Chemotherapy drugs can be administered in the following ways:

• Some drugs need to be fed into your body through a drip (intravenous infusion). The drugs are diluted in liquid and put into a bag, which is linked to a cannula (a fine tube) in your arm. The drugs move slowly through the tube and into your blood stream
• Injection through a cannula that is put into a vein and taped securely to your arm. The chemotherapy drugs are injected through the tube directly into your body
• Some chemotherapy drugs can be taken orally as tablets or capsules or may even be in a liquid form that you can drink
• By injection into a body cavity (lungs or bladder)
• Through a central feed line (a plastic tube temporarily linked to a vein in your chest)
• By injection into a muscle or under the skin
• Through a PICC (peripherally inserted central catheter) line, which is similar to a central line but goes into the arm near the elbow

How does chemotherapy work?

Cancer cells grow and divide more quickly than normal, healthy cells. When chemotherapy drugs are absorbed into your blood stream, they are carried to all parts of your body where there are fast-growing cells. When the drug arrives at its destination, it damages or kills the cancer cells and slows tumour growth.

A side-effect of chemotherapy is that it can also damage other, healthy cells which grow and divide rapidly. Commonly affected are hair root cells, cells of the mouth lining, bone marrow cells and the cells that line the bowel. On the positive side, normal cells have the ability to recover and repair themselves, so the damage is usually only temporary.

Why do I have to have chemotherapy?

Chemotherapy is normally used to try to cure cancer. Some cancers are cured by chemotherapy alone, but it is more usual for chemotherapy to be given before or after other treatments such as surgery and radiotherapy.

How will I receive my chemotherapy?

The administration of chemotherapy varies according to each individual, the type of treatment and your personal treatment plan.

Chemotherapy is usually administered in cycles of treatment. Patients may be given a course of chemotherapy drugs lasting up to six months, followed by a rest period where no treatment occurs.

The reason you have a period of rest is so your normal cells can repair themselves, while the cancer cells should die. Progress during treatment will be monitored by your oncologist to make sure the cancer is responding.

Chemotherapy can sometimes be administered to provide different forms of treatment:

• Radical chemotherapy is used as the main treatment and aims to cure the cancer without the need for any other treatments, such as radiotherapy or surgery
• Adjuvant chemotherapy is used in addition to surgery or radiotherapy to shrink a tumour or to reduce the chances of the cancer coming back
• Palliative chemotherapy is administered if the cancer has spread to other parts of the body. The aim is to relieve certain symptoms of cancer

Will I have chemotherapy in hospital?

Most people can have chemotherapy as an outpatient or a day patient, while others can receive treatment at home. If you go to hospital as a day patient, you may be there for around five or six hours, although this time can be shorter.

You should have someone to take you to hospital the first few times that you have chemotherapy, as you may feel sleepy or dizzy after treatments. Chemotherapy may sometimes involve a short stay in hospital.

Before chemotherapy can start you may have to undergo several tests:

• An electrocardiogram (ECG) test for your heart
• Liver function tests
• Kidney function tests

During your treatment cycle, a blood sample will be taken to check your levels of white cells, red cells and platelets before each dose of chemotherapy is given. Platelets and red and white blood cells are produced in the bone marrow, which can be affected by chemotherapy. Treatment may be delayed for a few weeks until your blood count returns to normal.

What will happen to me during treatment?

If your blood count is normal, your drugs will be prepared for you while you wait. You should know that this can take time, so be prepared - take a book or magazine to read. The nurse will wear protective gloves and an apron when the chemotherapy drugs are administered. If the drugs come into contact with skin, they can be harmful.

What are the side-effects of chemotherapy?

The side-effects of chemotherapy can vary dramatically between individual patients and depending on the type of drug you are prescribed. Some people suffer no, or few, side-effects. If you do have side-effects, you should talk to your specialist team to see if anything can be done to reduce them.

Common side-effects of chemotherapy:

• Tiredness
• Skin rashes
• Chemotherapy drugs can lower the immune system, which can make you more susceptible to infection. If you become ill, you must see your doctor immediately
• Sore mouth
• Nausea and vomiting
• Hair loss or thinning or brittle hair. You hair will grow back when treatment has finished, however
• Constipation or diarrhoea
• Skin sensitivity to sunlight (avoid strong sunlight)

Are there any long-term side-effects?

Chemotherapy can affect the heart and lungs and, rarely, a second cancer may form. Your specialist team should talk to you about the side-effects of the drugs you are taking.

Women may stop menstruating during chemotherapy treatment and a man's sperm count can be reduced. Men and women should delay having a baby for at least 12 months after treatment, or bank eggs and sperm just in case.

You must not breastfeed, as chemotherapy drugs can pass into your breast milk and would then be passed onto the baby.

What is life like after treatment?

Once your treatment has finished, most of the side-effects should begin to disappear. You may find it difficult to adjust back to normal life at first, both practically and emotionally, as you will no longer have the support network that the hospital provided. Taking small steps towards returning to your normal routine and getting support from friends and family can help you have more control over your life.

Infolinks:

• Cancer Research UK
• Cancer Backup
• Macmillan Cancer Support
• Marie Curie Cancer Care
• Cancer North Network