Chemotherapy

Chemotherapy, often called chemo, refers to the medications used to treat cancer. These medicines stop cancerous cells from growing or multiplying. Unlike radiation, the medicines travel throughout the body rather than targeting a specific area. Most patients receive chemotherapy in our Outpatient Cancer Center and do not need to stay overnight. Not all people with cancer receive chemotherapy.

Because some medicines work better when combined with others, chemotherapy often consists of more than one medication. Combination chemotherapy is often referred to as a regimen. Chemotherapy can be given by mouth, through an IV or placed into a body cavity such as the bladder. Most chemotherapy is given by IV. Sometimes, the doctor requests that the patient receive chemotherapy through a central line that remains in place until treatment is entirely complete.

Dosage and Frequency

Chemotherapy dosage and frequency may vary depending on the type of cancer, treatment goals and other factors. Sometimes, chemo is given before surgery to shrink the tumor and make it easier to remove. If chemo is required after surgery, the patient will have time to heal first.

It’s normal to feel anxious about chemotherapy treatments, especially in the beginning. Over time, the body’s response becomes routine, making the treatment easier to handle. Because cancer cells grow and divide rapidly, chemo medicines kill fast-growing cells. However, certain normal, healthy cells also multiply quickly, and chemotherapy can affect those cells, too, resulting in many side effects.

Side Effects

Because chemotherapy medicines can affect healthy cells in the digestive tract, hair follicles and blood cells forming in the bone marrow, the most common side effects include nausea and vomiting, mouth sores, hair loss, fatigue, infection, anemia and bleeding. Certain chemotherapy medications can damage the heart, kidney, bladder, lungs and nervous system cells. Your oncologist may refer you to another specialist, such as a cardiologist or pulmonologist, who can monitor these areas.

All chemo medicines work differently. The healthcare team provides patients with information about the side effects for each medicine they receive. It is important to report severe side effects right away.

Home Chemotherapy Safety

Receiving chemotherapy at home is sometimes an option. Because the medicines are toxic, it is important to follow safety precautions.

Safety Precautions

• Keep all medications out of the reach of children and pets.
• Label all medications accurately and in a way that shows they are hazardous.
• Store medicines in a moisture-free, temperature-controlled place.
• Wear gloves when opening oral chemo medications. (Applies to caregivers, too).
• Abstain from sexual contact or use latex condoms during sex for the first 48 hours after treatment.

Caregiver Precautions

For the first 48 hours after a chemotherapy treatment, anyone handling blood, urine, vomit or other bodily fluids should:

• Flush the toilet twice with the toilet lid down to avoid splashing.
• Machine-wash linens and cloth diapers twice in hot water with regular detergent. Wash those items separately from other laundry.
• Place soiled disposable diapers in a disposal bag marked “Hazardous Waste.” Put the bag inside a plastic garbage bag along with any other hazardous waste.

Central Lines (Catheters)

If your treatment plan includes chemotherapy, the doctor may request a central line. Central lines are connected to the superior vena cava, or SVC, the body’s largest vein. The SVC carries blood through the body. By placing a central line, medications can be diluted in the blood with less irritation and damage to veins. Central lines also are often used to draw blood for lab tests.

Types of Central Lines

• Peripherally-inserted central catheters (PICC). A PICC line is similar to an IV catheter. It is threaded up the arm to the chest and into the SVC. Part of the line protrudes from the skin at the insertion site and must be covered with a special dressing.
• Implanted venous port (port-a-cath). A surgeon or other specially-trained physician places the port-a-cath, or port, under the skin while the patient is under anesthesia. The port has a reservoir and catheter, which extends into the SVC. When not in use, the port looks like a bump under the skin. A specially-trained nurse accesses this device with a needle for each intermittent use.
• Groshong and Hickman catheters. A surgeon places these catheters while the patient is under anesthesia. The lines extend from the chest and are covered with a dressing. These catheters are not used often.

Your doctor determines which line is most appropriate based on the treatment plan and lifestyle.