Chemotherapy

Chemotherapy is the name given to medicine which is used to kill cancer cells.These anti-cancer drugs are sometimes known as ‘cytotoxic drugs’. They are carried through the bloodstream and can reach the cancer cells wherever they are in your body. They work by disrupting the growth of these cells.

There are more than 50 chemotherapy drugs, and the choice depends on the type of cancer you have and how advanced it is. You may need several different drugs to treat your cancer. Once your specialist has decided on your treatment plan, they will let you know what drugs you will need and their particular side effects.

When is chemotherapy used as a treatment?

For some cancer types, chemotherapy on its own is the main treatment.

Chemotherapy is also used to:

  • Shrink the tumour before surgery or radiotherapy (known as neoadjuvant therapy)
  • Reduce the risk of the cancer coming back after surgery or radiotherapy (adjuvant therapy).

Some cancers, such as leukaemia, need chemotherapy because the cancer cells are in the blood and therefore all over the body. In other cases, when a solid tumour is removed with surgery, specialists may also prescribe chemotherapy to target any cancer cells that might be left.

How is chemotherapy given?

Not everyone has chemotherapy. If you do, it’s common to have intravenous chemotherapy (this means given directly into a vein). This can take a few hours or even several days. Chemotherapy can also be given as a liquid or tablet to take by mouth, or by injection into the muscle or under the skin. You might just have tablets, or you might have a combination of intravenous chemotherapy followed by tablets.

With some types of chemotherapy, you can go to the clinic, have your treatment, and then go home. Some chemotherapy can also be given at home. Other times, you have to stay in hospital.

Ways to have intravenous chemotherapy

Intravenous chemotherapy always involves inserting a thin tube (or ‘line’) into your vein, but this can be done in different ways:

  • Using a normal cannula, which is put into a vein in your hand or arm. These are usually put in specifically for each treatment, then removed immediately afterwards
  • Through a PICC line (peripherally inserted central catheter). This is inserted into one of the veins of your arm, then slid into the vein until the tip sits in a large vein just above the heart
  • Using a central line, which is a tube placed into a vein in your chest, usually the one that lies just under your collarbone. There are different types of central line. With a Hickman or Broviac line, the end of the tube is on the outside of your chest and is sealed with a cap. A portacath is located under your skin and accessed with a needle when it’s needed. The central line is put in place while you are under anaesthetic and can stay in place for weeks or months if necessary.

Chemotherapy is usually given in cycles. This means you have several days or weeks of treatment, then a rest period, then more treatment. The number of chemotherapy cycles you need will depend on your individual circumstances, such as the type of cancer you have, and how well it’s responding to treatment. Some people just have one cycle, while other people can have many.

For more information about these, see our side effects section.

Chemotherapy and contraception

If you are on the pill or use an implant, either for contraception or to control periods, discuss this with your care team as some methods of contraception may be less effective due to chemotherapy side effects (eg diarrhoea). It’s important not to become pregnant, or make someone pregnant, if you are having chemotherapy as it can affect an unborn baby.

Updated December 2014, next planned review 2017.

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