Before My First Chemotherapy: The Fear of What Was About to Happen
- Deborah Ann Martin
- 1 day ago
- 14 min read
The Emotions, Uncertainty, and Small Decisions I Faced Before My First Chemotherapy
Before my first chemotherapy appointment, I was afraid.
Not just a little nervous.
I was afraid of what was about to happen to my body, afraid of losing my hair, afraid of the unknown, and afraid of walking through the doors of the cancer center for the first time.
I wanted chemotherapy.
I needed chemotherapy.
I wanted the doctors to do everything possible to treat my cancer.
And I was still scared.
I eventually learned that those feelings could exist at the same time.
You can desperately want treatment and still be terrified of receiving it.
You can be determined to fight cancer and still wonder what the treatment will do to you.
That was where I was before my first chemotherapy treatment.
I was standing at the beginning of something I had never experienced before, trying to prepare myself for something no one could completely prepare me for.
The Fear Started Before I Ever Walked Through the Door
Before my first chemotherapy appointment, I already knew one change was coming.
My hair was likely going to fall out.
I had known intellectually that chemotherapy could cause hair loss.
Knowing it as a possible side effect was one thing.
Knowing that I was about to receive the medicine that could make it happen to me was something completely different.
Until then, I had never thought very much about my hair.
It was simply part of me.
Then suddenly, I was facing the possibility of watching it come out in handfuls.
And that was only one of the things I was afraid of.
I was afraid of the treatment.
I was afraid of what my body would experience.
I was afraid of what I did not know.
And I was about to walk through a door I had never wanted to enter.
I Cut My Hair Before Chemotherapy
My hair had been long, extending past my shoulders.
After the surgeries and before my first chemotherapy treatment, I had it cut short.
I wanted to make the coming change feel a little less extreme.
Going from very long hair to no hair felt overwhelming.
I thought that cutting it first might give me time to adjust.
The haircut did not remove the anxiety.
But it gave me one small decision I could make for myself before chemotherapy made so many decisions for me.
That mattered.
Cancer can make you feel as though control is being taken away piece by piece.
The haircut was something I could choose.
The American Cancer Society explains that not every chemotherapy drug causes complete hair loss. Hair loss depends on the specific drug, dose, and treatment plan. Some people experience thinning, while others lose much of their hair. Hair loss also varies from person to person.
You Never Think About Your Hair Until You May Lose It
Hair can feel completely ordinary until it becomes threatened.
Then you begin thinking about things you never thought mattered.
How does it frame my face?
How long have I worn it this way?
Will people stare?
Will children be frightened?
Will I recognize myself?
Will losing my hair make the cancer feel more real?
Do I want a wig?
A hat?
A scarf?
Nothing?
Should I cut it before it falls out?
For some people, hair loss is one of the most emotionally difficult parts of cancer treatment.
It is not because hair matters more than survival.
It is because hair loss can make an illness visible.
A person may feel fairly normal one day and then suddenly look different enough that everyone knows something has changed.
The National Cancer Institute recognizes that cancer and its treatment can affect how people feel about their bodies and themselves. Fear, worry, sadness, anger, and a sense of losing control are common emotional responses to cancer.
For me, hair was becoming one more reminder that cancer was no longer something happening somewhere in my medical records.
It was about to become visible.
I Wanted Chemotherapy, But I Was Still Afraid
I had already survived two surgeries.
The surgeons had removed three large abdominal tumors and the tumor on my back.
I had struggled with severe anemia, weakness, a blood transfusion, wound care, and a recovery I barely remembered.
Chemotherapy was the next stage.
To fight the cancer, I HAD to do chemotherapy.
I wanted every possible effort made to treat the remaining cancer, so I wanted to do the chemotherapy and get it over as soon as possible. I needed it to survive.
I wanted to make my 5-year cancer survival mark, and in order to make it. I HAD to do chemotherapy. I HAD to lose my hair. I HAD to do whatever it took to make it to 5 years.
At the same time, I was afraid to walk into the building.
It was the beginning of COVID, and I had to do it alone. My support was going to be waiting in the car and in the prayers of me and my friends. I was determined I could make it through this first session. I'd worry about the others later. But I HAD to get through the first round.
All those feelings did not contradict each other.
Fear and determination can exist together.
Wanting treatment does not mean you are not frightened of it.
