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Before your first cycle

Before Starting Chemotherapy — The Complete Checklist

Preparation for chemotherapy is not a single appointment. It is an ordered series of tests, reviews and clearances that typically takes one to two weeks — and each step has to happen before the next one can.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • More than one appointment — Blood tests, organ checks, dental review and counselling each need separate visits.
  • The order matters — Your oncologist cannot finalise the regimen until test results are back.
  • Time-sensitive referrals — Dental and fertility reviews must happen before chemotherapy begins, not after.
  • You are not waiting — you are preparing — Each step protects you from complications once treatment starts.
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Preparing for chemotherapy takes one to two weeks. You need blood tests, organ function checks, a dental review, and sometimes a fertility discussion before your first cycle can be scheduled. Your oncologist finalises the order once they have your results. Nothing in this sequence can be safely skipped.

Why does preparation take this long before chemotherapy starts?

Chemotherapy affects healthy cells alongside cancer cells, so your team needs a clear picture of how your heart, liver and kidneys are working before deciding which medicines are appropriate for you.

Some chemotherapy drugs are hard on specific organs. A result that comes back outside normal range may change the regimen your oncologist prescribes, or mean that one step — a dental procedure, for example — needs to be completed before treatment can begin.

The fortnight of preparation is not a delay. It is what makes the first cycle safe.

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Dr. Naresh Gundu
Medical Oncologist

Dr. Naresh Gundu

MBBS, DNB (Internal Medicine), DM (Medical Oncology)

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Dr. C. Raghavendra Reddy
Medical Oncologist

Dr. C. Raghavendra Reddy

MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)

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Dr. Bharati Devi Gorantla
Medical Oncologist

Dr. Bharati Devi Gorantla

MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)

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Dr. Owais Mohammed
Medical Oncologist

Dr. Owais Mohammed

MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)

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Dr. T. Raghavender Reddy
Medical Oncologist

Dr. T. Raghavender Reddy

MBBS, DM (Medical Oncology), MD (Radiation Oncology)

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Dr. N. Kiranmayee
Medical Oncologist

Dr. N. Kiranmayee

MBBS, DM (Medical Oncology), MD (Internal Medicine)

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Dr. Muralidhar Muddusetty
Surgical Oncologist

Dr. Muralidhar Muddusetty

MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)

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Dr. Raghavendra Naik
Surgical Oncologist

Dr. Raghavendra Naik

MBBS, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Mohammed  Imaduddin
Surgical Oncologist

Dr. Mohammed Imaduddin

M.B.B.S, MS (General Surgery), M.Ch (Surgical Oncology)

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Dr. Vinay Mamidala
Surgical Oncologist

Dr. Vinay Mamidala

MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)

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Dr. Paila Gowri Naidu
Surgical Oncologist

Dr. Paila Gowri Naidu

MBBS, MS (General Surgery), M.Ch (Surgical Oncology), FMAS

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Dr. Venkata Sushma P
Radiation Oncologist

Dr. Venkata Sushma P

MBBS, MD (Radiation Oncology)

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Dr. Kirti Ranjan Mohanty
Radiation Oncologist

Dr. Kirti Ranjan Mohanty

MBBS, MD (Radiation Oncology)

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Dr. Gangadhar Vajrala
Radiation Oncologist

Dr. Gangadhar Vajrala

MBBS, MD (Radiation Oncology), MPH

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Dr. Basudev Pokhrel
Hematologist

Dr. Basudev Pokhrel

MBBS, M.D (Immunohematology & Blood Transfusion)

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Dr. Mohammed Imran
Interventional Radiologist

Dr. Mohammed Imran

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Dr. Vajja Sandeep Kumar
Surgical Oncologist

Dr. Vajja Sandeep Kumar

MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology

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Dr. Sridhar Kamani
Surgical Oncologist

Dr. Sridhar Kamani

MBBS, MS (General Surgery), DrNB (Surgical Oncology)

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What happens, in what order, before your first cycle?

  1. Oncology consultation and treatment plan

    Your oncologist reviews your biopsy, imaging and treatment history, then prescribes a specific regimen. This consultation is the starting point for everything that follows.

  2. Pre-treatment blood tests

    A full blood count, liver function tests, kidney function tests and other markers are taken. Results guide every decision that follows and are usually available within a day or two.

  3. Heart function assessment

    Some chemotherapy drugs can affect the heart muscle. If your regimen includes one of these, an ECG or echocardiogram is arranged before you start. Your oncologist will tell you whether this applies to your plan.

  4. Dental review

    Chemotherapy lowers your ability to fight infection. An untreated tooth or gum problem that would normally wait can become dangerous once treatment starts. A dental review before your first cycle is time-critical — it cannot be left until after.

