How chemotherapy is given

How chemotherapy is given depends on the type of cancer you
have and the drugs used. Chemotherapy is most commonly given by mouth (orally) or by injection into a vein using a syringe or in an infusion (‘drip’). Occasionally, a drug may be injected into a muscle or under the skin. Sometimes it can be injected into your spine, lungs or bladder, if that is where treatment is needed.

If your chemotherapy treatment can be taken as tablets or capsules, you will be able to continue your treatment at home. You will still need to visit the outpatient department for regular check-ups. All bottles of tablets given out by the pharmacy department carry instructions about how and when to take them. Please follow these instructions carefully and if they’re not clear, ask your doctor, nurse or pharmacist. It is very important that you take your tablets regularly on the days specified. If you miss a dose for any reason, contact the ward for advice.

When chemotherapy is given intravenously (into a vein), it is given through a venous access device. There are several different types of devices available. You may be able to choose the type of device you have, however, your choice will depend on the type of therapy you are going to have and your physical condition. Sometimes a choice isn’t possible. Your doctor and nurse will discuss which device is appropriate with you.

Usually, chemotherapy is not generally more painful than any other injection or blood test. However, occasionally veins become hardened or sore. Please tell your chemotherapy nurse or doctor if this happens so that they can avoid the sore area. Some drugs can cause damage if they leak out of the vein while they are being injected. If you feel any stinging, ‘burning’ or pain when you are receiving the drug, tell your nurse or doctor straight away. After the injections, if your arm or hand is sore, painful or swollen where the cannula was sited or in the area around the catheter or port, please contact your chemotherapy nurse or doctor.

Depending on the chemotherapy drug or combination of drugs, each cycle lasts from a few hours to a few days. Your doctor may recommend that your chemotherapy is given continuously at a lower dose, over weeks or months. This keeps a steady level of the drug in your bloodstream. You will receive the drug from a small infusion pump while you are at home. This is called ambulatory chemotherapy.

For some types of cancer, for example, lymphomas and leukaemias, cancer cells can pass into the cerebrospinal fluid (CSF) which surrounds the brain and spinal cord. Your doctor may prescribe intrathecal chemotherapy. This means that anti-cancer drugs will be given through a needle into the space around the spinal cord in your back. This procedure is called a lumbar puncture. Injecting chemotherapy into the spinal fluid can destroy any cancer cells that may be there and prevent cancer cells growing.

Where will I have my chemotherapy treatment?

Most patients receive their chemotherapy as outpatients or day patients, visiting the hospital on the day of treatment. Your length of stay in hospital will depend upon the type of tests, assessment, chemotherapy preparation and treatment you need. If you are a day patient, you are likely to be at the hospital between four and six hours, sometimes longer if the treatment is complex.

Before you are given your chemotherapy, you will usually have blood tests and see the doctor. As you may have to wait while your chemotherapy drugs are being prepared, you may want to bring someone with you or something to occupy you while you wait.

Sometimes you might need to stay in hospital overnight when treatment is first started or if several drugs and fluid infusions are to be given. In these circumstances, a 24–48 hour hospital stay is usually all that is needed. There are special treatments which require longer admissions and, if necessary, they will be explained to you.