You can desperately want the medicine that may help you and still be terrified of what that medicine might do.
That was where I was.
The Fear of the Unknown
I had questions.
What would chemotherapy actually feel like?
Would I become sick?
Would I be exhausted?
Would I be able to work?
Would I be able to eat?
Would I sleep?
Would I lose all my hair?
How would my body react?
What if something went wrong?
And perhaps the biggest question:
What would happen to me after that first treatment?
The National Cancer Institute notes that fear and worry are common during cancer, including concerns about treatment, physical changes, family responsibilities, work, finances, and the possibility of dying. It also recommends asking questions and learning what you can about your treatment because understanding what to expect may help people feel more in control.
I was learning that information can help with fear.
But information cannot erase it.
It Felt Like the First Day at a New School
My first chemotherapy experience reminded me of starting at a new school.
You know it is a school.
You understand the basic idea.
There will be classrooms, teachers, rules, and schedules.
But you do not know where anything is.
You do not know where to sit.
You do not know what everyone expects from you.
You do not know which parts of the day will be easy or difficult.
That was how the infusion center felt.
I knew chemotherapy involved cancer medicine.
I knew there would probably be an IV or port.
I had spoken with Tina and Kim.
They had warned me about certain side effects and shared practical advice.
But their lived experience could not become my lived experience.
I still had to walk through the process for the first time.
Advice Helps, but It Cannot Remove the Unknown
Kim had survived breast cancer years earlier.
Tina had uterine leiomyosarcoma and was only a few weeks ahead of me.
Both women helped prepare me.
Their advice mattered.
Their experience mattered.
But neither could tell me exactly how my body would respond.
The chemotherapy drugs, doses, treatment plans, medical histories, and bodies were different.
Even Tina and I, with the same rare cancer and the same oncologist, did not have identical disease or treatment experiences.
Shared knowledge can make the unknown smaller.
It cannot make it disappear.
That may be one of the hardest lessons about cancer.
Someone can tell you what happened to them.
You can listen carefully.
You can prepare.
And then you still have to experience your own body and your own treatment.
COVID Made the First Step Even Harder
I began chemotherapy during the COVID-19 pandemic.
Restrictions meant that no family member could sit beside me through the normal check-in and treatment process.
I entered alone.
That made the experience feel even more like the first day of school, except this was not a new opportunity I had chosen.
I was entering because I had Stage IV uterine leiomyosarcoma and needed treatment.
There was no hand to hold in the waiting room.
There was no adult child beside me taking notes.
There was no friend sitting nearby while I waited for the medicine.
I had to learn the process while carrying my own fear.
COVID added another layer to an already frightening experience.
Cancer was isolating enough.
Walking into treatment without my usual support system made the first step feel even bigger.
The Normal Check-In Came First
Before chemotherapy could begin, there were ordinary medical and administrative steps.
There were questions.
Identification.
Insurance information.
Vital signs.
Bloodwork.
Medical review.
The process was more involved than simply walking in and receiving a bag of medicine.
A first infusion visit may include laboratory testing, checking vital signs and weight, reviewing the treatment plan, seeing a doctor or advanced practice provider, accessing an IV or port, preparing medications, receiving premedications, and then receiving the cancer treatment itself.
The exact process varies by cancer center and treatment regimen.
I did not fully understand all those steps before arriving.
That is one reason the unknown felt so large.
My New Port Could Not Be Used
The port had been placed only shortly before the chemotherapy appointment.
When the staff examined it, they told me it was not ready to use.
The area had not healed enough.
That meant they had to place a regular IV in my arm.
The port had been inserted because I would need repeated access for blood draws, pretreatment medicines, and chemotherapy.
Yet on the first day, I could not use it.
That felt frustrating.
I had prepared myself mentally for one process.
Now the process was changing.
The chemotherapy could still be given through the IV for that treatment, so that became the plan.
The experience reminded me of something else about cancer treatment:
Even when you think you know what is going to happen, the day may not go exactly according to plan.
Potent Medicine Through an Arm Vein
The chemotherapy I was receiving was powerful.
I understood that giving it through a peripheral IV was not something anyone wanted to do repeatedly if a port was available.
For this first treatment, however, the IV was the option the medical team could safely use.
The nurses prepared the line carefully.
