What to Expect on Your First Day of Chemotherapy: From Someone Who’s Been There

There are some days in your life you never forget.

Your wedding day. The day your children are born. The day you hear the words, “You have cancer.”

And then there’s your first day of chemotherapy.

It’s a day I never wanted marked on my calendar. But there it was.

Chemo.

You can research every medication. You can read every pamphlet your oncologist gives you. You can pack the perfect chemo bag and ask a million questions.

But nothing completely prepares you for what it feels like to walk into an infusion center knowing that the medication hanging from that IV pole is about to become part of your life.

I’ve been in that chair. I know how scary the unknown can be.

So if your first chemotherapy treatment is coming up, I want to walk you through what you might expect—not as a doctor, but as someone who has been on the patient side of that chair.

Every cancer center, chemotherapy regimen, and patient is different, so your experience may not look exactly like mine. Your oncology team should always be your primary source for information about your specific treatment.

But sometimes it helps to hear from someone who has simply been there.

First: You’re Probably Going to Be Nervous

Let’s just acknowledge this right away.

Your first chemotherapy treatment can be terrifying.

There are so many unknowns.

Will I get sick?

Will it hurt?

How long will I be there?

Will I have a reaction?

When will the side effects start?

What will I feel like tomorrow?

What about next week?

Your brain can go in a thousand different directions before you ever sit down in the infusion chair.

Whatever you’re feeling that morning is okay.

You don’t have to walk into chemotherapy feeling inspirational.

You don’t have to be positive.

You don’t have to be brave every second.

You can be scared.

You can cry.

You can be angry that you’re there.

You can make jokes because that’s how you cope.

You can feel completely numb.

There is no correct emotional response to starting cancer treatment.

Checking In

When you arrive at your cancer center or infusion clinic, you’ll typically check in before treatment.

Depending on your treatment plan and cancer center, you may have bloodwork done before your infusion. Sometimes labs are drawn earlier; other times they’re done when you arrive.

This becomes part of the routine pretty quickly.

Check in.

Labs.

Wait.

Treatment.

Repeat.

At first, everything feels foreign. Eventually, you’ll probably know the routine better than you ever wanted to.

They’ll Check Your Bloodwork

Before many chemotherapy treatments, your medical team will review your lab results.

They may look at things such as:

• White blood cell counts
• Hemoglobin/red blood cells
• Platelets
• Kidney function
• Liver function
• Electrolytes

These results help your medical team determine whether it’s appropriate for you to receive treatment that day.

Sometimes treatment schedules need to be adjusted based on lab results or other symptoms. Your oncology team will make those decisions based on your individual situation.

You’ll Meet Your Infusion Nurse

Let me tell you something about oncology nurses:

They are incredibly important people during treatment.

Your nurse will typically get you settled into your infusion chair or room and may check things like your blood pressure, temperature, heart rate, weight, and current symptoms.

This is also your opportunity to tell them how you’ve been feeling.

Don’t minimize things because you think they’re “not a big deal.”

Tell them.

Nausea.

Neuropathy.

Diarrhea.

Constipation.

Mouth sores.

Headaches.

Pain.

Fatigue.

Rashes.

Anything that has changed since your last appointment.

Your care team can’t help manage symptoms they don’t know you’re experiencing.

Your Port or IV Will Be Accessed

If you have a chemotherapy port, your nurse will clean the area and access it using a special needle.

If you don’t have a port, your chemotherapy may be administered through an IV or another type of vascular access depending on your treatment.

I know the idea of having a port can sound intimidating before you actually have one.

Ask your care team questions about it.

Ask how to care for it.

Ask what sensations are normal.

Ask what isn’t normal.

You are allowed to understand what is happening to your body.

You May Receive Premedications

Chemotherapy isn’t always the first thing that goes into your IV.

Depending on your regimen, you may receive medications beforehand to help prevent or reduce certain side effects.

These can include medications for things such as nausea or allergic/infusion reactions.

The exact medications will depend on the chemotherapy drugs you’re receiving and your individual treatment plan.

Then, eventually, the actual treatment begins.

And I remember thinking:

Okay. This is really happening.

Then the Chemotherapy Begins

Your medications may be administered one at a time.

Some infusions are relatively quick.

Others can take hours.

Your first treatment may also take longer than future appointments because your team may need additional time for education, medications, monitoring, or slower initial infusion rates depending on the drugs you’re receiving.

This is why I always recommend bringing things to occupy yourself.

A book.

Headphones.

Your phone.

A tablet.

A journal.

A movie.

Or honestly?

Sleep.

There is no award for being productive during chemotherapy.

If your body wants to rest, let it.

One of the Most Important Things I Learned: Tell Your Nurse EVERYTHING

I cannot emphasize this enough.

