Ep 4: Chemotherapy Basics (Part 1): What I Wish I’d Known Before My First Chemo

Newly diagnosed with lung cancer—or supporting someone who is—and facing chemotherapy? This raw, practical episode is for you. Host Tina Powell, stage 4 lung cancer survivor, thriver, and patient advocate, breaks down her own experience with 27 rounds of chemotherapy—demystifying the process, side effects, and survival tips she wishes she’d heard before sitting in the infusion chair.

In plain language, Tina Powell walks listeners through what chemotherapy is, how it's delivered, and the 12 most common side effects (including nausea, hair loss, fatigue, chemo brain, and more) with zero sugar-coating and deep compassion. This patient-focused episode is packed with the honest, actionable information Tina Powell searched for—and couldn’t find—when she was first diagnosed.
 
 You’ll learn:
 • What chemotherapy really is and how it works
 • How oncologists decide if you’re ready for a chemo round (labs and tests)
 • IV, port, or pills? The main ways chemo is given
 • The 12 most common side effects in plain English, including nausea, hair loss, fatigue, chemo brain, and neuropathy
 • How to talk to your oncologist about side effects and get the support you need
 • Why it’s normal to feel overwhelmed—and how to give yourself grace on this journey

Chapters

• 0:17 Why No One Can Prepare You for Chemo
• 1:42 Hearing “You Have Lung Cancer”: First Steps
• 2:15 What Is Chemotherapy, Really?
• 4:36 How Do You Prepare for Chemo?
• 5:26 IV, Port, or Pills: How Chemo’s Administered
• 6:15 12 Most Common Chemo Side Effects
• 6:25 #1: Anticipatory Stress
• 7:01 #2: Nausea and Vomiting
• 7:49 #3: Hair Loss and Thinning
• 8:55 #4: Constipation
• 9:54 #5: Fatigue
• 10:08 #6: Tinnitus (Ringing in the Ears)
• 11:53 #7: Mouth Sores and How to Treat Them
• 12:37 #8: Changes in Taste
• 13:13 #9: Heightened Sense of Smell
• 13:42 #10: Chemo Brain (Memory/Focus Challenges)
• 14:31 #11: Neuropathy (Tingling in Hands/Feet)
• 15:18 #12: Weight Loss or Gain
• 16:26 Summary: 12 Side Effects Explained
• 16:58 Final Words: Strength, Hope, and What’s Next
• 17:17 Hacks and Tools Coming Soon
• 18:14 Outro: Lung Cancer Strong

