How is chemotherapy administered

Where you have chemotherapy Depending on the type of chemotherapy, people may have it in different places: in a chemotherapy day unit or outpatient clinic during a stay in hospital at home. Chemotherapy day units Chemotherapy drugs into a vein intravenous are usually given to you by nurses in a chemotherapy day unit. But you may have to wait: for blood tests results for your chemotherapy drugs to be prepared and checked to see your cancer doctor.

You can take things with you to help pass the time like a book, music or playing cards. Chemotherapy in hospital Some chemotherapy treatments are more complicated or take longer. Chemotherapy at home Sometimes, specialist chemotherapy nurses visit people at home to give intravenous chemotherapy. If you are having chemotherapy at home as tablets or through a pump, there are certain things to remember: Store your medicines safely Chemotherapy tablets, capsules or injections may need to be stored in a particular way, such as in the fridge.

Always follow the instructions given by your nurse or pharmacist. Be aware of other people at home Other people in your household should avoid direct contact with your chemotherapy drugs and avoid picking them up with bare hands.

All drugs must be stored out of the reach of children, as they could cause serious harm if taken by accident. Follow instructions if your pump leaks If you are having intravenous chemotherapy by pump and you notice the drug leaking from the pump or tube, you should close the clamps on the pump, wrap it in a plastic bag and wash your hands. Some hospitals provide a spill or leakage kit, which includes instructions on what to do if your pump leaks.

You should then contact the nurse or doctor at the hospital straight away. Keep your contact numbers close by If you feel unwell at any time of the day or night, use the contact numbers you have been given to get advice. Chemotherapy into a vein Chemotherapy drugs given into a vein intravenously can be delivered in different ways. It can be given through: a cannula — a short, thin tube put into a vein in your arm or the back of your hand a central line — a long, thin tube inserted into a vein in your chest a PICC peripherally inserted central venous catheter put into a vein in the arm and threaded through to a vein in the chest an implantable port portacath put into a vein, with an opening port under the skin on your chest or arm.

As an injection The chemotherapy drugs are injected directly into a vein through your cannula or central line over a few minutes. As a drip through pump The chemotherapy drugs are dissolved in a bag of fluid and given to you as a drip that runs through an infusion pump. As a drip on its own Sometimes chemotherapy is given through a drip without a pump. Through a small portable pump Some types of chemotherapy are given over a few days and are set up at the hospital, so you can go home with it.

If a chemotherapy drug leaks If a drug leaks into the area around the vein while being given, this is called extravasation. Other ways of having chemotherapy There are other ways you can have chemotherapy, apart from into a vein intravenously.

By mouth oral chemotherapy. It is very important to: read the labels on the drug boxes before you leave the hospital and speak to your nurse, doctor or pharmacist if any instructions are unclear take your drugs exactly as prescribed, because not taking them at the right times can affect how well treatment works contact your nurse or doctor at the hospital straight away for advice if you cannot take your medicines for any reason, are sick after taking them, or have forgotten to take a dose.

Injection into a muscle or skin. Some drugs are given by injection under the skin subcutaneous using a very fine needle. Injection into the spinal fluid intrathecal. Into a body space intracavitary Chemotherapy drugs can be given into a space cavity in the body.

Chemotherapy can be given into the following places: Into the bladder intravesical This is used to treat early bladder cancer. Liquid chemotherapy drugs are given directly into the bladder through a catheter, which is removed when it is over. We have more information about this treatment. Into the abdominal cavity This is very occasionally used to treat ovarian cancer or mesothelioma in the abdomen peritoneal mesothelioma.

Between the two layers of the pleura Chemotherapy is sometimes put in between the two layers of the pleura tissue that covers the outside of the lungs to treat cancer cells that have spread there. Oral drugs may provide greater ease of administration since patients can take them at home rather than going to a clinic or hospital for treatments.

