Chemotherapy is the use of medications to treat cancer. Depending on the type of cancer and its stage, the four main goals of chemotherapy are: to cure cancer, to keep cancer from spreading, to slow the growth of cancer, and to relieve cancer symptoms.
Chemotherapy helps destroy cancer cells by stopping them from growing and multiplying. It may be used along with radiation therapy, surgery, or both. More than one chemotherapy drug may be given at a time because some drugs work better together than alone. Your doctor will recommend the medications and dosage schedule appropriate for you. The decision depends on the kind of cancer you have, whether or not it has spread (metastasized) from its original site, the extent of its growth, and your general health.
How chemotherapy is given
Chemotherapy can be given in different ways. Some common methods include intravenous, oral, intramuscular, and intrathecal.
The intravenous route (IV) is a common way to put medicine directly into a vein. A small needle is inserted into one of the veins in the lower arm. Sometimes a syringe is used to push the chemotherapy through the tubing. This is called an IV push medication. When you receive chemotherapy through an IV, it's important to tell your nurse right away if there is any redness, burning, or discomfort in the IV area.
Central Venous Catheters
A more permanent type of catheter may be recommended to avoid repeated needle sticks into the vein. These permanent catheters are called central venous catheters or implanted ports. Central venous catheters are surgically inserted into one of the large central veins in the chest and stay in place until the therapy is completed. Chemotherapy, blood and IV fluids can be given through this catheter, and blood for lab tests can be drawn from this site. The tube will be capped and covered by a dressing, and your nurse will teach you how to care for the catheter to avoid infection.
An implanted port is round in shape and usually surgically inserted under the skin surface on the chest wall between the neck and shoulder or in the lower arm. To use the port, the nurse will insert a needle through the top skin surface to access the port. Chemotherapy, blood, and IV fluids can be given through this port, and blood can be drawn from the port. Home care is usually required only at initial insertion.
Other chemotherapy delivery methods include:
- Oral: This includes pills, capsules, or liquid taken by mouth.
- Intramuscular: An injection into the muscle.
- Intrathecal: Injecting chemotherapy medication into the spinal fluid through a spinal tap, because certain types of cancer have a tendency to spread to the central nervous system.
Treatment length and frequency
You may be treated in your doctor’s office, in the hospital, receive pills to take on a specific schedule at home, or receive drugs at home via an implanted pump. Your dosage schedule may last from a few weeks up to a year, with varying cycle frequency (once a week, once a month, or other intervals). If you are going to be treated as a hospital inpatient, we have specialized facilities and nurses to take care of you.
Feel free to bring reading materials or a hand-held electronic entertainment device to help pass the time while you are receiving treatment at the doctor’s office or as an outpatient at the hospital. Treatments are followed by rest cycles to give your body time to build healthy new cells and regain strength.
Your doctor may provide a list of instructions for care between chemotherapy cycles. Follow them carefully and stay focused on having a good outcome from treatment.
Inpatients will check-in at the hospital's front desk, where you will be directed to the oncology department on the fifth floor.
Outpatients will check-in at the hospital’s emergency entrance. Let the staff know you are here for infusion.
If you are an inpatient, we suggest you bring comfortable bedclothes, including a robe, pajamas or nightgown and slippers. You might wish to bring in your own books or magazines for entertainment and personal pillows for comfort. The most important item to bring is a list of your medications and nutritional supplements. Be sure to include the correct name, dosage and frequency. Please include any over-the- counter medications and herbs you take as well.
If you are an outpatient, you will normally be seated in a chair for your chemotherapy, unless you are told otherwise. Wear comfortable, non-binding clothing and bring in your own books, magazines, music, etc. for entertainment. You may invite an adult loved one to stay with you during your treatment.
Some, but not all, chemotherapy drugs may cause nausea and vomiting if you do not take any preventive measures. Your healthcare team knows which medications are likely to cause nausea and vomiting, and you may be prescribed additional anti-nausea medications to take before, during or after a chemotherapy treatment. We also give patients “angel mints” that help calm nausea.
Some treatments may cause hair loss on your head and other parts of the body. Generally your hair will grow back after treatment. Your doctor knows which treatments are likely to cause hair loss.
Chemotherapy is usually delivered systemically, so that both your healthy and cancerous tissues are exposed to the drug. Chemotherapy can be used this way because cancer cells are more vulnerable to treatment than healthy cells. However, your body’s healthy tissues need time to recover their strength.
Typically, you will receive an initial course of treatment, which will let the doctor know if the drug is effective against your cancer. Depending on your overall health afterward, you will receive additional courses necessary to destroy any remaining cancer cells in your body.