Transcript

0:00

No one can prepare you for what chemotherapy actually feels like. Not your doctor, not the pamphlet they hand you, not the late night Dr. Google. You only understand it when you're the one sitting in the chair. I've had 27 rounds of chemotherapy in different combinations over the last three years, and today I'm sharing the things I wish someone told me before I started. This podcast is strictly for informational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult with your oncologist, doctors, and medical team for questions specific to your own health, diagnosis, and treatment. If you're listening to this, you or someone you love has just heard the words, you have lung cancer. Right now, you might feel scared, overwhelmed, shocked, or even numb. I know because I've been there. Hi, I'm Tina Powell, stage four lung cancer survivor, thriver, and patient advocate. And when I was diagnosed on January 16, 2023, I had a thousand questions and nowhere to turn for real answers from those who have lived it. That's why I created Lung Cancer Strong. Here you'll find things I wish I had from day one. Real, real stories, honest answers, and the tools and hope to face every moment ahead. Here we get real about treatment, fears, setbacks, small victories, and finding purpose, even on the hardest and the most crushing of days. Here we get strong through information, inspiration, and community. And most of all, we get through it together because this is a place of true connection, compassion, and unfiltered strength. So whether you're newly diagnosed, fighting with everything you've got, or standing by someone you love, this is your invitation to live intentionally, powerfully, and with hope. One breath, one story, one day at a time. Welcome to Lung Cancer Strong. Hi, everyone. Tina here, stage four lung cancer survivor, thriver, and your host of lung Cancer Strong. Today, we're talking about chemotherapy. It's a question that I get asked asked all the time, especially from new people who have been diagnosed. So if you've been diagnosed with lung cancer, chances are that your oncologist has recommended chemotherapy as part of your treatment plan. So let's walk through what it actually is and what you might experience without the medical jargon and all the sugar coating. Thank you. I'm going to also outline 12 side effects that I personally experience across multiple chemo regimens, as well as a few that are common to other patients. Some of these are actually quite manageable. Some of them are a little bit harder, and all of them will depend on your specific combination of the drugs that you receive. So remember that. So, just for context, my chemo journey has Included permetrexate, cisplatin, carboplatin, and right now I'm on an antibody drug, conjugate and ADC that I'm receiving as part of a clinical trial at Memorial Sloan Kettering since May of 2025. So all this to say that your experience might look a lot different, and that's okay. But my goal here is simple. To arm you with the information that I wish that I had before my first round. Let's discuss what chemotherapy is first. What is chemo? Chemotherapy is a type of cancer treatment that uses powerful medicines to stop cancer cells from growing, dividing, and spreading. These medicines travel throughout your bloodstream, which means that they can reach cancer cells from anywhere in your body. But because chemo targets fast dividing cells, it also affects healthy cells like your hair, like the lining of your stomach, and like your blood cells, which is why side effects happen. At its core, chemo is a tool to shrink tumors, slow cancer growth, or keep the disease stable. But the decision to do or not to do chemo is deeply, deeply personal. And it should be made with your oncologist and of the board of directors that I talk about in my videos. So how do you prepare for chemo? I wish I had the answer to that question when I started as well too. Before each treatment, your oncologist is going to order a set of labs that's basically blood work to make sure that your body can handle chemotherapy safely. What they're looking at, they're looking at your liver and your kidney function. They're going to look at your white blood cell and your red blood cell counts, and they're going to look at you as the total picture of your overall ability to tolerate another round. This helps them decide whether to proceed, whether to adjust the treatment, or whether even you need to delay a treatment. Your blood work is going to change throughout, like the course of, of weeks and months. So the your oncologist really needs to make sure that your body can handle it. So here was another big question that I was so unsure about, and that was, how is chemo given? That was a big, big question. I wasn't sure, am I getting a port? Do I need one? How does this work? In my case, my chemo is administered through an iv, usually in my right arm. And the oncology nurse actually puts that in the day of my chemo. However, some of you listening, some patients will receive a chemo port which is placed under local anesthes. Other people can also take chemo in pill form. So again, it really depends. There's no right or wrong path. It's just the one that treats, that fits your treatment plan. Now that we've covered what chemo is, why it's used, and how it's delivered, let's finally walk through the 12 common side effects that you might experience. Number one, something I