Not all chemotherapy drugs are available in oral form. Furthermore, intravenous IV administration is sometimes preferable because the doctor can be more certain that the patient received the appropriate dose as scheduled and they can monitor the patient during administration. What is a venous access device VAD and what types are used for cancer patients? A VAD is a surgically implanted device that provides long-term access to a major vein. Although there are several different types of VADs, the two most commonly used for cancer treatment and taking blood samples are:.

A port-a-cath is implanted completely beneath the skin into a major vein under the collarbone. The port may then be accessed by a special needle through the skin to deliver chemotherapy, hydration, transfusions, and for taking blood samples. For some chemotherapy treatment plans, the inconvenience of implanting and accessing a VAD may outweigh the benefits.

You may wish to ask your doctor if a VAD is an appropriate option for you, especially if you experience any of the following:. Your VAD must be flushed in order for it to work properly. Flushing your VAD requires placing a needle in your port and flushing it out with heparin. Chemotherapy drugs can also cause side effects that don't become evident until months or years after treatment.

Late side effects vary depending on the chemotherapy drug but can include:. Ask your doctor if you have a risk of any late side effects. Ask what signs and symptoms you should be aware of that may signal a problem. How you prepare for chemotherapy depends on which drugs you'll receive and how they'll be administered. Your doctor will give you specific instructions to prepare for your chemotherapy treatments.

You may need to:. Make arrangements for help at home and at work. Most chemotherapy treatments are given in an outpatient clinic, which means most people are able to continue working and doing their usual activities during chemotherapy.

Your doctor can tell you in general how much the chemotherapy will affect your usual activities, but it's difficult to predict exactly how you'll feel. Ask your doctor if you'll need time off work or help around your home after treatment. Ask your doctor for the details of your chemotherapy treatments so that you can make arrangements for work, children, pets or other commitments. Prepare for your first treatment. Ask your doctor or chemotherapy nurses how to prepare for chemotherapy.

It may be helpful to arrive for your first chemotherapy treatment well rested. You might wish to eat a light meal beforehand in case your chemotherapy medications cause nausea. Page last reviewed: 29 January Next review due: 29 January Chemotherapy can be carried out in many different ways, depending on your circumstances. Before treatment starts Deciding to have treatment If you're diagnosed with cancer, you'll be cared for by a team of specialists.

For example, you may want to find out: what the aim of treatment is, for example, is it being used to cure the cancer, relieve your symptoms or make other treatments more effective about possible side effects and what can be done to prevent or relieve them how effective chemotherapy is likely to be whether any other treatments could be tried instead If you agree with your care team's recommendation, they'll start to plan your treatment once you've given your consent to treatment.

Tests and checks Before chemotherapy begins, you'll have tests to check your general health and make sure the treatment is suitable for you. The tests you'll have may include: blood tests to check things such as how well your liver and kidneys are working, and how many blood cells you have X-rays and scans to check the size of your cancer measurements of your height and weight to help your team work out the correct dose During treatment you'll also have tests to monitor your progress.

Your treatment plan Chemotherapy involves several treatment sessions, typically spread over a few months. Before treatment starts, your care team will make a plan that outlines: the type of chemotherapy you'll have how many treatment sessions you'll need how often you'll need treatment — after each treatment you'll have a break before the next session, to allow your body to recover Your treatment plan will depend on things such as the type of cancer you have and what the aim of treatment is.

Further information Cancer Research UK: planning chemotherapy Macmillan: planning your chemotherapy treatment How chemotherapy is given Into a vein intravenous chemotherapy In most cases, chemotherapy is given directly into a vein. This can be done using: a cannula — a small tube that's placed into a vein in the back of your hand or lower arm for a short time a peripherally inserted central catheter PICC line — a small tube inserted into a vein in your arm that usually stays in place for several weeks or months a central line — similar to a PICC, but inserted into your chest and connected to one of the veins near your heart an implanted port — a small device inserted under your skin that's kept in place until your treatment course finishes; medicine is given using a needle inserted into the device through the skin The time it takes to get a dose of intravenous chemotherapy can range from several hours to several days.

You usually go into hospital for the treatment and go home when it's finished.