If something suddenly feels different during your infusion, tell your nurse immediately.

Don’t sit there wondering if you’re imagining it.

Don’t worry about being dramatic.

Don’t convince yourself you should wait five more minutes.

Depending on your treatment, symptoms such as flushing, itching, chills, difficulty breathing, chest discomfort, dizziness, nausea, or other sudden changes can be important for your medical team to know about immediately.

Your nurses want you to speak up.

You are not bothering them.

You are not being difficult.

You are not overreacting by telling someone that something feels wrong.

That’s exactly what they’re there for.

What Should You Bring to Chemotherapy?

You don’t need to bring your entire house with you, but a few comfort items can make a long infusion day much easier.

Consider packing:

• A water bottle
• Snacks, if your treatment center allows them
• A blanket or sweatshirt
• A long phone charger
• Headphones
• A book or Kindle
• Lip balm
• Comfortable clothes
• Something to keep your mind occupied

And here’s one thing I wish more people understood:

Dress for comfort, not fashion.

You’re going through chemotherapy.

Nobody cares what you’re wearing.

Wear the sweatpants.

You Might Leave Your First Treatment Feeling…Fine

This surprised me.

You may walk out of your first chemotherapy appointment thinking:

Wait. That’s it?

And depending on your treatment, you might initially feel relatively normal.

Some chemotherapy side effects aren’t immediate. They may develop hours or days after treatment.

Your oncology team should explain the common side effects associated with your particular medications and approximately when they may occur.

Don’t compare your experience to someone else’s.

Cancer treatment is incredibly individual.

One person may be exhausted.

Another may be nauseated.

Another may experience neuropathy.

Another may have several good days before symptoms begin.

Someone else’s chemotherapy experience is not a prediction of yours.

Before You Leave, Know Who to Call

Before leaving your first treatment, make sure you understand what you’re supposed to do once you’re home.

Your team may give you instructions about medications, hydration, food, activity, symptom management, and other precautions specific to your treatment.

One practical thing I recommend:

Save your oncology team’s after-hours number in your phone.

Don’t leave it buried inside a folder of paperwork.

Save it.

Also ask your team specifically:

“What symptoms mean I should call you immediately?”

Because when you’re exhausted, scared, sick, or running a fever in the middle of the night, you don’t want to be searching through paperwork trying to figure out what you’re supposed to do.

The Emotional Side of Your First Chemo Day Matters Too

People talk a lot about the physical side effects of chemotherapy.

We don’t talk enough about what happens emotionally.

Sitting in that chair can make everything suddenly feel real.

Maybe you’ve spent the weeks since diagnosis scheduling appointments, getting scans, meeting surgeons, having your port placed, dealing with insurance, telling family members, figuring out work, and trying to keep your life functioning.

You’ve been busy surviving the logistics.

Then suddenly you’re sitting still.

There’s an IV pole beside you.

Medication is running into your body.

And you have time to think.

I have cancer.

That realization can hit hard.

Give yourself permission to feel whatever comes up.

You Don’t Have to Be the “Strong Cancer Patient”

This is something I wish every newly diagnosed person could hear.

You don’t have to perform strength for everyone around you.

Cancer patients hear things like:

“You’re so strong.”

“You’ve got this.”

“Stay positive.”

“You’re a warrior.”

And sometimes those words are comforting.

Sometimes they’re exhausting.

You can be strong and terrified.

Grateful and angry.

Hopeful and devastated.

You can laugh during chemotherapy and cry in the parking lot afterward.

Two things can be true at once.

If Your First Chemotherapy Treatment Is Coming Up…

I know you’re scared.

I know your brain is probably running through every possible scenario.

But you don’t have to understand the entire road ahead today.

You don’t have to figure out how you’re going to survive months of treatment.

You don’t have to know how you’ll handle surgery, radiation, hair loss, side effects, scans, or survivorship.

Today, you only have to get through today.

Walk through the doors.

Check in.

Sit in the chair.

Ask your questions.

Tell your nurses how you’re feeling.

Accept the help.

Rest when your body asks you to rest.

And when you walk back out those doors after your first treatment, give yourself credit.

Not because you were fearless.

But because you were scared and you showed up anyway.

That’s enough.

One Last Reminder

This article is based on my personal experience with cancer treatment and general information about what patients may encounter during chemotherapy. I am not a doctor or medical professional, and chemotherapy protocols vary significantly depending on the cancer, medications, patient, and treatment center.

Always follow the guidance of your oncology team regarding your medications, side effects, symptoms, and when to seek medical care.

And if you’re reading this because your first chemotherapy treatment is coming up:

I’m rooting for you. One treatment, one day, one moment at a time.