don't hear people talking about at all, and that is anticipatory stress. Wow. Before you're going in for your first chemo session, your stress hormones are really, really high. I want to assure you that this is all natural. And even if you've gone through chemo as many times as I had, again almost 30 times, I still experience that anticipatory stress. So just realize that it will get a little bit easier as you go along. But side effect number one, anticipatory stress. Side effect number two, which is probably the thing you hear about all the time, is nausea and vomiting. Does that happen to me? Yes, that happens to me. In the next video, we're going to talk about the things to counteract that nausea and vomiting. But chances are that you will experience some form of feeling sick. You may or may not vomit. And even if you're on the same chemo regimen, you may vomit one cycle and not vomit another. You may vomit on day two versus vomit on day one or day four, so it really depends. But nausea and vomiting is unfortunately a big side effect of chemo. Your oncologist will give you drugs to help you counteract that, but it is a major side effect, so keep that in mind. Number three, hair loss and thinning. That has absolutely happened to me. Some chemotherapies will result in you losing your hair completely. My chemotherapy has resulted in hair thinning substantially, so I've lost about 50% of my hair, which you can't tell because it's, it's, it's tied up right now. I do also, too, I do have a, have a wig that I sometimes wear. I have enough of a hair that I could tie it back and put it on a, in a ponytail or tie it up like you see here. I will talk about some of the things that I'm doing for my hair loss. I have lost all of my body hair as well, too. So that is something that may or may not happen to you. So again, hair loss loss and hair thinning are a major side effect of chemotherapy. And it may or may not happen to you. Depending on what type of drug that you are on. Your oncologist will let you know in advance whether or not that you are going to lose your hair. So don't be afraid to ask that question. And if you're really that concerned, don't be afraid to talk to your oncologist about the different options. Okay? Number four, constipation. Unfortunately, a lot of the anti nausea medications and the medications that you'll be taking anyway for chemo and for your cancer, unfortunately some have a major side effect and that is constipation. Constipation can be excruciating. It can be very, very painful. You guys, I do recommend a stool softener and a laxative that you take no matter what. You should really make sure that you're also too drinking plenty of water. I know that's not always easy to do when you're in chemo and you're feeling sick, but constipation is a major, major side effect. Work with your oncolo. They can also give you prescription drugs to help you. Please make sure that you nip this one in the butt because no, no pun intended guys. But it can get extremely painful, okay? And there's no reason for it. There's plenty of drugs and over the counter drugs that can make you feel better. Number five, fatigue. This is a real, real thing, you guys. Fatigue always accompanies my chemotherapy. So for this week example, I had chemotherapy on Friday and it took a lot. Today this is actually day three. So the first chemo was day was Friday. Today's a Sunday. So today's actually day three. I'm not going to lie, you guys. It took a lot for me to. Get out of bed. I've been taking my Zofran. I have been forcing myself even to. Record this video today because I don't want to let you down, you guys. I've heard from a lot of you. Tinaung Cancerstrong is my email. Thank you for all the YouTube love. And the comments here and letting me. Know that these videos are really helpful helping you. But I needed to show up even if I wasn't feeling a hundred percent. So you're going to feel that fatigue, that exhaustion also too. Like I would just describe it as lethargy. You know, I'm a person that works. Out all the time and right now. My workout meter is like a number. One on a scale of 10. So that fatigue is real, is real and it's sometimes debilitating. Chances are that you're going to need. A lot more rest. So make in terms of fatigue, make. Sure that you're in bed early, okay? Side effect number six, tinnitus, ringing in the ears. Actually right now I have this going on. The good news about the tinnitus is the tinnitus disappears. It's not permanent, as well as all. Of these side effects that we're talking about. But for tinnitus, it's that little ringing in the ear. If you've ever gone to like a rock concert or a sporting event and you walk outside or, or like a loud movie, you hear that ringing in your ears. It's almost like a background noise. So that is definitely a side effect of chemo. It has happened for me on all of the drugs I listed permetrexate, cisplatin and carboplatin as well as this anti drug conjugate side effect. Number seven, mouth sores. Mouth sores also too can be a very painful thing right now. Luckily I don't have mouth sores with this particular chemo, but I have had it in the past and they could be extremely painful, especially depending on where they are in your mouth as you bite in your chew and also to what you put in your mouth, right? Can really, really agitate it. So mouth sores are a common thing. Look into magic mouthwash and that is a prescription from your oncologist