First Chemotherapy Guide: What I Wish I Had Known
Updated: 3 days ago
The Fear Before the First Infusion
The night before my first chemotherapy, I could not stop thinking about what was coming. I was afraid of losing my hair. I was afraid of the unknown. I was afraid to walk through the doors of the infusion center and become, officially, a chemotherapy patient.
If you are about to start chemotherapy, you may be feeling the same fear. You may have heard frightening stories from friends or seen dramatic scenes in movies. You may be worried about nausea, pain, exhaustion, hair loss, or whether you will be able to keep working and caring for your family.
I want you to know that fear before chemotherapy is normal, and that the anticipation is often harder than the first day itself. Every person's experience with chemotherapy is different. Some side effects can be prevented or managed, and your care team is there to help you through it.
This guide is the fourth stage of my Cancer Journey collection. It shares what I wish I had known before my first chemotherapy day, how I handled hair loss and an infusion reaction, what it was like to work through treatment, and how a false-positive TB test helped find my pneumonia.
What Chemotherapy Is and Why It Is Used
Chemotherapy uses medicines to kill cancer cells or slow their growth. It may be given before surgery to shrink tumors, after surgery to destroy remaining cancer cells, or as the main treatment for cancer that has spread. Chemotherapy can be given through an IV, a port, a pill, or a shot, depending on the medicine.
Because chemotherapy affects cells that divide quickly, it can also affect healthy cells like hair follicles, the lining of the mouth and stomach, and blood cells. That is why side effects happen.
Your oncology team will explain which medicines you are getting, how often, and what side effects to watch for.
What I Wish I Knew Before My First Chemotherapy Day
My first chemotherapy day taught me that treatment involves much more than the medicine itself. There were blood draws, vital signs, waiting, premedications, and hours in a chair. Some things I wish I had known:
Plan for a long day. Infusion appointments can take several hours.
Bring snacks, water, a blanket, a phone charger, and something to pass the time.
Wear comfortable, layered clothing that gives easy access to your port or arm.
Bring a support person if allowed, or plan a video call.
Write down questions for your nurse and oncologist.
Ask what side effects to expect in the days after treatment, and when to call.
Know your after-hours phone number before you leave.
My First Infusion Reaction and Why I Learned to Speak Up
During my first chemotherapy infusion, I had a reaction. Something did not feel right, and I had to decide whether to say something or wait. I spoke up, and the nurses responded quickly.
Infusion reactions can include flushing, itching, chest tightness, trouble breathing, back pain, or feeling suddenly unwell. Nurses are trained to watch for these and treat them. But they need you to tell them how you feel. Never stay quiet because you do not want to bother anyone.
Speaking up during treatment is one of the most important things you can do.
Why You Should Let Yourself Grieve Your Hair
Losing my hair during chemotherapy was much more emotional than I expected. Hair is tied to identity, femininity, and how we see ourselves. When it falls out, it can feel like cancer has become visible to the whole world.
It is okay to grieve your hair. It is okay to cry when it falls out, to feel angry, or to feel like you do not recognize yourself. Grieving a part of yourself is not vanity. It is a normal response to loss.
Some people shave their heads before hair loss starts so they feel more in control. Others wait.
Some choose wigs, scarves, or hats. Others go bare. There is no wrong choice.
The Hats That Helped Me Face Cancer
When my hair fell out, my coworkers gave me hats. Those hats became much more than head coverings. They became a source of comfort, confidence, and connection. Every time I put one on, I remembered that people cared about me.
Sometimes the smallest gifts carry the biggest meaning. Those hats reminded me, every single day, that I was not facing this alone.
Working Through Chemotherapy
I worked during chemotherapy. It helped me maintain my income and gave me a sense of normal life. Flexible hours made it possible. But I also learned that working through treatment had a cost.
There were days when my body wanted nothing more than to sleep, and I pushed through anyway. Looking back, I realize that working during chemotherapy sometimes cost me the rest my body needed to heal. If you are working during treatment, it is worth asking yourself and your care team honest questions:
Can my schedule be reduced or made more flexible?
Can I work from home on treatment days or the days after?
Am I eligible for leave or short-term disability if I need it?
Am I resting enough to let my body recover?
There is no single right answer. Some people need to work for financial reasons or for their mental health. Others need to step back. Both choices deserve respect.
Eating During Chemotherapy
Chemotherapy can change your appetite, your sense of taste, and how your stomach handles food. Some days you may be hungry. Other days, even the smell of food may be too much. Eating well during treatment is less about perfect nutrition and more about getting enough calories, protein, and fluids to keep your body going.
Ideas that may help include eating small meals often, keeping bland and easy foods on hand, trying cold foods if smells bother you, and drinking fluids between meals instead of with them.
Ask your care team if a dietitian can help you, especially if you are losing weight or struggling to eat. My Eating for Your Body series also shares gentle ideas for eating when appetite and taste change.
Protecting Yourself From Infection
Chemotherapy can lower your white blood cell count, which makes it harder for your body to fight infections. Your care team will tell you when your counts are likely to be lowest.
During those times, it helps to wash your hands often, avoid people who are sick, be careful with food safety, and keep your port site clean. Learn which symptoms mean you should call right away, such as a fever, chills, cough, or redness around your port. Do not wait to see if it gets better. Infections during chemotherapy need prompt attention.
