Your first day of chemotherapy is mostly about gathering information, speaking up when something feels off, and getting comfortable in an unfamiliar setting. You don’t need to have everything figured out before you arrive. But knowing what to ask, what to report, and how to talk to the people around you can make the experience feel far less overwhelming.
Questions to Ask Your Care Team Before the Infusion Starts
The time before your infusion begins is your best window to get clear answers. Your nurses expect questions on day one, and asking them upfront prevents confusion later. Start with the basics: How long will today’s session take? How many sessions are in my treatment plan? What side effects might happen during or between sessions? These aren’t annoying questions. They’re exactly what the team wants you to ask.
You’ll likely receive pre-medications before the chemotherapy itself. These usually include drugs to prevent nausea and sometimes a steroid to reduce the risk of fluid retention or allergic reactions. If a nurse hangs a bag or hands you a pill you weren’t expecting, ask what it is and what it does. A simple “Can you walk me through what each of these medications is for?” gives you a much clearer picture of the process and helps you feel less like a passive bystander.
Two questions are especially important to ask before you leave that day: Who do I call if I have problems after hours, and when should I go to the emergency room instead? Most cancer centers have an after-hours triage line staffed evenings, weekends, and holidays specifically for patients with urgent symptoms. Get that number saved in your phone before you walk out. For life-threatening emergencies, you always call 911, but many symptoms fall into a gray area where the triage line is the right first step.
What to Say During the Infusion
Once the infusion is running, your main job is to pay attention to how your body feels and tell your nurse immediately if something changes. Infusion reactions are not rare, and the faster you speak up, the easier they are to manage. The standard response is to pause the infusion at the first sign of a reaction and give you additional medication to calm it down.
The most common symptoms to watch for and report right away:
- Skin changes: itching, hives, or flushing (these occur in up to 90% of infusion reactions)
- Breathing changes: wheezing, shortness of breath, or tightness in your throat (reported in about 40% of reactions)
- Circulation symptoms: dizziness, feeling faint, or a sudden drop in energy
- Digestive symptoms: nausea, cramping, or diarrhea that comes on suddenly
- Unusual sensations: jaw tightness, difficulty swallowing, or strange feelings in your tongue or throat (particularly with certain platinum-based drugs)
You don’t need to diagnose anything. Just describe what you feel in plain language: “My skin feels hot and itchy,” “I’m having trouble catching my breath,” or “My jaw suddenly feels tight.” Most reactions happen within minutes to hours of the infusion starting, and reactions that come on quickly tend to be more significant. Don’t wait to see if a symptom passes. Flag it immediately, even if it seems minor.
Talking About Anxiety and Emotional Distress
If you feel anxious, scared, or emotionally overwhelmed, say so. This is not something to push through silently. Anxiety during treatment can worsen nausea, increase pain sensitivity, and disrupt sleep. Cancer centers routinely screen for distress using a simple 0-to-10 scale, and a score of 4 or higher typically triggers a conversation about what kind of support would help.
You don’t need clinical language. Telling your nurse “I’m really anxious right now” or “I’m feeling overwhelmed and I’m not sure how to handle it” is enough to open the door. Depending on what you need, the team can connect you with a social worker, a psychologist, a support group, or relaxation techniques like guided imagery, meditation, or progressive relaxation. Some of these can even be used during the infusion itself to help with anticipatory nausea or procedural anxiety.
What to Say to Friends and Family
People in your life will want to know how it went, and you get to decide how much you share. There’s no obligation to give a detailed medical update to everyone who asks. For people outside your inner circle, a simple script works well: “I have cancer and I’m in treatment.” If they press for details you don’t want to share, repeat the same line. You can be a broken record without being rude.
With closer friends and family, the most useful thing to communicate is what you actually need. Be specific about your energy levels and limitations. If you usually meet a friend for a weekly walk but you’re feeling wiped out after treatment, telling them that directly lets them suggest something more manageable, like a short visit at home. People generally want to help but don’t know how unless you tell them.
A few phrases that set clear boundaries without shutting people out:
- “I’m too tired for visitors today, but a text would be nice.”
- “I don’t really want to talk about treatment details right now.”
- “The best way to help me is [specific request: a meal, a ride, being left alone].”
Your story is yours to share on your terms. Some people find it helpful to designate one person to relay updates to the wider circle so they’re not fielding the same questions from fifteen people on a low-energy day.
Before You Leave: What to Clarify
The end of your first session is when important details can slip through the cracks. Before you head home, make sure you’re clear on a few things: what medications you need to take at home and when, how much fluid you should be drinking, what side effects are expected versus which ones require a phone call, and what you can eat if your appetite changes. If you’re unsure whether a liquid nutritional supplement might help you maintain your calorie intake, ask about it now.
Write things down or bring someone who can take notes for you. The combination of new information, residual anxiety, and whatever medications you’ve received can make it surprisingly hard to remember details later. Most centers will give you printed discharge instructions, but don’t leave without understanding them. If something on the sheet doesn’t make sense, ask before you walk out the door.
The single most important thing to leave with is the after-hours contact number and clear instructions on when to use it versus when to call 911. Knowing exactly who to reach at 2 a.m. if something feels wrong provides a level of reassurance that makes the first few days at home significantly less stressful.