if you're really having bad side effects with mouth sores. I've tried gargling also too, with salt water and that has helped. But you know, mouth sores, like everything you guys has to run its course. Number eight, changes in taste. This happens to me all the time with chemo. It's amazing. You guys like the foods that you normally love. You will like all of a sudden have a strong aversion to that. I can't explain it. Like, people are like, oh, can I help you with chemo? You know, can I drop off some meals? Can I make a plate for you? And the only thing that I can say is like, the changes in taste are very real and what you feel like eating that day or that minute is going to vary. People really mean well and they really want to help out, give your body whatever it's craving. Number nine, heightened sense of smell. Wow, this is, this is a crazy thing that happens to me. It might not happen to you, but having a strong sense of smell, all of a sudden I could smell things that I don't normally smell. And sometimes it's bothersome, right? Sometimes that I've had to like spray something or you know, chew a piece of gum or rolled down the windows of my. Again, I have this heightened sense of smell. You may or may not experience that. Number 10, chemo brain. Hey, you guys this is also too a real thing. You may or may not forget even a person's name, like the simplest things. So I would say that chemo brain really refers to your ability to recollect facts and things that you know off the top of your head. But all of a sudden you try to think of it and then you can't think of it, and then you're wait, chemo brain. So that's what we talk about with chemo brain. It, it doesn't impair your ability to drive or even to do things, but you'll notice definitely your ability to recollect facts and figures very quickly will be impaired somehow. Again, that is not a permanent thing, but it is definitely a state that happens to me. Number 11, neuropathy. So I, I haven't had neuropathy happen to me, but I know that it has happened to a lot of lung cancer patients is where you might get tingling in the hands and feet. And again, you're, you're feeling, your sense of feeling for those different parts of your body are altered. So I'm not going to spend too much time on that. But if you are experience any type of neuropathy or nerve pain, which can be very, very debilitating, please make sure that you consult with your oncologist and you let your oncologist know. Acupuncture could be a great way to actually treat it. I know of people who have treated it successfully with acupuncture. So again, neuropathy. Number 11, side effect. Number 12, side effect. Weight gain or weight loss. You guys, I've had both sides of this. I've had extreme weight loss and I've had, I won't call it extreme weight gain, but I've had weight gain. So just because you're on chemotherapy doesn't mean automatically that you're gonna like, lose all kinds of weight. You will lose all kinds of weight. If you're throwing up, you're not eating, you're not replenishing your nutrients and all of that, but you might also experience weight gain. I talked a little bit about that constipation. That constipation is real. So you might all of a sudden like, have to eat certain foods. You might even crave some junk food. And you guys, that's okay. Give yourself some space here. Give yourself the, give yourself a break, right? If you're craving Cheetos, have some Cheetos. If you're craving Cheerios or popcorn, whatever it is, do that. But you may experience weight gain or weight loss. So in summary, Here are the 12 effects that 12 side effects that we've covered for chemo anticipatory stress. Number 2 nausea and vomiting. Number 3 hair loss and thinning. Number 4 constipation. Number 5 fatigue. Number 6 tinnitus. Number 7 mouth sores. Number 8 changes in taste. Number 9 heightened sense of smell. Number 10 chemo brain Number 11 neuropathy and Number 12 weight loss or weight gain. So in closing, if you're about to start chemo or if you're somewhere in the middle of it, I want you to hear this. You are stronger than you think, you are braver than you know, and you are absolutely capable of gutting through this. I know it's hard. I've been there again. I'm approaching my 30th round of chemotherapy. Remember that chemotherapy may change your body. It might affect your energy and your appetite and even your identity for a while, but it does not get to define you. You define you. And in the next video, I'll talk about some of the hacks and the tools and the tips that I've learned to navigate every single one of these. So please subscribe to my channel Lung Cancer Strong to be notified when these videos come out. And remember, on Lung Cancer Strong, we take it one day, one story, and one breath at a time. Thank you so much for listening. Thank you for joining me today on Lung Cancer Strong. Remember, this podcast is strictly for informational purposes and does not constitute medical advice. Always talk to your oncologist, doctors and healthcare team about your individual situation. If you'd like to reach out to me or share your thoughts, please email me@tinaung cancerstrong.com and be sure to at least least allow 48 hours for a reply. And don't forget, you can find us on YouTube and on all the major podcast outlets. Hit subscribe so you never miss an episode and get notified when something new drops. One breath, one story, one day at a time. This is Lung Cancer Strong.