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Systemic Therapy (Chemotherapy)

Systemic therapy includes a large group of drug treatments that will damage or kill cancer cells. Chemotherapy is one type of systemic therapy.

Systemic therapy is given at all BC Cancer regional cancer centres and in community hospitals and clinics. If you have been diagnosed with cancer, you will get the same treatment, no matter where you live in B.C.

What is systemic therapy?

Systemic therapy travels through your blood to cells all over your body, to your whole "system".

Traditionally, most systemic therapy was called chemotherapy (or "chemo") and was often described as cytotoxic (because the drugs directly killed cancer cells). Today, there are over 200 different systemic therapy drug treatments used to treat cancer. Not all of these treatments are considered cytotoxic in the traditional way.

Other types of systemic therapy include:

  • Hormone therapy: Some cancer cells need hormones to grow. Hormones, like estrogen and testosterone, are made by your body. Hormonal therapy either stops your body from making the hormone or stops the cancer cells from using the hormone to grow.
  • Targeted therapy: These drugs work on specific molecules, like proteins or genes, in the cancer cell. By targeting these molecules, the drugs stop the cancer cells from growing or spreading. Targeted therapy is sometimes called biological therapy.
  • Immunotherapy: These drugs turn on your immune system to damage or kill cancer cells.
Systemic therapy can:

Some cancers need only one kind of drug treatment. Other cancers might need more than one drug treatment. Your specific treatment plan is called a treatment protocol.

Systemic therapy can affect both cancer and normal cells. This is what causes side effects from treatment.  For more information, see our Managing Symptoms and Side Effects page. 

Who gets systemic therapy?

You may or may not have systemic therapy. Your cancer treatment depends on:

  • The type of cancer you have
  • Where the cancer is in your body
  • Your overall health


To help you prepare for systemic therapy, please watch our video: 

If you have any questions about preparing for your treatment, please talk to your health care team.

For more information about chemotherapy and immunotherapy, please watch these videos:



Before treatment starts

Your systemic therapy will be planned by a medical oncologist. This is a cancer doctor who specializes in drug treatments.

Before you start your systemic therapy, you may need to have some tests. For example:

  • Teeth cleaned and checked: systemic therapy may make your mouth dry and sore. It is important to have your mouth and teeth checked before starting treatment.
  • Check your heart: some systemic therapy drugs can damage your heart. Your health care team may ask you to get an electrocardiogram to check how well your heart is working.

Systemic therapy can affect your fertility (your ability to get pregnant, stay pregnant or get someone else pregnant). There may be things you can do to protect your fertility. Some of these things need to be done before treatment. If this is important to you, talk to your health care team before you start your treatment.

Having systemic therapy

Most people get systemic therapy in regular intervals called cycles. For example, you may have treatment one day every three weeks.  The time between your treatment is a rest period. This allows your body to heal and recover from any side effects.

The entire course of your treatment, from the first treatment to the last, may be a few months or longer.

Your health care team will talk to you about your treatment cycles and course.

You may get systemic therapy in one of four ways:

Intravenously (IV) 

A needle attached to a tube is put into your vein. The drug treatment travels through the needle into your vein.

If you get treatment this way, we will give you an appointment date and time. A nurse will give you the treatment. The nurse will also talk with you about your treatment and any side effects you may have. 

IV treatment can take anywhere from several minutes, to several hours, to a full day.  It depends on your treatment. 


Some drug treatments are pills that you swallow.

If you get treatment this way, we will give you an appointment date and time to meet with a BC Cancer pharmacist. The pharmacist will explain your treatment, talk about side effects and give you the pills you need.


If you get treatment this way, a nurse, or another member of your health care team, will give you an injection. This is when a needle is put into a part of your body, such as your arm, and the drug treatment is injected.  

IV infusion pump

Some patients may go home with a continuous IV infusion pump.  This is a portable pump that is connected by a tube to a needle in your vein.  It allows you to have your treatment at home. This way, you do not have to stay at the hospital or clinic. Not all IV drug treatments can be delivered this way.

Patient Video

To help you prepare for systemic therapy, please watch our video:

If you have any questions about preparing for your treatment, please talk to your health care team.

Preventing pregnancy during cancer treatment: What you need to know

Why you should not get pregnant during cancer treatment

When having cancer treatment, it is important that you or your partner do not get pregnant.

Cancer treatments, like radiation and systemic therapy (chemotherapy, immunotherapy, hormone or targeted therapy) may damage eggs, an embryo (very early part of pregnancy), a fetus (unborn baby), or sperm.

If you can get pregnant, your healthcare team will offer to do a pregnancy test before treatment starts. This test is done with your agreement. 

What could happen if I get pregnant during treatment? 
  • You may have to consider stopping treatment.
  • You may not be able to have certain treatments or tests.
  • Some cancer treatments may damage the egg, sperm, or embryo (especially during the first 3 months). The health of the person having the child may also be affected.
  • You may have a miscarriage (fetus or embryo dies) or the baby may have damage (the baby's brain or body may be affected).

It is important to prevent pregnancy while you are getting cancer treatment and often for some time after treatment. Talk to your healthcare team about when it's safe to get pregnant after treatment.


If you or your partner can become pregnant, it is important to use effective birth control when having vaginal sex.

Some hormonal birth control (such as the birth control pill, patch or injection) may not work during cancer treatment.


Your healthcare team can talk with you about what types of birth control are safe to use during your treatment. They can also talk about any concerns you have about preventing pregnancy before, during and after your cancer treatment.

No. It is very important to talk with your health care team about your specific treatment and if you have any questions or concerns.


If you are able to get pregnant and think you might be pregnant, your doctor may order a blood test. This blood test will check to see if you are pregnant. 

If you think that you could be pregnant any time during your treatment, please tell your health care team right away. They will ask you to do a blood or urine pregnancy test.


Systemic therapy treatments may be in your body fluids. If your partner comes in contact with your bodily fluids containing treatment drugs during sex, they may harm your partner or fetus.


We recommend using barrier devices (condoms, dental dams) throughout your treatment during oral, vaginal or anal sex. You should use these devices for at least 48 hours after your last treatment. This will prevent your partner from being exposed to any medication that may be in your body fluids.

Side effects

There are many side effects from systemic therapy. No patient gets all of the side effects. Your health care team will talk to you about side effects that may happen from your specific treatment. 

Managing symptoms & side effects

We have lots of information on managing the symptoms and side effects of your cancer treatment.  Please go to our Managing Symptoms & Side Effects page.

Our Pain & Symptom Management team can help you deal with your side effects. 

You can use our Patient Handout Search tool to find a handout. 

You can also contact our Library and they can send you the information you need.

If you have questions about side effects or cannot find the information you are looking for, please talk to your health care team.

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