Should You Ever Postpone Chemotherapy?

Chemotherapy is one of the main components of cancer treatment for many patients. Oncologists often prescribe chemotherapy in conjunction with surgery or radiation to eradicate tumors and help prevent recurrence. If you've been diagnosed with cancer, you probably want to start-and complete-treatment as soon as possible. However, there are times when physicians will postpone chemotherapy.

Side effects

Chemotherapy drugs are extremely toxic chemicals. They have to be to kill cancer cells, which are hardy and tenacious. Unfortunately, chemotherapy also kills healthy cells and, for many patients, causes side effects that can range from mild to severe. One of the main reasons physicians may postpone chemotherapy treatments, or lower a patient's dose, is to relieve severe side effects.

Chemotherapy-induced peripheral neuropathy (CIPN). Chemotherapy can damage the nerves that transmit information between the brain and spinal cord (central nervous system) and the rest of the body, causing CIPN. When it becomes severe enough to interfere in patients' quality of life, many physicians believe it justifies postponing or discontinuing chemotherapy.

Low White Blood Cell (WBC) Count. White blood cells are part of the body's defense against disease. Chemotherapy may reduce patients' WBC count, making them vulnerable to infection. There are drugs physicians can prescribe to help preserve WBCs during chemotherapy.

Insufficient results

More is not necessarily better when it comes to cancer treatment. Researchers have found that adding chemotherapy to initial radiation treatment-either before or after radiation-for some types of cancer did not improve patients' overall survival rates. Because chemotherapy is so damaging to healthy cells, physicians sometimes recommend postponing it until cancer recurs to delay the toxic effect of the medications.

Co-existing conditions

Patients with advanced age or life-threatening infections may not tolerate chemotherapy.


Traditionally, women diagnosed with cancer during pregnancy or while trying to conceive feared for their unborn baby's health. Faced with the options of terminating the pregnancy or putting their baby at risk, many women choose to postpone treatment until after their baby was born. You may recall the widely publicized case of the mother of nine who postponed chemotherapy during her last pregnancy rather than end the pregnancy; she subsequently died from her cancer.

Recent research finds that chemotherapy may be safe during pregnancy in some cases. Evaluating options about chemotherapy during pregnancy is difficult. Women must weigh the pros and cons and ultimately reach a decision they are comfortable with.


"Testicular Cancer Treatments: Chemotherapy." Testicular Cancer Resource Center. Web. 26 May 2010.

"Finding out You Have Colorectal Cancer: What You Can Expect from Treatment." Mercy Health Partners. Web. 28 December 2007.

"Side Effects Limiting Chemotherapy." Aetna Intelihealth. Web. 28 April 1999.,IHW|~st,333|~r,WSIHW000|~b,*|

Kuroi, Katsumasa, Shimozuma, Kojiro, Ohashi, Yasuo, Takeuchi, Ayano, Aranishi, Toshihiko, Morita, Satoshi, Ohsumi, Shozo, Watanabe, Toru, Bain, Stacey, and Hausheer, Frederck H. "A Questionnaire Survey of Physicians' Perspectives Regarding the Assessment of Chemotherapy-induced Peripheral

Neuropathy in Patients with Breast Cancer." Japanese Journal of Clinical Oncology 38(11) (2008): 748-754. Web.

Grady, Denise. "Study of Women With Breast Cancer Finds Half Didn't Get All Suggested Chemotherapy." New York Times. Web. 13 December 2003.

"Pregnant Women Can Receive Breast Cancer Chemotherapy Without Endangering Health of Their Babies, Study Suggests." Web. 29 March 2010.