Preparing for chemotherapy involves a mix of medical steps, practical planning, and getting your home and schedule ready for the weeks ahead. Most of this preparation happens in the two to four weeks between your diagnosis and your first infusion, and the more you handle upfront, the smoother treatment will be. Here’s what to focus on.
Get a Dental Exam First
This one surprises many people, but a dental checkup before chemo starts is genuinely important. Chemotherapy suppresses your white blood cell production, which cripples your body’s ability to fight bacterial and fungal infections. Your mouth is one of the primary routes bacteria use to enter your bloodstream, so any existing dental problems become a real threat once treatment begins.
A pre-chemo dental visit accomplishes three things. First, your dentist can identify and treat active infections, abscesses, or gum disease before your immune system takes a hit. Periodontitis, a common gum disease, can break down the barrier between your mouth and your bloodstream, raising the risk of a dangerous blood infection during treatment. Second, your dentist will walk you through daily care routines (brushing, flossing, antibacterial rinses) that keep bacterial growth in check while you’re immunosuppressed. Third, you’ll learn about xerostomia, a severe dry mouth that chemotherapy frequently causes. Dry mouth reduces your natural oral defenses and accelerates dental problems, so knowing what to expect helps you manage it early.
Perhaps most importantly, addressing dental issues now reduces the chance you’ll need an extraction during or after treatment. Some cancer therapies increase the risk of osteonecrosis, a serious deterioration of the jawbone that causes persistent pain and difficulty eating. Getting dental work done before chemo is far safer than dealing with complications mid-treatment.
Talk to a Fertility Specialist Early
If there’s any chance you want biological children in the future, bring this up with your oncologist immediately. Fertility preservation needs to happen before your first infusion, and some options require several weeks to complete.
For women, egg freezing and embryo freezing both involve a hormone stimulation cycle followed by egg retrieval, a process that typically takes several weeks from start to finish. Ovarian tissue cryopreservation, where a small piece of ovarian tissue is surgically removed and frozen for later reimplantation, is another option. For men, sperm banking is straightforward: samples are frozen at a fertility clinic and can be stored for decades. For children who haven’t gone through puberty, testicular or ovarian tissue freezing may be possible.
The key point is timing. These conversations need to happen as soon as possible after diagnosis so that preservation procedures don’t delay the start of treatment.
Understand Your Blood Work
Before every chemotherapy cycle, you’ll have blood drawn to check whether your body is strong enough to handle the next dose. The most important number is your absolute neutrophil count (ANC), which measures a specific type of white blood cell responsible for fighting infection.
A healthy ANC is above 1,500. If yours drops below that, your care team may delay your next cycle until it recovers. Mild neutropenia (1,000 to 1,500) is common and usually manageable. Moderate neutropenia (500 to 1,000) requires more caution. Severe neutropenia (below 500) means your infection risk is high, and profound neutropenia (below 100) is a medical emergency. Your team will also monitor platelet counts and other markers, but ANC is the number that most often determines whether treatment proceeds on schedule. Understanding these thresholds helps you make sense of the lab results you’ll see throughout treatment.
Learn About Your Access Line
Most chemotherapy regimens require a central venous catheter rather than a standard IV in your arm. The two most common options are an implanted port and a PICC line, and your oncologist will recommend one based on how long your treatment will last, how many drugs you’ll receive at once, how long each infusion takes, and whether you have other medical issues like blood clots.
A port is a small device implanted under the skin of your chest, usually near the collarbone. Once the insertion site heals, you can bathe and even swim with it in place, which makes it convenient for longer treatment plans. A PICC line is a catheter inserted through a vein in your arm that threads toward your heart. It’s often used for shorter treatment courses. Ask your oncologist which option makes sense for your regimen, and schedule the placement procedure early enough that you’re healed and ready for your first infusion day.
Consider Scalp Cooling
If hair loss is a concern, ask your oncologist about scalp cooling (sometimes called cold caps). These devices cool your scalp during infusion, reducing blood flow to hair follicles and limiting the amount of chemotherapy that reaches them. A large Dutch registry study of over 7,400 patients found that 53% of those who used scalp cooling reported minimal hair loss by their final treatment.
Scalp cooling isn’t appropriate for everyone. It’s not recommended for people with cold sensitivity disorders, cold agglutinin disease, cryofibrinogenemia, or cryoglobulinemia. Your oncologist can tell you whether it’s safe for your specific diagnosis and treatment plan. If you want to try it, arrange this before your first session, since cooling needs to start with the very first infusion.
Prepare Your Home
Chemotherapy drugs leave your body through sweat, urine, and other fluids for 48 to 72 hours after each infusion. During that window, your household needs a few precautions. If possible, use a separate toilet from the rest of your family. If that’s not an option, clean the toilet seat with a sanitizing wipe after each use, put the lid down before flushing to prevent splashing, and flush twice if you have a low-volume toilet.
On the infection prevention side, stock up on hand soap, sanitizing wipes, and hand sanitizer. Your immune system will be compromised, so reducing your exposure to germs at home matters. Keep surfaces clean, wash your hands frequently, and ask anyone in your household who’s sick to take extra precautions around you.
Stay Hydrated and Well Nourished
Good hydration before and during treatment helps your body process chemotherapy drugs and reduces side effects like headaches and fatigue. Water is the best choice, but flavored water, milk, sports drinks, tea, coffee, soup, yogurt, and even gelatin all count toward your fluid intake. The key is to space fluids throughout the day rather than drinking large amounts at once.
There’s no single fluid target that applies to everyone. Your needs depend on your body size, the specific drugs in your regimen, and other health factors. Ask your care team for a referral to a clinical dietitian who can set personalized goals for fluids, calories, and protein. Having this guidance before your first cycle, rather than scrambling after side effects hit, puts you in a much better position.
Handle Paperwork and Medical Leave
Chemotherapy often means missed work, and getting your paperwork in order before treatment starts removes a layer of stress. If you’re eligible for FMLA (Family and Medical Leave Act) protection, your employer can ask you to provide a medical certification. You generally have 15 calendar days from the request to submit it. If the employer finds the certification incomplete, you’ll typically have seven days to provide additional information. Recertification can be required no more often than every 30 days.
Contact your HR department early to understand what forms your oncologist needs to complete. At the same time, call your insurance company to confirm that your treatment plan has been authorized and to understand your out-of-pocket costs. Sorting out these logistics before your first infusion means you can focus on treatment instead of chasing paperwork while feeling unwell.
Pack for Infusion Day
Chemotherapy sessions can last anywhere from one to eight hours, so think of your infusion bag like a carry-on for a long flight. Wear comfortable clothes, and if you have a port, choose a V-neck or button-down shirt that keeps the port accessible.
For comfort, bring water (dehydration headaches are common), your favorite snacks in case hospital food doesn’t appeal to you, hard candy like ginger drops or lemon drops to combat dry mouth and mild nausea, and lip balm to soothe chapped lips that some chemo drugs cause. Infusion centers tend to run cold, so pack warm socks, close-toed shoes or slippers with a hard sole, and a blanket you find comforting.
For entertainment, bring headphones with a playlist (the hum of infusion machines can get grating), a laptop or tablet with a charger, books or magazines, or puzzles and games to keep your mind occupied. A journal can also help you process what you’re feeling, whether through writing or just doodling. And if you can, bring a friend. Having someone to talk to, hold your hand, and simply sit with you makes a long infusion day far more bearable.