At a glance
Chemotherapy is a cancer treatment that uses powerful drugs to kill cancer cells or stop them from multiplying. The drugs travel through the bloodstream, which means they can reach cancer cells almost anywhere in the body, not just in one spot.
Cancer cells divide faster than most normal cells. Chemotherapy drugs exploit that difference by targeting cells that are dividing rapidly. Because some healthy cells also divide quickly, such as those lining the mouth and gut, they can be affected too, which is why side effects occur. Doctors carefully choose which drugs to use and how often to give them so the cancer is attacked while the body has time to recover between doses.
Medical Condition
Chemotherapy is used across a wide range of cancers and can be given at different stages of the disease, either as the main treatment or alongside surgery and radiotherapy (radiation treatment using high-energy beams).
- Breast cancer, including cases where the tumor needs to be shrunk before surgery or treated after surgery to reduce the chance of return.
- Lung cancer, both the small-cell type and the non-small-cell type.
- Colorectal cancer (cancer of the colon or rectum).
- Lymphoma (cancer of the lymphatic system) and leukemia (cancer of the blood and bone marrow).
- Ovarian, cervical, and uterine cancers.
- Stomach, liver, and pancreatic cancers.
- Head and neck cancers.
- Testicular cancer.
- Brain tumors in certain situations.
- Bone and soft-tissue sarcomas (cancers of connective tissues such as muscle and fat).
Chemotherapy is not always suitable, and the oncologist (cancer specialist) will weigh several factors before recommending it.
- Severe kidney or liver disease may make it unsafe to process the drugs.
- Very low blood cell counts before treatment starts can make the risks too high.
- Certain cancers respond poorly to chemotherapy and are better treated by other means, such as targeted therapy or immunotherapy.
- Patients in very poor overall health may not tolerate the side effects well enough for the treatment to be worthwhile.
- Pregnancy is usually a reason to delay or choose a different approach, though some drugs can be given cautiously in the second or third trimester.
Risks & Complications
Chemotherapy affects the whole body, so side effects are common, though their severity varies greatly depending on which drugs are used, the dose, and the individual patient.
- Fatigue, often the most persistent complaint throughout and after treatment.
- Nausea and vomiting, which modern anti-sickness medicines can usually control well.
- Hair loss, which is temporary for most patients and grows back after treatment ends.
- Increased risk of infection because chemotherapy lowers white blood cell counts, reducing the body's defenses.
- Anaemia (low red blood cells), causing tiredness and breathlessness.
- Easy bruising or bleeding due to low platelet counts.
- Mouth sores and difficulty swallowing.
- Loss of appetite and weight loss.
- Peripheral neuropathy (nerve damage in the hands and feet), causing tingling, numbness, or pain.
- Memory and concentration problems, sometimes called 'chemo brain'.
- Damage to the heart muscle with certain drug combinations, monitored by regular heart scans.
- Kidney or liver stress, monitored with blood tests.
- Reduced fertility; this can sometimes be addressed before treatment starts by storing eggs or sperm.
- A small long-term risk of developing a secondary cancer caused by the treatment itself, which doctors weigh against the benefit of treating the primary cancer.
Preparation & Procedure
Before the first session begins, a medical team runs tests to confirm the body can handle chemotherapy and to set a baseline for monitoring during treatment. Common pre-treatment tests include blood tests to check kidney and liver function, a full blood count, heart function tests such as an echocardiogram (ultrasound of the heart), and imaging scans to document the size and spread of the cancer.
Patients are usually asked to stop certain medications before treatment, particularly blood thinners, some supplements, and anti-inflammatory drugs, because they can interact with chemotherapy drugs or affect bleeding. The oncology team will provide a specific list based on the drugs chosen. Patients who smoke are typically advised to stop, as smoking can reduce how well the treatment works and slow recovery. Heavy alcohol use is also discouraged throughout the treatment period.
Fasting requirements depend on the specific drugs and whether sedation is needed. Many chemotherapy sessions require no fasting at all, though some centres ask patients to eat a light meal rather than a heavy one beforehand to reduce nausea. The team will give clear instructions before each cycle.
Most chemotherapy is given through a drip (intravenous infusion) into a vein. For patients who need many cycles, doctors often insert a central line, such as a PICC line (a thin tube placed in a large vein in the arm) or a port (a small device placed under the skin of the chest), to avoid repeated needle sticks and protect smaller veins.
A typical intravenous chemotherapy session follows these general steps, though the exact sequence and length vary by drug and hospital.
- The patient arrives and a nurse checks weight, blood pressure, and temperature.
- A blood sample is taken to confirm blood counts are safe enough to proceed.
- Pre-medications such as anti-nausea drugs and steroids are given through the drip first.
- The chemotherapy drug or combination of drugs is infused, which can take anywhere from thirty minutes to several hours.
