Preparing for chemotherapy involves a series of practical steps in the weeks before your first infusion, from dental work and blood tests to stocking your kitchen and sorting out legal paperwork. Most oncology teams will guide you through the medical essentials, but many patients find that the non-medical preparation makes the biggest difference in how smoothly treatment goes. Here’s what to prioritize and when.
Get a Dental Exam Early
Chemotherapy suppresses your immune system, which means infections that would normally stay contained in your mouth can spread and become serious. A dental evaluation before treatment starts is one of the most important steps you can take. The goal is to eliminate any source of infection: untreated cavities, gum disease, cracked teeth, or old root canals that may be failing.
Your dentist will likely take a panoramic X-ray to get an overview of what’s happening below the gumline. Teeth that can’t be saved, including badly decayed teeth and retained roots, should be extracted. Teeth with deep gum pockets (6 millimeters or more) or significant looseness typically need to come out as well. Any cavities should be filled, and a professional cleaning helps reduce bacteria levels across the board.
Timing matters here. If you need extractions or other surgical dental work, your mouth needs at least 7 to 10 days to heal before chemotherapy begins. That means scheduling your dental visit as soon as possible after your cancer diagnosis, not the week before your first infusion. Let your dentist know you’re starting chemotherapy so they can prioritize the work that reduces infection risk.
Ask About Fertility Preservation
Many chemotherapy drugs can affect fertility, sometimes temporarily and sometimes permanently. If having biological children matters to you now or might matter in the future, this conversation needs to happen before treatment starts. Once chemotherapy begins, the window closes.
For men, sperm banking is straightforward and can often be completed in a few days. For women, egg or embryo freezing requires hormonal stimulation and an egg retrieval procedure, which takes roughly two weeks. Your oncologist and a reproductive endocrinologist need to coordinate on how much time is available before treatment must begin, what the reproductive risks of your specific regimen are, and whether your overall health allows for the procedure safely.
Despite guidelines from major oncology organizations recommending early fertility consultations, referral rates remain low. If your oncologist doesn’t bring it up, ask. The choice depends on your cancer type, treatment urgency, age, and personal goals, but you deserve to make that decision with full information rather than learning about it after the fact.
Build Your Nutritional Reserves
Chemotherapy often suppresses appetite, changes how food tastes, and causes nausea, making it hard to eat well during treatment. The weeks before your first cycle are your best opportunity to build up protein and calorie reserves that will help your body tolerate what’s coming.
European nutrition guidelines for cancer patients recommend a protein intake of 1.0 to 1.5 grams per kilogram of body weight per day. For a 150-pound person, that translates to roughly 68 to 102 grams of protein daily. For patients at risk of muscle wasting, the minimum target rises to 1.2 grams per kilogram. This is significantly more protein than most people eat in a normal diet, so you may need to be intentional about it. Greek yogurt, eggs, chicken, fish, beans, and protein-dense nutritional supplements can help close the gap.
In the week before your first cycle, consider batch-cooking and freezing meals that are easy on the stomach: soups, stews, smoothie packs, rice dishes. On treatment days and the days after, you may not feel like cooking. Having a freezer full of ready-to-heat meals removes one source of stress when your energy is lowest.
Review Your Medications and Supplements
This is the step people most often overlook. Many common herbal supplements interfere with how your body processes chemotherapy drugs, either making them less effective or increasing their toxicity. Six herbal products in particular have documented interactions with chemotherapy agents in humans: echinacea, garlic supplements, ginseng, grapefruit juice, milk thistle, and St. John’s wort.
St. John’s wort is especially problematic because it speeds up the enzymes that break down many drugs, potentially clearing chemotherapy from your body before it can work. Garlic supplements, ginseng, and milk thistle do the opposite, inhibiting those same enzymes and potentially increasing drug levels to dangerous concentrations. Grapefruit juice affects the same pathways.
Bring every bottle from your medicine cabinet to your pre-treatment appointment: prescription medications, over-the-counter drugs, vitamins, herbal supplements, everything. Your oncologist needs the full picture to identify interactions. Don’t assume something is safe just because it’s “natural” or sold without a prescription.
Get Caught Up on Vaccines
Your immune system will be compromised during treatment, which makes you more vulnerable to infections and also means certain vaccines become unsafe to receive. Live vaccines, which contain weakened but active viruses, must be given at least four weeks before chemotherapy starts. These include vaccines for chickenpox, shingles, measles/mumps/rubella, and the nasal flu spray. If given less than four weeks before treatment, the weakened virus in the vaccine could cause the very illness it’s meant to prevent.