Today, patients receiving intravenous cancer treatment are generally instructed to tell the infusion team immediately if they notice pain, burning, swelling, redness, leaking, or other changes around the IV or port. Certain chemotherapy drugs can damage tissue if they escape from the vein, so infusion teams monitor the access site closely. The specific risk depends on the medication.
At the time, I trusted the nurses to watch the IV.
I was still trying to understand everything else happening around me.
The Bloodwork Had to Come First
Before chemotherapy could begin, the team drew blood.
The doctors needed information about my blood counts and organ function before treatment.
Because I had already struggled with severe anemia, I knew my numbers mattered.
Chemotherapy treatment plans commonly include blood tests to check blood-cell counts and may include tests of kidney and liver function. The results can help the oncology team determine whether treatment can safely proceed, whether the dose needs to change, or whether treatment needs to be delayed.
I learned that bloodwork was not just another routine test.
It could affect whether treatment happened that day.
That gave those numbers a very different meaning.
I Started Paying More Attention to Food
I began thinking about food differently.
When a laboratory result was moving toward the low end, I wanted to know whether there was anything medically appropriate I could eat to support my body.
I ate high-protein foods because I was healing.
I included iron-rich foods because anemia had already been a problem for me.
I planned vegetables, fruit, meals, and snacks around what my body was being asked to do.
Food could not guarantee that my chemotherapy would continue on schedule.
Diet could not correct every abnormal blood result.
And I learned that I should not assume that a low blood count could be fixed simply by eating more of one particular food.
Some treatment-related blood problems may require medication, a transfusion, a treatment delay, or another medical response.
But eating intentionally gave me one more way to participate in my care.
That distinction matters.
Nutrition can support the body.
It cannot replace medical treatment.
A Treatment Delay Was Something I Wanted to Avoid
I had an aggressive, fast-growing cancer.
Every part of my treatment had already felt tightly scheduled.
I had surgery on my abdomen.
Two weeks later, I had surgery on my back.
Then the port procedure and chemotherapy followed.
I did not want a low blood count to delay treatment if there was anything safe and reasonable I could do to support my health.
But I was also learning that some things were simply outside my control.
That can be difficult for someone who wants to fight cancer with everything they have.
Cancer patients often carry a feeling that says:
“Tell me what I can do, and I will do it.”
Sometimes the answer is to eat well.
Sometimes it is to rest.
Sometimes it is to ask questions.
Sometimes it is to take the medicine exactly as prescribed.
And sometimes it is simply to let the medical team make the decision.
The Counselor Stayed Beside Me
After the first steps, I was taken to the area where patients received treatment.
A counselor from the cancer center sat beside me.
She had already been helping me with questions, resources, financial guidance, and requests related to genetic and tumor testing.
On that first chemotherapy day, she was also there to provide comfort.
I appreciated that more than I could explain.
COVID had removed the person who normally might have accompanied me.
The cancer center made sure I was not completely alone.
Emotional Support Was Part of My Treatment Experience
The counselor was not administering my chemotherapy.
She was not deciding the dose.
She was not interpreting my bloodwork.
Her presence still mattered.
Cancer centers may offer social workers, counselors, patient navigators, financial counselors, support groups, and other services to help patients manage the emotional and practical effects of cancer. The National Cancer Institute notes that people with cancer may benefit from support from healthcare professionals, counselors, family, friends, and other sources of support.
That day, her job was not to make cancer disappear.
It was to help me feel less alone while I crossed a line I had never wanted to cross.
What I Wish Someone Had Told Me Before I Walked In
I wish someone had walked me through the emotional experience of the first treatment.
Not just the medical steps.
The feelings.
I wish someone had told me that it was normal to be afraid.
I wish someone had told me that I could want chemotherapy and still dread it.
I wish someone had told me that cutting my hair might feel like grieving.
I wish someone had told me that the infusion center could feel unfamiliar even after other survivors described it.
I wish someone had told me that asking questions did not make me difficult.
I wish someone had told me that I did not have to understand everything the first time someone explained it.
And I wish someone had told me:
You are allowed to be new at this.
Questions I Wish I Had Written Down
Before the first treatment, I think it would have helped to have questions ready.
About the Treatment
What drugs am I receiving?
Why were these drugs chosen for my cancer?
How long will the infusion take?
What medicines will I receive before chemotherapy?
