Chemotherapy is the use of one or more anti-cancer drugs (called cytotoxics) to kill or slow the rate of growth of cancer cells.
Most chemotherapy drugs travel through the bloodstream to target rapidly dividing cells. Unfortunately, chemotherapy drugs cannot target only cancer cells and some normal cells will be affected. However, normal cells recover more quickly than cancer cells, allowing for more cancer cells to be damaged with every treatment.
What is chemotherapy used for?
- As a cure. Chemotherapy can be used alone or alongside other treatments to cure some cancers.
- As a secondary treatment. Chemotherapy can be used before or after a primary treatment.
- Before primary treatment (neo-adjuvant therapy). Chemotherapy can be used to make the cancer smaller before other primary treatments such as surgery or radiotherapy.
- After primary treatment (adjuvant therapy). Chemotherapy can be used to treat any remaining cancer cells that are left after other treatments.
- To control cancer. Chemotherapy can be used to control and slow the growth of cancers for extended periods of time.
- For symptomatic relief. Chemotherapy can be used to treat the symptoms and pain of cancers that cannot be cured. This is called palliative treatment.
How is chemotherapy given?
The type, length and frequency of your chemotherapy differs greatly between patients and is dependent on the type of cancer you have, the drugs used for treatment and the purpose of your chemotherapy.
Usually chemotherapy is given as a period of treatment followed by a break. This is called a cycle of treatment. The rest periods in between the courses allow for the healthy cells to repair themselves and the body to recover from any side effects.The number of treatments and their frequency will depend upon the type of cancer you have and the drugs you require. The length of your treatment will depend on how the cancer responds to the drugs and may take several months. Treatments could be given daily, weekly or even monthly within a cycle. Common types of chemotherapy include the following.
The most common way to receive chemotherapy is through a liquid drip into your vein. Most patients receive chemotherapy as an outpatient in Day Therapy. Although, some patients might receive their chemotherapy on the ward or even at home by a portable pump, especially if the therapy is administered continuously over a number of days.
There are two ways to receive intravenous chemotherapy. They may use the veins in your arms or a device known as a central venous catheter which is placed into one of the large veins in your chest and remains in until your course of treatment is complete. Having these inserted feels similar to having a blood test or an injection.
Chemotherapy itself can take anywhere between 20 minutes and several hours to administer, depending on what kind of treatment you are having. Generally your treatments will be a few hours long and you may have to wait for appointments before or after your treatment so make sure you allow more time than your treatment is expected to take.
Some chemotherapy treatment can be given by oral tablets or capsules that the patient takes at home.Your treating team, including your doctor, pharmacist and nurse, will closely monitor your oral chemo to ensure tablets are taken at the right time and handled correctly.
Chemotherapy creams can be used topically to treat some skin cancers and are generally administered by the patients themselves.
Chemotherapy can be injected to different parts of the body including into a muscle, under the skin, into the fluid around the spine (lumbar puncture), into an artery, into the abdomen, into the lining of the lung, into the bladder or even directly into a tumour. Injections are less common than other chemotherapy treatments.
High-dose chemotherapy is used in conjunction with bone marrow and stem cell transplants, which are used to treat some blood cancers. High-dose chemotherapy is used to kill the cancer cells in the blood before the patients own healthy cells, or cells from a healthy donor, are transplanted back in the days following chemotherapy.
Chemotherapy and radiation therapy are sometimes given together to treat certain cancers.
What does Chemotherapy feel like?
Chemotherapy should not be painful ; however you may have a cold feeling while the chemotherapy goes into the vein because the chemotherapy fluid is cooler than your blood. If at any time you feel any tingling, burning or pain where the chemotherapy is going into your vein, let your nurse know straight away.
Unfortunately chemotherapy cannot target only diseased cells and some normal cells will also be damaged. This may cause a range of side effects. Some patients will experience many side effects and some patients may experience none.
Your treating team will be able to give you some idea of what symptoms you may expect, but this will just be a guide. The side effects experienced are dependent on the type and dose of chemotherapy you are receiving, the cancer type, other treatments and medications and the individual.
For more information about the side-effects of treatment, please visit our treatment related side-effects page.
Who can I call for help?
You can speak to medical or nursing staff 24 hours a day, seven days a week at Peter Mac.
Monday to Friday, between 8 am and 6 pm, call: Day Therapy on (03) 8559 5330
Outside these hours (evenings, weekends and public holidays), call: (03) 8559 5000 and ask for the Patient Services Manager
Please have your hospital PUR number ready when you call the hospital.
Cancer Council’s 13 11 20 is open Monday to Friday, 9 am to 5 pm, and staffed by experienced cancer nurses who can support those affected by cancer, their carers and loved ones by providing emotional and practical support.
This is a service run by Cancer Council Victoria.
When to contact the hospital urgently
If it is a medical emergency call 000
If you have any of the following symptoms please contact Peter Mac straight away and ask for the registrar on call, on (03) 8559 5000:
- a temperature over 38˚C or fever and chills (these might indicate an infection)
- diarrhoea that continues over 24 hours, particularly if watery
- persistent vomiting that lasts more than 24 hours or nausea lasting more than 48 hours despite taking antinausea
- any abnormal bruising and bleeding
- constipation: if you have not opened your bowels for more than two days
- a cough or shortness of breath
- a sudden decline in your health.
- Any changes in mood including feeling withdrawn, depressed or anxious
Level 3, 3C Day Therapy
Peter MacCallum Cancer Centre
305 Grattan Street
Melbourne VIC 3000
Phone: 03 8559 5308
This information has been adapted from the Cancer Councils 'Understanding Chemotherapy - A guide for people with cancer, their families and friends'.