- The line is flushed with saline (salt water) to clear residual drug.
- The nurse monitors the patient throughout for any immediate reaction such as flushing, rash, or difficulty breathing.
- The patient is observed briefly after the infusion ends before being discharged, unless an overnight stay is planned.
Aftercare
Recovery from each chemotherapy cycle is cumulative, meaning side effects often build up over several rounds rather than appearing all at once. Most patients go home the same day and rest there, though some hospitals admit patients overnight for the first cycle or for high-dose regimens.
- Blood counts are checked regularly, usually before each cycle, to catch infections or anaemia early.
- Patients are advised to avoid crowds and people with active infections while white blood cell counts are at their lowest, typically in the days following each infusion.
- Hydration is encouraged; drinking enough water helps the kidneys clear drug by-products.
- Mouth care is important during treatment: regular rinsing with salt water or prescribed mouthwash can reduce the severity of mouth sores.
- A light, bland diet often helps manage nausea in the days after infusion.
- Central lines or ports require specific cleaning and dressing changes; the nursing team will teach patients or carers how to do this.
- Fatigue usually requires adjusting daily activities; most teams recommend gentle movement such as short walks rather than complete rest.
- Fertility preservation options, if relevant, are ideally discussed and arranged before treatment begins.
- Follow-up imaging scans are scheduled at regular intervals to assess how well the cancer is responding.
- The oncologist reviews the treatment plan after a set number of cycles and may adjust drugs, doses, or timing based on response and tolerance.
- Emotional and psychological support, including counselling, is a recognized part of cancer care and can be requested through the treating team.
Cost & What Determines It
Chemotherapy costs vary enormously because no two treatment plans are the same. The type of cancer, how advanced it is, which drugs the oncologist selects, and how many cycles are needed all shape the final bill before anything else is considered.
- Drug choice: older standard drugs cost far less than newer targeted agents or biologics that may be added to the regimen.
- Number of cycles and frequency: a six-cycle plan given every three weeks has a very different cost profile from a weekly regimen running for months.
- Cancer type and stage: more advanced or complex cases may require combination regimens with multiple drugs, raising costs significantly.
- Hospital class and country: private specialist cancer centres in high-income countries charge considerably more than equivalent centres in countries with lower healthcare costs.
- Inpatient versus outpatient delivery: some regimens require an overnight or multi-day hospital stay, adding room and nursing fees.
- Central line or port insertion: placing and maintaining a PICC line or port is a separate procedure with its own cost.
- Supportive medications: drugs to manage nausea, infection risk (growth factors to boost white blood cells), and anaemia can add substantially to the total.
- Pre-treatment and monitoring tests: blood tests before each cycle, imaging scans during treatment, and cardiac monitoring are usually billed separately or as part of a bundle.
- Consultation fees: the oncologist's fees for the initial assessment and each follow-up review.
Hospital packages for chemotherapy, when offered, often cover the infusion room fee, nursing care during the session, standard pre-medications, and sometimes a set number of blood tests. What tends to be billed separately includes the chemotherapy drugs themselves (especially newer agents), imaging scans, port insertion, emergency consultations if complications arise, and specialist referrals such as to a nutritionist or psychologist.
BPJS Kesehatan and most Indonesian private insurance policies do not cover treatment received outside Indonesia, so patients who travel abroad for chemotherapy generally pay out of pocket or rely on international private health insurance that explicitly includes overseas cancer treatment. Before travelling, ask the hospital for a written cost estimate that lists the expected number of cycles, the drugs planned, and which tests and consultations are included. A clear estimate allows you to budget realistically and compare options without being caught off guard by additional charges once treatment begins.
Frequently Asked Questions
How many chemotherapy sessions will I need?
The number of sessions depends on the type of cancer, its stage, and how your body responds to treatment. Most courses are given in cycles, meaning you receive the drug for a day or a few days, then rest for a week or more before the next cycle. Your oncologist (cancer specialist) will set a plan after reviewing your diagnosis and test results.
What does chemotherapy feel like, and will I lose my hair?
How chemotherapy feels varies a lot from person to person and depends on which drugs are used. Common effects include tiredness, nausea, and a sore mouth, and some drugs do cause hair loss while others do not. Your care team will explain which side effects are most likely for your specific treatment and how to manage them.
How soon will I know if the chemotherapy is working?
Doctors usually check progress after two or three cycles, using scans or blood tests to see how the cancer is responding. It is rarely possible to feel the effect within the first few sessions, as the changes happen gradually inside the body. If the treatment is not working as hoped, your oncologist can adjust the plan.
How much does chemotherapy cost?
The cost depends on several factors specific to your situation, including the type and number of drugs prescribed, how many cycles you need, whether you stay in hospital overnight, and the class of hospital you choose. A written treatment estimate from the hospital, based on your actual diagnosis, is the most reliable way to understand what you will pay.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
