Chemotherapy for Children with Cancer

What is chemotherapy?

Chemotherapy, or “chemo,” is the treatment of cancer using powerful medicines. These medicines work to kill cancer cells or stop them from growing.

The specific type of chemotherapy and how it is given depends on many factors:

Type and stage of cancer
Goals of treatment
Other therapies used

Chemotherapy for childhood cancer

If your child has cancer, chemotherapy can be used to:

Cure cancer
Control cancer
Ease the symptoms of cancer

It may be used alone or with other treatments such as surgery and radiation therapy. For example, some patients receive chemotherapy to make a tumor smaller before surgery or radiation therapy.

Chemotherapy is also used after surgery or radiation to kill any cancer cells that remain. Chemotherapy can also be used in combination with radiation therapy to enhance its effects.

Your child or teen may have questions about cancer and its treatment. It’s important to be honest with your child and use age-appropriate language.

How chemotherapy works

Chemotherapy works by attacking cells that grow and multiply quickly, like cancer cells. Each chemo medicine works differently. In general, chemotherapy medicines work by interfering with cells as they divide.

Chemotherapy can cause cancer cells to undergo a form of cell death called apoptosis. In the video, a chemotherapy medicine attacks the cancer cells (blue cells).

Ways to give chemotherapy

Chemotherapy can be given in several ways. The method depends on the:

Type of cancer
Location of the cancer
Specific drug used

Chemotherapy works by attacking cells that grow and multiply quickly, like cancer cells. In this video, a chemotherapy agent attacks the cancer cells (blue) causing them to undergo a form of cell death called apoptosis.

Most often, chemotherapy is given by mouth or through a vein. This is called systemic chemotherapy because the drugs travel throughout the entire body. The chemotherapy can kill cancer cells that have traveled away from the main tumor.

Chemotherapy usually involves multiple doses of treatment over a period of time. These treatments are given on a specific schedule. The goal of the schedule is to maximize the work of the medicine and to give the body a chance to recover.

The medical team will decide:

How many days in a row the medication is given
Number of “rest days” between doses of chemotherapy
Number of cycles

A chemotherapy cycle is the number of days in a row of treatment plus the number of rest days. The number of cycles that are prescribed make up a course of chemotherapy.

Depending on the type of chemotherapy and patient health, chemotherapy may be given in a hospital, clinic, or at home.

Types of chemotherapy

Intravaneous (IV) chemotherapy

Chemotherapy is given through an IV in a vein. This is the most common form of chemotherapy in childhood cancer.

Oral chemotherapy

Chemotherapy is given by a pill or liquid that you swallow.

Injectable chemotherapy

Chemotherapy is injected using a syringe.

Intrathecal chemotherapy

Chemotherapy drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.

Intraperitoneal chemotherapy

Chemotherapy is directly into the abdominal cavity through a thin tube. The abdominal cavity is a large hollow space in the middle of the body between the chest and the pelvic area.

Topical chemotherapy

Chemotherapy is applied to the skin in a lotion or cream.

Side effects of chemotherapy

Side effects are problems caused by cancer treatments. Many of the side effects of chemotherapy go away after the treatment is over. But, sometimes side effects don’t go away for a long time or even develop later in life. These are called long-term side effects or late effects.

Chemotherapy targets cells that grow and divide quickly – like cancer. But, it can harm other fast-growing cells in the body. These include the cells that line the mouth and intestines and cells that cause hair to grow. This is why side effects like mouth sores, nausea, and hair loss are common.

Chemotherapy can also damage cells in the bone marrow where new blood cells are made. Low blood cell counts can increase risk for infection, bruising, and fatigue.

Medicines can have different side effects. Not all children respond to medicines in the same way. The care team will discuss common side effects, when they might occur, and some ways to manage them.

Learn more about kinds of side effects.

Chemotherapy safety

Chemotherapy medicines can sometimes be absorbed through the skin or breathed in through the lungs. Family members can also be exposed to chemotherapy if the medicines come into contact with foods or everyday surfaces in the home.

It is important to safely store and dispose of medicines. All medicines can be dangerous if not stored properly, if not taken as directed, if taken by the wrong person, or if not thrown away safely.

Learn more about safe handling of chemotherapy.

Riley Takes Medicine

A St. Jude kids coloring book

A young patient with a parent with medicine types nearby.

Download Riley Takes Medicine

Key points about chemotherapy

Chemotherapy, or “chemo,” is the treatment of cancer using powerful medicines.
Chemotherapy can be given in several ways. Most often, chemotherapy is given by mouth or through a vein.
Chemotherapy usually involves multiple doses of treatment over a period of time. These treatments are given on a specific schedule.
Chemotherapy can have side effects. Talk to your care team about possible side effects, when they might occur, and some ways to manage them.
Chemotherapy can be a risk for caregivers. Always follow the instructions for chemotherapy safety.

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Reviewed: February 2023