Understanding Chemotherapy: What to Expect at Apeksha Hospital

No word in oncology frightens patients more than "chemotherapy." I understand why. It carries images of hair loss, nausea, and suffering. Some of that is true — but much of it is exaggerated, outdated, or applies to treatments used decades ago. The reality in 2025 is that chemotherapy, used precisely, is one of the most powerful tools we have — and most patients tolerate it far better than they expect.

What Chemotherapy Does

Chemotherapy refers to drugs that kill rapidly dividing cells. Cancer cells divide much faster than normal cells, which makes them particularly vulnerable. The drugs travel through the bloodstream and attack cancer cells throughout the body — this is what makes chemotherapy a systemic treatment, different from surgery (which removes a local tumour) or radiotherapy (which targets a specific area).

Chemotherapy is used in several ways:

• Curative — with intent to eliminate the cancer entirely
• Adjuvant — after surgery, to kill any remaining cancer cells
• Neoadjuvant — before surgery, to shrink a tumour
• Palliative — to slow growth and control symptoms when a cure is not possible

How It Is Given

Most patients at Apeksha Hospital receive chemotherapy intravenously (IV) — through a drip into a vein, typically via a cannula in the arm or hand. Some chemotherapy drugs come as tablets. Treatment is given in cycles: a period of treatment followed by a rest period to allow the body to recover. A cycle might be three weeks — one week of treatment, two weeks of rest. Your oncologist will explain your specific protocol.

Sessions at Apeksha's chemotherapy ward usually take two to six hours. You can bring a family member. Bring something to read, headphones, or a small meal. Many patients sleep during the infusion.

The Real Side Effects (and How They Are Managed)

Side effects occur because chemotherapy also affects some normal rapidly dividing cells — particularly in the hair follicles, gut lining, and bone marrow. But side effects vary enormously between different drugs and different patients.

Nausea and Vomiting

This is the side effect people fear most. Modern anti-nausea drugs (antiemetics) have transformed this experience. Most patients who receive them before and after chemotherapy experience mild or no nausea. Tell your doctor immediately if nausea is severe — there are many antiemetic options.

Hair Loss

Not all chemotherapy causes hair loss. When it does, it is temporary — hair grows back within weeks to months after treatment ends, often thicker than before. This side effect, though distressing, is not medically dangerous.

Fatigue

The most common and often most underestimated side effect. Plan rest into your week, particularly in the days following each cycle. Accept help from family. Light activity — a gentle walk, if you are able — often helps more than complete bed rest.

Reduced Immunity

Chemotherapy can lower your white blood cell count, making you more vulnerable to infection. During treatment, avoid large crowds, wash hands frequently, and contact your team immediately if you develop a fever above 38°C. This is called febrile neutropenia and requires urgent assessment — it is manageable when caught early.

Getting Treatment at Apeksha Hospital

The National Cancer Hospital in Maharagama is the largest and most specialised cancer centre in Sri Lanka. Chemotherapy is provided free of charge for Sri Lankan citizens. Waiting times can be long — Sri Lanka manages a high burden of cancer with limited resources — so it is important to keep every appointment and communicate any problems to your care team promptly.

If you have a long journey from another district, ask your oncologist about satellite oncology units at district hospitals, where some follow-up and monitoring can be done closer to home.

A Word on Alternative Treatments

I am frequently asked by patients whether they should stop chemotherapy and try herbal preparations or alternative medicine. My answer is always the same: please tell your oncologist everything you are taking. Some herbal preparations interact with chemotherapy drugs and reduce their effectiveness or increase toxicity. Do not abandon a proven treatment based on advice from well-meaning relatives or social media. The stakes are too high.

Your oncologist is not your enemy. We want the same thing you do — for you to get better.