Medical Oncologist
Before you start
Emotional preparation before the first cycle
Three things help more than anything else: knowing what will actually happen on the day, having the practical arrangements settled so nothing is left to the morning, and telling someone how frightened you are rather than carrying it alone. Most of the dread before cycle one is fear of the unknown, and that part is removable.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
How do I prepare myself for the first cycle?
Three things help more than anything else: knowing what will actually happen on the day, having the practical arrangements settled so nothing is left to the morning, and telling someone how frightened you are rather than carrying it alone.
Most of the dread before cycle one is fear of the unknown. People imagine collapse, unbearable sickness, something dramatic. The usual reality is a long, dull day in a chair, and hearing that plainly helps more than reassurance does.
Fear before the first cycle is close to universal
Almost everyone dreads it, including people who appear composed about everything else. It is not a failure of courage, it is a reasonable response to something unknown being done to your body. It also tends to be worst before the first cycle and much less afterwards.
The anticipation is usually worse than the day
This is the single most common thing people say once they have been through one. Not that it was pleasant, but that the week of dreading it was harder than the hours of doing it.
Ask to see the day-care unit before your first cycle. Many hospitals will show you, and it removes a great deal of the unknown.In the days before
What people find actually helps
- Knowing the shape of the day
- Registration, blood test, waiting, the doctor's review, the cannula, the pre-medication, the infusion, going home. Knowing the sequence turns an unknown ordeal into a series of ordinary steps.
- Having everything packed
- The bag ready the night before, the file assembled, the transport arranged, the questions written. Anxiety feeds on unfinished tasks, and this is the part you can actually control.
- Deciding who comes with you
- Someone calm, who can sit for hours, handle the queues and remember what was said. Not necessarily the person closest to you — the right choice is whoever is steady on a long day.
- Saying it out loud
- To a friend, a relative, a counsellor or the nurse. Fear kept private grows; fear spoken usually shrinks. Many people find the nurses easier to say it to than their own family.
- Keeping the day before ordinary
- Work, a walk, cooking, a film, the temple. Clearing the whole day to sit and think about tomorrow is what most reliably makes the night before worse.
- Something to look forward to after
- However small. A particular meal, a film saved for the chair, a person visiting that evening. It gives the day a shape that is not only treatment.
Not sure whether this applies to you?
Ask an oncologistThe night before
Getting through the last few hours
Written for the person reading this at eleven at night with treatment in the morning.
Finish the practical list, then stop
Bag packed, file in it, medicines in it, alarm set, transport confirmed. Then deliberately close the subject. Checking the bag a fourth time is anxiety wearing the clothes of preparation.
Last things
- Phone and power bank charging
- Your written questions in the file
Eat, and drink water
Unless you have been told to fast, eat normally in the evening and drink well through the day before. Well-hydrated veins are easier to cannulate, and an empty stomach makes sickness worse.
Expect to sleep badly, and let that be alright
Most people do, and one poor night before treatment changes nothing about how the day goes. Lying awake worrying about not sleeping is the part that can be let go of.
If it is every night
- Say so at your appointment
- It is treatable, and worth treating
Do whatever steadies you
Prayer, a familiar film, a walk, talking to one person, slow breathing. Whatever has worked in other frightening weeks of your life will work in this one. There is no correct method.
!
Tell someone today if any of this is true
You cannot sleep at all for several nights · you feel sick or panicked at the thought of the hospital before anything has been given · you are thinking of refusing treatment because of fear rather than a considered decision · you feel hopeless most of the day · you have thoughts of harming yourself or that life is not worth continuing. Tell your oncology team, a counsellor or someone you trust today, not at the next appointment. All of these are treatable, and none of them means you are weak or ungrateful.
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After the first one
What tends to happen to the fear
For most people it drops sharply after the first cycle, because the unknown becomes known. You have sat in the chair, met the nurses, learned what the day involves, and discovered that your body handled it. Cycle two is usually easier to face than cycle one.
But sometimes it goes the other way
Some people find dread builds across a course, and a few start feeling sick on the journey in before anything is given. That is a recognised problem with its own treatment, and it reliably worsens if left alone. Say so rather than enduring it.
Write down what helped
After the first cycle, note what made the day easier and what you would change: the seat, the snack, the timing, who came with you. By the third cycle you will have a routine that fits you rather than a generic one.
Ask for a counsellor without waiting for a crisis
Most units have one, few people are offered one, and they are not reserved for people who are falling apart. If the weeks are heavy, that is reason enough. Asking early is easier than asking later.
Remember the attendant is frightened too
The person driving you and sitting through the hours rarely gets asked how they are. Saying it out loud to each other is better than both performing calm for the other's benefit.
Other patients in the unit are often the most useful people to talk to. Many say it is the one place nothing has to be explained.Commonly believed
Four things people tell themselves before cycle one
"I should be positive, or the treatment will not work as well."
Your mood does not determine how the drugs behave, and this belief adds guilt to an already hard week. You are allowed to be frightened, angry and tearful and still be treated exactly as well as anyone else.
"Being this scared means I will not cope."
Fear before the first cycle is close to universal, including among people who go on to manage the whole course comfortably. Dread beforehand tells you nothing about how you will actually handle the day.
"I should not burden the doctors with how I feel."
Anxiety, sleeplessness and dread are part of what they treat, not a distraction from it. There are approaches that help, and none of them can be offered to someone who says they are fine when they are not.
"Reading other people's experiences online will prepare me."
The accounts that get written and shared are disproportionately the difficult ones, and they are usually about different drugs and different situations. Ask your own team what your plan involves instead.
Questions we are asked
Common questions about the week before
Is it normal to be this frightened?
Yes, and close to universal before a first cycle. It is a reasonable response to an unknown, not a weakness. For most people it drops sharply once they have been through one day and know what it involves.
What is the single most useful thing to do beforehand?
Find out exactly what the day will involve, step by step, and ask to see the unit if you can. Most of the dread is fear of the unknown, and the unknown is easy to remove with a few questions.
I cannot sleep the night before. What helps?
Finish the packing early and then deliberately close the subject, keep the day before ordinary, and accept that one bad night changes nothing. If it is several nights every cycle, tell your team, because that is treatable.
Should I read about other people's experiences?
Be careful with it. The accounts most widely shared are the hardest ones, usually involving different drugs and different situations. Ask your own team what your plan typically involves rather than generalising from strangers.
Who should come with me?
Someone steady who can sit for hours, deal with the queues and remember what the doctor said. That is not always the person emotionally closest to you, and choosing on that basis is sensible rather than unkind.
Can I ask for something to calm me?
Yes, ask your oncologist. There are approaches that help, including for people who feel sick with dread before anything is given. Do not take anything from home for this without telling them.
How do I stop worrying about what comes after?
Most people manage by narrowing the horizon to the next cycle rather than the whole course. Ask what happens between now and the next scan, and leave the rest until there is information to base it on.
Is counselling available at the hospital?
Most units have a counsellor or medical social worker, and few patients are offered one unprompted. Ask. It is not reserved for crises, and asking early is considerably easier than asking late.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
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Sources
- Cancer Research UK — Coping emotionally with cancer
- Macmillan Cancer Support — Coping with your feelings
- National Cancer Institute — Feelings and Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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