Chemotherapy is one of the most common cancer treatments used in Canada today. It uses powerful drugs to find and destroy cancer cells in the body. Understanding how chemotherapy works — and what to expect — can help you or a loved one feel more prepared and less afraid. This guide covers everything from how the treatment is given to the side effects you may experience along the way.
What Is Chemotherapy and How Does It Work?
Chemotherapy uses anti-cancer drugs to target cells that grow and divide quickly. Cancer cells divide much faster than most healthy cells, which makes them vulnerable to these drugs. However, some healthy cells — like those in your hair, skin, and bone marrow — also divide quickly. This is why chemotherapy can affect healthy tissue as well.
The goal of chemotherapy depends on the type and stage of your cancer. In some cases, it aims to cure the cancer completely. In other cases, it works alongside surgery or radiation therapy to improve results. Sometimes, it is used to slow the cancer’s growth and manage symptoms.
Doctors often use more than one chemotherapy drug at the same time. Combining drugs can be more effective because each drug attacks cancer cells in a slightly different way. Furthermore, using multiple drugs together is often better tolerated than using a single drug at a very high dose.
According to Health Canada, cancer treatment decisions are always tailored to the individual patient. Your cancer care team will recommend the approach that gives you the best chance of a good outcome.
Types of Chemotherapy Treatment Settings
In Canada, chemotherapy can be given in several different settings. The right setting for you depends on your treatment plan, your overall health, and the type of drugs being used. Your oncologist and care team will help determine which option suits you best.
Hospital Inpatient Care
Some patients receive chemotherapy as an inpatient, meaning they stay in the hospital overnight or longer. This is common during the first few sessions, when doctors need to monitor how your body responds. It is also used for intensive chemotherapy regimens that require close medical supervision.
In rare situations, very high doses of chemotherapy are needed. In these cases, doctors may also arrange a bone marrow transplant. This replaces blood cells that the high-dose treatment has destroyed.
Outpatient or Day Clinic
Many Canadians receive chemotherapy at an outpatient cancer centre or day clinic. You come in for your treatment session and then go home the same day. This approach lets you maintain some normal daily routines and stay close to family. Most provincial health plans in Canada cover outpatient chemotherapy at designated cancer centres.
Home-Based Chemotherapy
Some patients can receive certain types of chemotherapy at home. A trained nurse visits your home to administer the treatment or to monitor a pump that delivers the drugs. A dietitian or physiotherapist may also visit if needed. This option is not available for all types of chemotherapy, so ask your care team if it applies to you.
How Long Does Chemotherapy Take?
Chemotherapy is given in cycles. Each cycle includes a period of treatment followed by a rest period. The rest period gives your body time to recover before the next round begins. The length of each cycle varies depending on the drugs used and your individual response.
A single infusion session can last anywhere from a few minutes to several hours. In some cases, a continuous infusion may run for several days. Therefore, it is important to plan ahead and arrange support from family, friends, or community services during your treatment period.
The total number of cycles you receive depends on the type of cancer, how well you respond to treatment, and your overall health. Your oncologist will review your progress regularly and adjust your plan as needed. Recovery time between cycles tends to be longer for older adults.
Can You Work During Chemotherapy?
Many people continue to work during chemotherapy, at least part-time. Whether this is possible depends on your job and how your body handles treatment. If fatigue is mild and your work is not too physically demanding, continuing to work may actually support your mental well-being. Talk openly with your employer and your doctor about what is realistic for you.
Some provinces offer short-term disability benefits or workplace accommodations for people going through cancer treatment. Check with your provincial health authority or a social worker at your cancer centre for guidance on available support.
Common Chemotherapy Side Effects
Because chemotherapy drugs act on fast-dividing cells throughout the body, they can cause a range of side effects. Not everyone experiences the same effects, and some people tolerate treatment better than others. In addition, newer supportive medications have made it much easier to manage side effects than in the past.
For a detailed overview of how these drugs work in the body, see this resource from the Mayo Clinic’s chemotherapy guide.
Changes in Blood Cell Counts
Bone marrow produces red blood cells, white blood cells, and platelets. Because these cells divide quickly, chemotherapy can temporarily reduce their numbers. Low white blood cell counts increase your risk of infection. Low red blood cell counts can cause anaemia, which leads to tiredness and shortness of breath.
Your care team will monitor your blood counts regularly throughout treatment. If your counts drop too low, your doctor may delay your next cycle or adjust your dose. Always report fever, unusual bruising, or extreme fatigue to your doctor right away.
Nausea and Vomiting
Nausea and vomiting are among the most well-known side effects of chemotherapy. They can happen during or immediately after an infusion. However, they can also appear a day or two later, even if you felt fine at first — this is called delayed nausea.
