Treating Cancer in Children: Chemotherapy

Chemotherapy or “chemo” uses cancer-fighting medications to destroy cancer cells. Chemo can be used alone or with surgery or radiation therapy to shrink a tumor or prevent its spread. Chemo medications are strong. They often cause side effects such as nausea and hair loss. Read on to learn more about chemotherapy.

Goals of Chemotherapy

The treatment’s goals are as follows:

  • Kill cancer cells

  • Cause remission (no evidence of the disease on medical testing)

  • Cure cancer (no evidence of the disease years after treatment)

How Chemotherapy Works

Teenage girl sitting in chair with IV line inserted under collarbone. IV bag and pump are in background. Girl is wearing hat and is holding magazine and drink.

Chemotherapy uses medication to kill cancer cells. But it also affects healthy cells, especially ones that grow fast. This includes cells in the mouth and stomach lining, blood, skin, and hair. This is why side effects, such as hair loss, occur. As a rule, chemo is given in cycles. After a treatment cycle ends, time is set aside so that normal cells can recover before the next cycle begins.

How Chemotherapy Medications Are Given

  • Intravenous (IV) line.  An IV (small tube) is inserted into a vein in the arm or other part of the body to deliver chemo medications. Sometimes, a long-term IV is surgically placed in the body. This is called a central line. It allows medications and other treatments to be given without having to place a new IV each time. IVs are the most common way chemo medications are given.

  • Pills or liquid. The medications are taken by mouth.

  • Injection. The medications are injected into a muscle in the arm or leg, or in the skin over a fatty part of the belly.

  • Intrathecal. The medications are injected into the lower part of the spine. This is called a lumbar puncture (spinal tap). The medication is sent directly into the spinal fluid. This way of giving chemo is important because certain cancers grow in the spinal fluid.

Your child may receive chemo in the hospital or clinic or at home. He or she may be given more than one medication at a time. This is called combination chemotherapy. It’s stronger and may be more effective at killing cancer cells.

Side Effects of Chemotherapy

Side effects occur when normal cells are affected by chemo. Most side effects are short-term and go away soon after treatment ends. But others are long-term and may be permanent. Or, they may occur months or even years after treatment. Each chemo medication can have its own side effects. Ask your child’s healthcare provider what these may be for your child. It’s unlikely that your child will come down with every side effect. But, he or she may experience some of the following:

Short-term side effects

These effects can occur during the treatment period:

  • Increased risk of infection

  • Bleeding

  • Anemia (a condition that occurs when the blood doesn’t have enough red blood cells to carry oxygen throughout the body)

  • Hair loss

  • Mood changes

  • Dizziness

  • Trouble concentrating

  • Tiredness (fatigue)

  • Clumsiness

  • Achy muscles

  • Sores in the mouth or gut (mucositis)

  • Stomach pain

  • Nausea and vomiting

  • Constipation (inability to release stool)

  • Allergic reaction, such as hives or itching

Long-term side effects

These are effects that may appear months to years after treatment:

  • Infertility

  • Damage to certain organs, such as the heart, kidneys, liver, or lungs

  • Lasting nerve damage

  • Another cancer at a later time

Treatment and Testing

Your child will likely be given medication to treat the short-term side effects of chemo. This may include medications to ease nausea, vomiting, constipation, and pain. The healthcare team will also teach you how you can help manage your child’s side effects. Also, tests may be done to check for possible long-term side effects, such as organ damage. Your child’s health care provider can tell you more.

Call Your Child’s Health Care Provider 

Contact your child’s health care provider right away if your child has any of the following:

  • Chest pain (call 911)

  • Trouble breathing (call 911)

  • Temperature of 100.4°F (38°C) or higher

  • Your child has had a seizure caused by the fever

  • Chills

  • Headaches or changes in vision

  • Dizziness or lightheadedness

  • Confusion

  • Trouble concentrating

  • Ongoing fatigue

  • Weakness in the hands or feet

  • Clumsiness

  • Pain that doesn’t go away, especially if it’s always in the same place

  • A new or unusual lump, bump, or swelling

  • Uncontrolled nausea and vomiting

  • Diarrhea that doesn’t improve over time

  • Constipation

  • Weight loss

  • Dehydration

  • Unusual rashes, bruises, or bleeding

  • Skin breakdown or significant pain due to skin irritation

Learning More

Go to to view “Chemotherapy Side Effects At-A-Glance,” a resource from the National Cancer Institute. The chart lists possible side effects from chemo and gives you tips to help your child feel better.

Cancer Resources

To learn more and find support check out these resources:

  • American Cancer Society   

  • National Cancer Institute  

  • CancerNet

  • KidsHealth

  • Teens Living with Cancer

  • The Adventures of Captain Chemo