My fellow chemo “colleagues” already know the answer, but every now and then someone asks me what chemotherapy is actually like and whether it hurts.

One person imagined a giant machine that would suck me in, pump me full of drugs, and send me back out again. Someone else thought the pain started the very moment the chemotherapy entered my body.

So I thought I’d tell you a little about it.

This time last year, I had absolutely no idea either. Every treatment plan is different, but in my case, I go to the hospital once every 21 days. The day before—or sometimes very early that morning at 6:45 a.m.—I first go for blood tests. Based on the results, my doctor decides whether I’m ready for another round of chemotherapy, or whether my body still needs more time to recover from the previous one before getting hit again. At eight o’clock, the oncology clinic opens and we all go in for our little chats with the doctors. If everything looks good, we mostly discuss logistics: blood tests, treatment dates, prescriptions, scans, appointments, and whatever else needs to be scheduled. After that, I head over to the day treatment unit.

There are changing rooms with lockers, and once you’re assigned a number, you find your spot in the main treatment room. Some people sit in recliners. Since my treatment usually takes at least two hours, I get a proper bed. I ask for an extra blanket, arrange my drinks and snacks on the little table, put my laptop within reach, and settle in.

Ready for battle.

We start with premedication, which is designed to reduce nausea, allergic reactions, and other side effects. Some patients jokingly call it an Aperol cocktail. First comes Ondansetron to prevent nausea and vomiting. Then Dexamethasone, a powerful steroid that helps reduce inflammation, swelling, and allergic reactions. Dithiaden is an antihistamine used for itching, rashes, and other allergy-related issues. Pantoprazole protects the stomach and reduces acid production.

All of that goes directly into the vein.

Then I get a shot of Diazepam in the backside, and we’re ready for the main event. Sometimes we have to wait a little while for the pharmacy to prepare and deliver the chemotherapy drugs. Most of the time, I ask to have my treatment split over two days. That usually means about two hours on Thursday and three hours on Friday. Occasionally, I squeeze everything into one day if I’m working or simply don’t feel like making multiple trips to the hospital.

The first drug I receive is Paclitaxel.

Its job is to stop cells from dividing, especially cancer cells. Some people experience flushing, itching, or a feeling of warmth in their chest while it’s being administered. For me, the most common effects are fatigue and occasionally a metallic taste in my mouth.

After that comes Carboplatinum.

Its mission is to damage the DNA of any cancer cells that are still trying to survive. Once their DNA is damaged, they can no longer divide properly and eventually die. In simple terms, Paclitaxel stops the cancer cells in the middle of dividing, and Carboplatin comes along and breaks them.

A war is taking place inside our bodies.

Cancer is not a common cold, so the weapons used against it aren’t gentle either. Unfortunately, chemotherapy doesn’t only target cancer cells. It attacks broadly.

Hair.

Eyebrows.

Eyelashes.

Blood cells.

Platelets.

The digestive system.

The nervous system.

Organs.

Fertility.

The list goes on.

Fortunately, many of these losses are temporary. Hair grows back. Blood counts recover. The body rebuilds itself. They’re not necessarily casualties in the permanent sense. Chemotherapy is an ally. A brutal one, perhaps, but an ally nonetheless. It fights where little else can. Modern chemotherapy is also very different from what many people imagine. Treatments are more targeted than they used to be, often combined with other therapies, and side effects are monitored and managed much more effectively than in the past. In my case, I’ve lost my hair and body hair. My blood tests tell us that my white blood cells, platelets, and liver aren’t particularly thrilled about the treatment either.

And with every cycle, I feel a little more tired.

Before my third and fifth treatments, my blood counts were too low and everything had to be postponed. That’s despite receiving injections at home after chemotherapy to stimulate the production of white blood cells. Sometimes I need additional booster injections because my bone marrow seems reluctant to wake up and get back to work. Apparently, it’s simply very sensitive. There’s not much anyone can do except wait. If things continue to worsen, we’ll have to adjust the dosage. But all of this is temporary damage.

The body heals.

Recovery comes.

Some changes, however, are permanent.

Cancer always takes something.

It never leaves empty-handed.