What is chemotherapy?

Chemotherapy is a systemic anti-cancer therapy (SACT) which is used to treat cancer. Many types of medicines are used in chemotherapy, all of which attack cancer cells in different ways. For this reason, we often give several drugs in combination to increase the effectiveness of treatment. Chemotherapy can be used alone or with radiotherapy and/or surgery.

How does chemotherapy work?

The chemotherapy drugs, which can be given as an injection or as a tablet, circulate in the bloodstream and can affect cancer cells in all parts of the body. Cancer cells are rapidly producing other new cancer cells. Chemotherapy can interfere with the growth of cancers by preventing new cancer cells forming.

Side effects from chemotherapy can occur because normal tissues in the body also rapidly produce new cells as a way of repairing themselves. These processes can also be temporarily affected by the chemotherapy. The commonest normal tissues that are affected are the hair roots (causing hair loss), bone marrow (causing low blood counts) and lining of the bowel (causing diarrhoea, constipation, nausea and vomiting).

How often is treatment given?

This depends on the type of treatment you are having. In most cases, each chemotherapy treatment (or regime) is followed by a rest period of between 1 and 4 weeks. This is called a cycle.

Depending on your condition and the reason for giving treatment, the total duration of chemotherapy varies. Your specialist team will discuss the details of your treatment with you.

You can find out more about how we deliver chemotherapy on our chemotherapy patient journey page.

Benefits of treatment

The benefits of treatment will depend on the type of cancer you have and how advanced it is. The aims include:

curing the cancer. This is when chemotherapy is given to destroy all the cancer cells.
reducing the chances of the cancer coming back, for example after surgery, by destroying any cancer cells that are still in the body but are too small to detect. This is often called adjuvant chemotherapy.
controlling the growth and spread of the tumour so that surgery or radiotherapy is easier to perform. This is often called neo adjuvant chemotherapy.
controlling the growth and spread of the tumour which may slow down its progress and relieve symptoms. This is often called palliative treatment.

Are there any alternatives to chemotherapy?

All treatments carry risks as well as benefits and thinking about possible options can help you decide what to do. Your doctor will discuss alternative treatments with you.

These may include surgery, radiotherapy, immunotherapy, radiotherapy and chemotherapy given together or taking medicines to help with symptoms. It may also be an option to delay chemotherapy until symptoms occur.

What happens if you decide not to have chemotherapy?

There is a risk that your cancer may continue to grow and your symptoms may get worse. You can discuss what to do next with your doctor or your clinical nurse specialist.

How is chemotherapy given?

Chemotherapy can be given in different ways and your doctor will discuss the most appropriate option for you. This might include:

By mouth: as a tablet, capsule or liquid.
By injection: into a vein using a device called a cannula. Treatment can be administered by hand (intravenous bolus) or through a drip (intravenous infusion). Treatment can also be administered as an injection directly under your skin (sub cutaneously) or by injection directly into a muscle (intramuscular). This treatment is usually given by a chemotherapy nurse and is no more painful than any other injection or blood test.
Central lines: some patients may need a central line (a central venous catheter). This is a fine tube which is passed into a vein in the chest. Central lines are usually put in under local anaesthetic and you may be offered a sedative. The line can be used both to take blood and to give chemotherapy, and so reduces the need for needles.
PICC lines: PICC lines (peripherally inserted central catheters) are another type of central line placed in the arm and inserted under local anaesthetic. PICCs are mainly used for shorter periods of time or if people are not suited to other types of central lines.
TIVADs: A totally implantable vascular access device is a special type of central venous catheter. It is sometimes called a portacath®. A long hollow tube is inserted into one of the large veins in your body. One end of the tube sits in a vein, usually just above the heart, and the other end is attached to the injection port that sits underneath the skin on the chest. TIVADs are usually inserted under local anaesthetic but you may be offered sedation.
Infusion pumps: pumps are used to give an intravenous infusion of medicines over several hours or days. They are compact and easy to carry around – usually attached to a belt around the waist. This will require a central line.

Some treatments consist of a combination of injections and tablets. In these cases, each cycle usually starts with an injection and is followed by the tablets which are taken at home for a period of up to three weeks.

Occasionally, chemotherapy leaks outside the vein. This is called extravasation. With certain medicines, this can be quite serious. We will do our best to minimise this, but if you develop pain during the injection, or afterwards around the site of the injection, please let the staff know, or if you are at home, call The Christie Hotline on 0161 446 3658 immediately.