What side effects should I report immediately?
What side effects are expected later?
Who should I call after I go home?
About My IV or Port
Is my port ready to use?
If it cannot be used, can my treatment safely be given through an IV?
What should I report if the IV site hurts or burns?
Who should I contact if I have a problem after leaving?
About Bloodwork
Which blood counts are being checked?
Are kidney and liver tests being checked?
What happens if my blood counts are too low?
Could treatment be delayed?
What can I safely do to support my nutrition?
Should I take any vitamins or supplements?
About Emotional Support
Is a counselor available?
Is there a social worker or patient navigator?
Can someone accompany me to future appointments?
Are support groups available?
Who can help if anxiety becomes overwhelming?
The American Cancer Society recommends asking questions about treatment, side effects, and what to expect during an infusion. Writing questions down ahead of time can help because it is easy to forget things when you are nervous.
Hope and Fear Can Exist Together
Before chemotherapy, I thought I needed to choose between being hopeful and being afraid.
I eventually understood that I did not.
I could hope the treatment would work.
I could be grateful that treatment was available.
I could want the chemotherapy to begin.
And I could still be terrified.
The National Cancer Institute explains that people with cancer can experience many different emotions, sometimes changing from day to day or even moment to moment. There is no single “right” way to feel.
That was comforting to learn.
I did not have to perform courage every minute.
I just had to keep moving forward.
The Moment Before the Medicine
Eventually, the preparation was finished.
The bloodwork had been checked.
The IV was in place.
The counselor was beside me.
The nurses were preparing the medications.
I knew the next step was chemotherapy.
I had spent so much time worrying about this moment that I almost expected something dramatic to happen before the treatment began.
Instead, the room was still.
The nurses were doing their jobs.
I was sitting there.
And then the first medicine began.
It was a pretreatment medication.
I did not remember the name of it at the time.
I only knew that it was supposed to come before the chemotherapy.
Then something happened that I had not expected.
I could not breathe.
And that is where my story of my first chemotherapy day truly begins.
Hope for Today
If you are about to walk into your first chemotherapy appointment, I want you to know something I wish I had known.
You do not have to feel brave every second.
You do not have to know exactly what will happen.
You do not have to remember every medical term.
You do not have to pretend that losing your hair does not bother you.
You do not have to stop being afraid simply because you decided to receive treatment.
You can be frightened and determined at the same time.
You can ask questions.
You can ask someone to explain something again.
You can tell your nurse that you are scared.
You can ask about emotional support.
You can make small choices that give you a sense of control.
For me, one of those choices was cutting my hair.
Another was learning everything I could.
Another was accepting help.
I walked toward chemotherapy carrying fear, questions, and hope.
I did not know exactly what was waiting for me behind those doors.
I only knew I had to walk through them.
And then the unexpected happened.
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References
National Cancer Institute. "Emotions and Cancer." www.cancer.gov/about-cancer/coping/feelings
National Cancer Institute. "Adjustment to Cancer: Anxiety and Distress." www.cancer.gov/about-cancer/coping/feelings/anxiety-distress-pdq
National Cancer Institute. "Chemotherapy and You: Support for People With Cancer." www.cancer.gov/publications/patient-education/chemo-and-you
American Cancer Society. "What to Expect on Your First Day of Chemo." www.cancer.org/cancer/latest-news/what-to-expect-on-your-first-day-of-chemo.html
American Cancer Society. "Chemo Infusions or Injections." www.cancer.org/cancer/treatment-types/chemotherapy/getting-chemotherapy.html
American Cancer Society. "Chemotherapy Side Effects." www.cancer.org/cancer/managing-cancer/treatment-types/chemotherapy/chemotherapy-side-effects.html
American Cancer Society. "Hair Loss." www.cancer.org/cancer/managing-cancer/side-effects/hair-skin-nails/hair-loss.html
About the Author:
Deborah Ann Martin is the founder of Surviving Life Lessons, a published author, poet, speaker, and trainer with over 20 years of management experience across multiple industries. An MBA graduate, U.S. veteran, single mother, and rare cancer survivor, Deborah brings both professional expertise and lived experience to her writing on resilience, leadership, personal growth, and overcoming adversity. Her mission is to empower others with practical wisdom and real-life insight to navigate life’s challenges with strength and purpose.
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