Inactivated vaccines (like the flu shot or pneumonia vaccine) are generally safer during treatment but produce a weaker immune response. Getting them beforehand, while your immune system is still functioning normally, gives you the best protection. After chemotherapy ends, you’ll typically need to wait at least three months before receiving any live vaccines again. Talk to your oncology team about which vaccinations make sense given your timeline.
Understand Your Baseline Blood Work
Before your first infusion, your medical team will draw blood to establish a baseline picture of how well your bone marrow, kidneys, and liver are functioning. The key markers include your white blood cell and neutrophil counts (which reflect immune function), creatinine levels (kidney function), and bilirubin levels (liver function). These numbers become the reference point your team uses throughout treatment to decide whether it’s safe to proceed with each cycle, whether doses need to be adjusted, or whether treatment should be paused.
This blood work is usually done within seven days before treatment starts. You don’t need to do anything special to prepare for it, but understanding why it matters can help you make sense of the ongoing blood draws you’ll have before every cycle. If your counts drop too low between cycles, your next infusion may be delayed to give your body time to recover.
If You’re Getting a Port, Plan for Recovery
Many chemotherapy regimens are delivered through an implanted port, a small device placed under the skin of your chest that connects to a large vein. This spares your arm veins from repeated needle sticks over months of treatment. The placement is a minor surgical procedure, typically done under local anesthesia with sedation.
After placement, you’ll have a small incision that needs to heal. You’ll wear a bandage over the site and should avoid heavy lifting or strenuous activity until your provider clears you. Once the incision heals, the port sits under the skin and shouldn’t cause ongoing discomfort. Your team will schedule the placement with enough lead time before your first infusion for the site to recover.
Consider Scalp Cooling for Hair Preservation
If keeping your hair during treatment is important to you, scalp cooling (cold cap therapy) can reduce hair loss with certain chemotherapy drugs. This requires preparation before your first session. You’ll need to find the right cap size, one that fits snugly against your scalp and touches the crown of your head without rising up. The cap needs direct contact with your scalp to work.
Before each session, you’ll dampen your hair with a spray bottle, apply a thin layer of conditioner to help with thermal contact, pull your hair back from your face, and position a headband on your forehead. The cold cap goes on before the infusion begins and stays on afterward. When cooling is finished, you wait about 10 minutes before removing the cap and gently patting your hair dry. Not every treatment center offers scalp cooling, so ask your oncology team early if it’s available and appropriate for your regimen.
Handle Legal and Financial Paperwork
Chemotherapy can occasionally cause complications that leave you temporarily unable to make decisions for yourself. A medical power of attorney, also called a health care proxy, designates someone you trust to make medical decisions on your behalf if you’re unable to. This is a standard advance directive, not a sign that something is expected to go wrong. It’s simply responsible planning.
Beyond the legal documents, there are practical financial steps worth addressing: confirming your insurance coverage and out-of-pocket costs for the full treatment plan, looking into copay assistance programs your oncology social worker can connect you with, and arranging short-term disability or medical leave paperwork with your employer if applicable. Handling these tasks while you’re feeling well is far easier than trying to manage them once treatment side effects set in.
Prepare Your Home and Support System
With a suppressed immune system, your home environment matters more than usual. Stock up on hand soap, hand sanitizer, and basic cleaning supplies. Wash bedding and towels before your first cycle. If you have pets, arrange for someone else to handle litter boxes or clean up after them during your lowest-immunity windows.
Line up your practical support network before you need it. Identify who can drive you to and from infusions (sessions can last several hours, and you may not feel well enough to drive afterward). Figure out who can help with groceries, childcare, or household tasks during the days when side effects peak, typically two to five days after each infusion. Many people find it helpful to set up a shared calendar or use a meal-coordination app so friends and family can sign up for specific tasks without you having to ask repeatedly.
Pack a bag for infusion days: comfortable loose-fitting clothes, a blanket, headphones, a phone charger, snacks you enjoy, and water. Some people bring a tablet loaded with shows or a book. Infusions can take anywhere from 30 minutes to several hours depending on your regimen, and having your comfort items ready makes the experience significantly more manageable.