The good news is that effective anti-nausea medications are now widely available. It is important to take these medications exactly as prescribed, including before your chemotherapy session begins. Severe or uncontrolled nausea and vomiting is not normal — contact your care team if this happens.
Diarrhoea and Constipation
Many chemotherapy drugs affect the digestive system. As a result, some patients experience diarrhoea while others develop constipation. Both conditions can become serious if left untreated. Do not hesitate to speak with your doctor or nurse — there are effective treatments available for both.
Staying well hydrated is especially important during this time. A dietitian can also offer practical advice on foods that are easier on your digestive system during treatment.
Hair Loss
Hair loss is one of the most emotionally difficult side effects of chemotherapy. The good news is that it is almost always temporary. Hair typically begins to grow back after treatment ends, often within a few months. In most cases, it returns to its normal colour and texture.
One option that may reduce hair loss is a cooling cap, also called a cold cap. This device cools the scalp during infusions, which reduces the amount of drug that reaches the hair follicles. Ask your oncologist or cancer centre whether this option is available to you.
Fatigue
Fatigue is one of the most persistent side effects during chemotherapy. It is caused by a combination of the cancer itself, the drugs, and the emotional toll of treatment. Many patients feel most tired in the days immediately following each treatment session.
Fatigue usually improves gradually after treatment ends. In the meantime, pacing yourself and accepting help from others can make a real difference. Light exercise, when approved by your doctor, may also help maintain your energy levels. For more information on managing cancer-related fatigue, visit Healthline’s guide on cancer fatigue.
When to See a Doctor
Always keep your family doctor informed throughout your chemotherapy treatment. Your oncologist manages your cancer care, but your family doctor plays an important role in supporting your overall health. They can help manage side effects, coordinate referrals, and provide emotional support.
If you do not have a family doctor, a walk-in clinic can help with urgent concerns between your scheduled appointments at the cancer centre. However, for serious symptoms, go to your nearest emergency department right away.
Contact your care team immediately if you experience any of the following:
A fever above 38°C (100.4°F)
Unusual bleeding or bruising
Severe or uncontrolled nausea and vomiting
Signs of infection, such as redness, swelling, or pain at the infusion site
Chest pain or difficulty breathing
Extreme weakness or confusion
These symptoms may indicate a serious complication that needs prompt medical attention. Your cancer care team will always provide you with a contact number to call in these situations — keep it accessible at all times.
Frequently Asked Questions About Chemotherapy
How does chemotherapy destroy cancer cells?
Chemotherapy drugs target cells that divide rapidly, which includes most cancer cells. The drugs interfere with the cancer cell’s ability to grow and reproduce, eventually causing it to die. Because healthy cells that also divide quickly can be affected, side effects may occur during treatment.
Is chemotherapy covered by provincial health plans in Canada?
In most provinces and territories, chemotherapy administered at a hospital or cancer centre is covered under your provincial health plan. Some oral chemotherapy drugs taken at home may require coverage through a private drug plan or provincial drug benefit programme. Check with your cancer care team or a social worker to understand your coverage options.
Will I lose my hair during chemotherapy?
Hair loss is a common side effect of chemotherapy, but it is almost always temporary. Hair typically grows back within a few months after treatment ends. A cooling cap may help reduce hair loss for some patients — ask your oncologist whether this is an option for you.
How long does a chemotherapy session last?
The length of a chemotherapy session varies widely depending on the drugs used and your treatment plan. Some infusions take only a few minutes, while others can last several hours or even multiple days. Your oncologist will give you a clear schedule so you can plan accordingly.
What can I eat during chemotherapy to manage nausea?
Eating small, frequent meals of bland, easy-to-digest foods can help manage nausea during chemotherapy. Cold or room-temperature foods are often better tolerated than hot meals. A registered dietitian at your cancer centre can create a personalised eating plan to support you through treatment.
Can I drive myself to chemotherapy appointments?
Some people are able to drive themselves to early chemotherapy sessions, but this may become difficult as fatigue builds up over the course of treatment. It is a good idea to arrange for a family member or friend to drive you, especially after longer infusion sessions. Ask your cancer centre if volunteer driver programmes are available in your area.
Key Takeaways
Chemotherapy uses drugs to destroy cancer cells that divide rapidly in the body.
It can be given in a hospital, at an outpatient cancer centre, or sometimes at home, depending on your treatment plan.
Treatment is delivered in cycles, with rest periods in between to allow your body to recover.
Common side effects include fatigue, nausea, hair loss, changes in blood counts, and digestive issues — most are manageable with proper medical support.
Always take anti-nausea medications as prescribed, and report severe or unusual symptoms to your care team immediately.
Keep your family doctor informed throughout your treatment — they are an important part of your overall care team.
Most chemotherapy treatments in Canada are covered by provincial health plans — speak with a social worker at your cancer centre for details.
As always, speak with your doctor or specialist before making any decisions about your cancer treatment plan.
