For decades chemotherapy has been one of the main treatments used to fight cancer. Learn exactly what chemotherapy is, how it works, and what the treatment involves from a patient perspective, including side effects.

Chemotherapy involves using cytotoxic drugs to kill cancer cells. It can treat cancer cells anywhere in the body because it circulates in the blood. There are many types of chemotherapy drugs that can be given individually or in combination. Chemotherapy can also be used in conjunction with other treatments, including radiotherapy, hormone therapy and biological drug therapies.

Why chemotherapy?

Chemotherapy can be given for different reasons, depending on your cancer.

  • It can be used to destroy the cancer completely
  • It can be given before or after surgery or radiotherapy to ensure that cells that cannot be seen are killed, thus reducing the chance of the cancer returning
  • Where a cure is not possible, chemotherapy can be given to control the growth of the cells. This is known as palliative chemotherapy.

How is chemotherapy given?

Chemotherapy drugs are administered in various ways:

  • By injection, or infusion, into a vein (intravenous chemotherapy)
  • By injection into a muscle (intramuscular chemotherapy)
  • Under the skin (subcutaneous chemotherapy)
  • By injection into the fluid around the spinal chord (intrathecalchemotherapy)
  • Directly into a body cavity, e.g., the bladder (intracavity chemotherapy)
  • Orally as a tablet or capsule
  • Applied as a cream to the skin.

A lot of chemotherapy drugs can be given on an outpatient basis; however, some treatments require a stay in hospital.

Methods of injection

There are different ways of injecting chemotherapy into the bloodstream.

  • Cannula: the nurse or doctor inserts a very fine tube into the patient’s arm or hand and the chemotherapy is given through this. The cannula is usually removed on the same day.
  • PICC line (peripherally-inserted central catheter, also called Groshong): this is a flexible tube that is inserted into a vein in the arm and advanced up until the tip sits in the right atrium of the heart. This catheter can be left in position for a number of months.
  • Central line: inserted through the skin in the chest into a major vein, this line can also be left in place for a number of months.
  • Port (also known as a portacath): this has a small reservoir implanted under the skin; it does not have an external catheter. A needle is inserted into the reservoir and removed at the end of the treatment. The port can be used for as long as needed.

Life after chemotherapy

Many people are surprised at how long it takes to get back to normality after treatment. In fact, it can take at least a year for you to get over the effects of treatment. Don’t be in a rush to get back to your normal routine with work, just do as much as you are comfortable with.

You may feel very anxious after treatment. You may miss the regular contact with the people who looked after you in hospital or worry about the cancer coming back. There are support groups available that provide patients and family with information, advice and emotional support. Contact the National Cancer Helpline, freefone 1800 200 700 for more details.

Following you treatment you will have regular follow-up visits with your specialist. These will allow your doctor to check for signs of recurrence of the cancer, or follow up on any side effects you still have. Your doctor will also be able to check for signs of new side-effects that may develop after you have finished your treatment. In rare cases, some types of chemotherapy may cause long-term damage to the heart and lungs. There is also a slight risk of developing a second cancer because of the treatment. If you are between check-ups, therefore, and you have a symptom or problem that worries you, it’s very important to let your doctor know.