Understanding ChemotherapyDownload this book (pdf, 1.05 mb)
Chemotherapy: ways to have chemotherapy
Intravenous (IV) chemotherapy
Chemotherapy is most commonly given as a liquid drip into your vein (intravenously). It is usually given through a tube. Depending on the treatment, this may take about 20 minutes or several hours. Sometimes you may receive chemotherapy over a few days.
Before chemotherapy, you may be given medication so you don't feel sick (anti-nausea or anti-emetic medication). You may also be encouraged to drink several glasses of water during the treatment.
You will probably be in a room or a lounge area with other patients when you are getting the chemotherapy. You are usually able to walk around the ward during the procedure, for example if you need to go to the toilet.
The nurses will assess you before chemotherapy, and monitor you during and after the treatment. They will let you know when you are able to go home.
Your nurses will also talk to you about managing side effects and tell you about any medication you need to take at home.
Inserting the tube
To prepare you for IV chemotherapy, you will need to have a tube inserted. There are different types - your doctor will choose the most appropriate one depending on how often you need chemotherapy and how long each treatment will last.
- A small plastic tube that is temporarily inserted into a vein using a needle.
- When the needle is removed, the cannula remains in place in your arm or the back of your hand.
- The cannula can be kept in place for a few days if necessary.
- If you have day treatment every few weeks, the cannula is usually put in and taken out each time you visit.
Central venous access device (CVAD)
- A type of thin plastic tube that remains in your vein throughout the entire course of treatment, often for several weeks to months. Blood for testing can sometimes be taken through this tube.
- Common types of CVADs include: the central line - inserted into the chest or neck; Hickman line - inserted into the chest; peripherally inserted central catheter - inserted into the arm; port-a-cath (port) - small device inserted under the skin of the chest or arm.
All tubes or lines need to be kept clean to prevent infection or blockage. If you have a CVAD, a nurse may visit you at home to clean, dress and flush your line, or you may go to a clinic to have this done. This usually happens on a weekly or monthly basis.
A line doesn't cause pain or discomfort if it is properly placed and cared for, although you will be aware that it is there. Tell your doctor or nurse immediately if you have pain, discomfort, redness or swelling around the line. This may indicate that you have an infection.
Intravenous chemotherapy at home
Some people are able to have their chemotherapy at home using a portable pump. The pump is programmed to give the prescribed amount of chemotherapy over a specified period.
A chemotherapy pump can be carried in a bag or belt holster. It is usually attached to a central line. The nurses at the clinic or hospital will show you how to care for the pump.
Other ways of having chemotherapy
There are other methods of having chemotherapy, but your options will depend on what is available, the type of cancer you have, and what your doctor recommends.
Oral chemotherapy - Many people need to take tablets or capsules at home. Your doctor, nurse or pharmacist will tell you how and when to take them, and how to handle the medication safely.
Cream - Some skin cancers are treated using a chemotherapy cream applied directly to the skin.
Injections - Less commonly, chemotherapy can be injected using a needle into different parts of the body:
- intramuscular - into a muscle, usually in your buttock or thigh
- subcutaneous - just under the skin
- intrathecal - into the fluid around the spine (also known as a lumbar puncture)
- intra-arterial - into an artery, for example, the hepatic artery in the liver
- intraperitoneal - into your abdominal area (peritoneum)
- intrapleural - into the outer lining of the lungs
- intravesical - into the bladder
- intralesional - into the tumour; this treatment is rare.
Chemotherapy wafers - Some people who have surgery for a brain tumour (craniotomy) will have small, dissolvable gel wafers of chemotherapy placed directly into the tumour site during the operation.
High-dose chemotherapy - This is a treatment given as part of a bone marrow or peripheral blood stem cell transplant for conditions such as leukaemia or lymphoma. The high-dose chemotherapy kills off all the cancer cells in the blood before the new, healthy cells are transplanted a day or two later.
Chemoembolisation - Used for liver cancer or some types of cancer that have spread to the liver, chemoembolisation is a procedure of injecting chemotherapy directly into the blood vessels supplying a tumour. The chemotherapy is mixed with tiny spheres that block the vessels and stop the tumour getting nutrients and oxygen.