  5. Fertility discussion, if relevant

    Some chemotherapy drugs can affect fertility. If this is a concern, raise it with your oncologist before treatment begins. A referral to a fertility specialist must happen before your first cycle, not after. Availability varies by centre, so ask early.

  6. Port or access device planning

    If your regimen calls for a port or PICC line rather than a standard cannula, this is arranged and placed before your first cycle.

  7. Medicines and supplements review

    Your oncology team reviews everything you currently take — prescription medicines, over-the-counter tablets and supplements — to identify anything that could interact with your chemotherapy. Bring a complete list to this appointment, including herbal preparations.

  8. First cycle scheduled

    Once all results and clearances are in hand, your first chemotherapy appointment is confirmed. Day-care chemotherapy at CION typically runs for several hours; one family member can usually accompany you.

Did you know?

Dental infections are among the most common preventable causes of chemotherapy delay. A tooth problem treated before treatment starts takes a few days to resolve. The same infection during chemotherapy — when your immune defences are lowered — can become a medical emergency.

Book the dental appointment in the same week you receive your treatment plan.

Source: ASCO supportive care guidelines for infection prevention during chemotherapy

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Common questions

Frequently asked questions

How long does preparation usually take before my first chemotherapy cycle?

For most patients, one to two weeks covers all the tests and reviews needed. The main variables are how quickly results come back, whether additional tests are needed based on your specific regimen, and whether a dental or fertility appointment adds to the timeline. If one result is delayed or falls outside normal range, your team will explain what needs to happen next and how that affects your schedule.

Why do I need a dental check before chemotherapy?

Chemotherapy lowers your white blood cell count, which reduces your ability to fight infection. An untreated tooth decay, gum disease or abscess that your body might ordinarily manage can become a serious infection during treatment. Treating dental problems before your first cycle removes that risk. The appointment ideally happens early in your preparation week, because some procedures need time to heal before chemotherapy begins.

Should I stop my regular medicines before chemotherapy starts?

Do not stop or change any medicine without asking your oncology team first. Some medicines and supplements — including herbal preparations and over-the-counter tablets — can interact with chemotherapy drugs or affect how they work. Bring a complete list of everything you take to your medicines review appointment. Your team will tell you what to continue, what to pause and what to avoid during treatment.

What happens if a blood test result means I cannot start on the planned date?

It depends on which result is outside range and by how much. A low blood count sometimes recovers within a week and can be rechecked. Some results lead your oncologist to adjust the regimen rather than delay the start. If a result points to something that needs attention first — an infection, or an organ that needs time to recover — your team will explain the revised plan. A short delay at this stage is common and does not mean that treatment will not work.

What should I bring to my first chemotherapy appointment?

Bring your treatment plan letter, a list of all medicines and supplements you take, and any health insurance documents. Wear comfortable, loose clothing with easy access to your arm or port site. Bring a meal or snack — day-care sessions run for several hours. One family member can usually accompany you. Your team will advise on anything specific to your regimen or centre.

Full index

Browse all 579 chemotherapy topics

Every page in this section, grouped by the part of treatment it belongs to. Open a group to see what is in it.

Before You Start: Tests, Ports & Fertility42
Blood Counts, Infection, Fever & Emergencies73

Anaemia & Low Haemoglobin

HUB — Low Blood Counts, Infection and Fever During Chemotherapy

Chemotherapy and Supportive Medicines by Name75

Chemotherapy Drugs by Name

HUB — Chemotherapy Drugs by Name

HUB — Generic, Branded and Biosimilar Chemotherapy in India

HUB — Supportive Medicines Used With Chemotherapy

Chemotherapy at CION Cancer Clinics1
Chemotherapy by Cancer Type and Special Situations5

Special Populations & Comorbidities

HUB — Chemotherapy in Special Situations

Chemotherapy in Hyderabad: Cost, Centres & Access93

HUB — Choosing a Chemotherapy Centre and Safe Administration

Common Side Effects and How They Are Managed78
Food, Diet, Hydration & Household Safety6
How Chemotherapy Is Given: Regimens, Cycles & Infusion Days85

Other Ways Chemotherapy Is Given

HUB — Cycles, Schedules and What Happens on Infusion Day

Is It Working, Finishing Chemotherapy & Survivorship7

Is It Working? Response & Scans

HUB — Is Chemotherapy Working? Scans and Response

HUB — When Chemotherapy Stops Working

Nerve, Skin, Heart, Kidney and Cognitive Effects5

Skin, Nails & Hand-Foot Syndrome

Heart, Lung & Organ Toxicity

HUB — Effects on the Heart, Kidneys, Liver and Nerves

Understanding Chemotherapy, Myths & Trials97

HUB — Chemotherapy Myths and Alternative Treatment Claims

HUB — Clinical Trials in Cancer Treatment

HUB — What Is Chemotherapy and Why Has It Been Advised?

Work, Family, Relationships and Emotional Support12
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