Managing Common Chemotherapy Side Effects
Side effects depend on the medicines you receive and how your body responds. Common side effects can include fatigue, nausea, appetite changes, mouth sores, hair loss, low blood counts, and a higher risk of infection. Ask your care team about medicines and strategies to prevent or manage them.
Small things that may help:
Take anti-nausea medicine as prescribed, even before you feel sick.
Eat small, simple meals and stay hydrated.
Rest when you need to, without guilt.
Keep a symptom journal to share at appointments.
Wash your hands often and avoid crowds when your counts are low.
The False-Positive TB Test That Helped Find My Pneumonia
During chemotherapy, my immune system was weakened, and I developed pneumonia. I only found out because my son had a positive TB test, which made me ask for a chest X-ray. His result turned out to be a false positive, but the X-ray showed I had pneumonia.
That experience reminded me how important it is to ask questions and connect the dots. If someone in your household has a health concern, or if you feel off during treatment, tell your care team. Infections can be serious during chemotherapy, and early treatment matters.
My First Year With Stage IV Uterine Leiomyosarcoma
My first year with Stage IV cancer brought surgery, chemotherapy, pneumonia, complications, and more appointments than I could count. It also brought love from family, support from coworkers, faith, and moments of joy I will never forget.
Looking back, I see that I survived that year one day at a time. Some days were about getting through treatment. Some days were about resting. And some days were about laughing, making memories, and remembering that I was still alive.
Small Steps to Get Through Chemotherapy
Chemotherapy can feel like a long, overwhelming road. The heart of Surviving Life Lessons is breaking big problems into small, manageable steps. Here are some SMART-style examples:
"Before my first infusion, I will pack a treatment-day bag with snacks, water, a blanket, and a charger."
"During each infusion, I will tell my nurse right away if anything feels different."
"For the three days after each treatment, I will schedule rest instead of extra tasks."
"This week, I will choose one head covering or plan for hair loss that feels right to me."
"Each day during treatment, I will drink at least six glasses of water unless my doctor says otherwise."
If a step feels too big, make it smaller. If a time frame feels too short, give yourself more time. Your energy will change from cycle to cycle, and your goals can change too.
Making These Steps Fit Your Treatment
Every chemotherapy plan is different. Your medicines, schedule, side effects, job, and support system will shape what is possible. Before you try a step, ask yourself whether it fits your energy right now. If something does not work, the plan needs adjusting, not you. You can also ask other patients what helped them. That is why we have free community groups, where survivors share practical tips for getting through treatment.
Where to Start in This Series
If your first infusion is coming up, start with Before My First Chemotherapy and What I Wish I Knew Before My First Chemotherapy Day.
If you are worried about hair loss, read Why You Should Grieve Your Hair During Chemotherapy and Chemotherapy Hair Loss: The Hats That Helped Me Face Cancer.
If you are working during treatment, read Working Through Chemotherapy When My Body Wanted to Sleep.
If you want the bigger picture, read My First Year With Stage IV Uterine Leiomyosarcoma.
Frequently Asked Questions
What should I bring to my first chemotherapy appointment?
Bring snacks, water, a blanket, comfortable layers, a phone charger, something to do, a list of questions, and a support person if allowed.
What is an infusion reaction?
An infusion reaction is a response to a medicine given through an IV or port. Symptoms can include flushing, itching, chest tightness, or trouble breathing. Tell your nurse right away if you feel anything unusual.
Is it normal to grieve hair loss during chemotherapy?
Yes. Hair loss can affect how you see yourself, and grieving it is a normal response. Hats, scarves, wigs, or going bare are all valid choices.
Can I work during chemotherapy?
Many people work during chemotherapy, often with flexible schedules. Talk with your care team and employer about what is realistic and make sure you are getting enough rest.
Journal Prompts for This Stage
What am I most afraid of about chemotherapy?
What would make treatment days more comfortable?
How do I feel about losing my hair, and what would help?
Am I giving my body the rest it needs?
What small joy can I plan between treatments?
One Infusion at a Time
Chemotherapy is hard, but you do not have to face it all at once. Focus on one infusion, one day, and one small comfort at a time. Speak up when something does not feel right, let people help, and give yourself permission to rest. You are stronger than you know, and every treatment you finish is a step forward. When you finish your last infusion, celebrate it in a way that feels meaningful to you. You earned it.
Posts in This Series
These posts make up the fourth stage of my Cancer Journey: the fear before chemotherapy, losing my hair, working through treatment, and getting through my first year with Stage IV cancer.
This guide is part of my full cancer story. See every stage in the Stage IV Cancer Journey Guide: I Was Kept Alive to Live.
Where to Go From Here
Chemotherapy is easier to face with people who understand. At Surviving Life Lessons, we believe in life survivors helping life strugglers. Our Healthcare Self-Advocacy Support Group is a place to learn how to speak up for your care, and our Cancer Support Group connects you with others who understand what you are facing. You can also browse our Community Groups Catalog to find every group that fits where you are right now.
Next, read What I Wish I Knew Before My First Chemotherapy Day or Stage IV Cancer Journey Guide: I Was Kept Alive to Live.
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References
National Cancer Institute. Chemotherapy to Treat Cancer. cancer.gov
American Cancer Society. Managing Chemotherapy Side Effects. cancer.org
Centers for Disease Control and Prevention. Preventing Infections in Cancer Patients. cdc.gov
American Society of Clinical Oncology. Cancer.Net: Hair Loss or Alopecia. cancer.net
National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment. cancer.gov
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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