Chemotherapy

Information

HOW CHEMOTHERAPY IS GIVEN

Depending on the type of cancer and where it is found, chemotherapy may be given in a number of different ways, including:

• Injections or shots into the muscles
• Injections or shots under the skin
• Into an artery
• Into a vein (intravenous, IV)
• Pills taken by mouth
• Shots into the fluid around the spinal cord or brain

When chemotherapy is given over a longer period of time, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery.

There are many types of catheters, including:

• Central venous catheter
• Central venous catheter with a port
• Percutaneously inserted central catheter (PICC)

Different chemotherapy drugs may be given at the same time or after each other. Patients may receive radiation therapy before, after, or while they are getting chemotherapy.

Chemotherapy is most often given in cycles. These cycles may last one day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose.

Often, the chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicines and IVs. Patients and their family members will receive special training.

SIDE EFFECTS OF CHEMOTHERAPY

Because these medicines travel through the blood to the entire body, chemotherapy is described as a body-wide (systemic) treatment.

As a result, chemotherapy may damage or kill some normal cells, such as those found in the bone marrow, hair, and the lining of the digestive tract.

When this damage occurs, there can be side effects. Some people who receive chemotherapy:

• Are more likely to have infections
• Become tired more easily
• Bleed too much, even during everyday activities
• Feel pain from damage to the nerves
• Have a dry mouth, mouth sores, or swelling in the mouth
• Have a poor appetite or lose weight
• Have an upset stomach, vomiting, or diarrhea
• Lose their hair

Side effects of chemotherapy depend on many things, including the type of cancer, and which drugs are being used. Each patient reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer side effects.

Your doctor and nurse will explain what you can do at home to prevent or treat side effects, such as:

• Being careful with pets and other animals to avoid catching infections from them
• Eating enough calories and protein to keep your weight up
• Preventing bleeding, and what to do if bleeding occurs
• Practicing safe eating and drinking habits            
• Washing your hands often with soap and water

You will need to have follow-up visits with your doctor and nurse during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to:

• Monitor how well the chemotherapy is working
• Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body

References

Perry MC. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 182.

Update Date: 6/5/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.