleared to go home.
Immediate Aftermath and Managing the First 72 Hours
Immediately after the first treatment, many people feel surprisingly normal or energetic, often due to the high-dose steroids given beforehand. This feeling is frequently temporary, and patients should still plan to go home and rest, having pre-arranged transportation. Fatigue is the most common side effect following chemotherapy, often presenting as a profound exhaustion distinct from ordinary tiredness.
The first wave of acute side effects, such as nausea, typically appears within 4 to 24 hours after the infusion, though this varies by drug type. Managing this period involves strictly adhering to the prescribed schedule for anti-nausea medication, even if symptoms have not yet manifested. Hydration is paramount in the first 72 hours, as drinking plenty of fluids helps the kidneys clear the chemotherapy agents from the body.
During this time, patients should eat small, frequent meals of bland, easy-to-digest foods. Avoid anything spicy, fatty, or overly acidic, which can irritate the stomach. A temporary feeling of mental fogginess, sometimes called “chemo brain,” may also be noticeable, making concentration difficult. Conserve energy by prioritizing rest and allowing others to assist with demanding tasks.
A drop in blood counts, leading to immunosuppression, is a concern in the days following treatment. Patients must take precautions to avoid infection, such as frequent hand washing and avoiding crowded public spaces or contact with sick individuals. The care team provides specific instructions on when to call the doctor, including a fever of 100.4°F (38°C) or higher, chills, uncontrolled vomiting, or persistent diarrhea.