Which Drugs Will I Get?
Your doctor decides which drug or drugs will work best for you. The
decision depends on what kind of cancer you have, where it is, the extent
of its growth, how it is affecting your normal body functions, and your
general health.
Your doctor also may suggest that you join a clinical trial for
chemotherapy, or you may want to bring up this option with your doctor.
Clinical trials are carefully designed research studies that test
promising new cancer treatments. Patients who take part in research may be
the first to benefit from improved treatment methods. These patients also
can make an important contribution to medical care because the results of
the studies may help many people. Patients participate in clinical trials
only if they choose to and are free to withdraw at any time.
To learn more about clinical trials, call the National Cancer
Institute's Cancer Information Service and ask for the booklet "What
Are Clinical Trials All About?" You also may want to ask about the
video "Patient to Patient: Cancer Clinical Trials and You." This
videotape can put to rest fears you may have about taking part in clinical
trials. The Cancer Information Service can be reached by dialing 1-800-4-CANCER
(1-800- 422-6237).
Where Will I Get Chemotherapy?
You may get your chemotherapy at home, in your doctor's office, in a
clinic, in your hospital's outpatient department, or in a hospital. The
choice of where you get chemotherapy depends on which drug or drugs you
are getting, your hospital's policies, and your doctor's preferences. When
you first start chemotherapy, you may need to stay at the hospital for a
short time so that your doctor can watch the medicine's effects closely
and make any adjustments that are needed.
How Often Will I Get Chemotherapy, and How Long
Will I Get It?
How often--and for how long--you get chemotherapy depends on the kind
of cancer you have, the goals of the treatment, the drugs that are used,
and how your body responds to them. You may get chemotherapy every day,
every week, or every month. Chemotherapy is often given in on-and-off
cycles that include rest periods so that your body has a chance to build
healthy new cells and regain its strength. Your doctor should be able to
estimate how long you will be getting chemotherapy.
Whatever schedule your doctor prescribes, it is very important to stay
with it. Otherwise, the anticancer drugs might not have their desired
effect. If you miss a treatment session or skip a dose of medication,
contact your doctor for instructions about what to do.
Sometimes, your doctor may delay a treatment based on the results of
certain blood tests. Your doctor will let you know what to do during this
time and when it's okay to start your treatment sessions again.
How Will I Get Chemotherapy?
Depending on the type of cancer you have and the drug or drugs you are
getting, your chemotherapy may be given in one or more of the following
ways:
- Into a vein (intravenously, or IV). You will get the drug through a
thin needle inserted into a vein, usually on your hand or lower arm.
Another way to get IV chemotherapy is by means of a catheter, a thin
tube that is placed into a large vein in your body and remains there
as long as it is needed. This type of catheter is known as a central
venous catheter. Sometimes, a central venous catheter is attached to a
port, a small plastic or metal container placed surgically under the
skin.
- By mouth (orally, or PO) in pill, capsule, or liquid form. You will
swallow the drug, just as you do many other medications.
- Into a muscle (intramuscularly, or IM), under the skin (subcutaneously,
or SQ or SC), or directly into a cancerous area in the skin (intralesionally,
or IL). You will get an injection with a needle.
- Topically. The medication will be applied onto the skin.
Chemotherapy also may be delivered to specific areas of the body using
a catheter. Catheters may be placed into the spinal fluid, abdominal
cavity, bladder, or liver. Your doctor or nurse may use specific terms
when talking about certain types of catheters. For example, an intrathecal
(IT) catheter is used to deliver drugs into the spinal fluid.
Intracavitary (IC) catheters can be placed in the abdomen, pelvis, or
chest.
Two kinds of pumps--external and internal--may be used to control the
rate of delivery of chemotherapy. External pumps remain outside of the
body. Some are portable and allow a person to move around while the pump
is in use. Other external pumps are not portable and may restrict
activity. Internal pumps are placed surgically inside the body, usually
right under the skin. They contain a small reservoir (storage area) that
delivers the drugs into the catheter. Internal pumps allow people to go
about most of their daily activities.
Does Chemotherapy Hurt?
Getting chemotherapy by mouth, on the skin, or by injection generally
feels the same as taking other medications by these methods. Having an IV
usually feels like having blood drawn for a blood test. Some people feel a
coolness or other unusual sensation in the area of the injection when the
IV is started. Report these feelings to your doctor or nurse. Be sure that
you also report any pain, burning, or discomfort that occurs during or
after an IV treatment.
Many people have little or no trouble having the IV needle in their
hand or lower arm. However, if a person has a hard time for any reason, or
if it becomes difficult to insert the needle into a vein for each
treatment, it may be possible to use a central venous catheter or port.
This avoids repeated insertion of the needle into the vein.
Central venous catheters and ports cause no pain or discomfort if they
are properly placed and cared for, although a person usually is aware that
they are there. It is important to report any pain or discomfort with a
catheter or port to your doctor or nurse.
Can I Take Other Medicines While I Am Getting
Chemotherapy?
Some medicines may interfere with the effects of your chemotherapy.
That is why you should take a list of all your medications to your doctor
before you start chemotherapy. Your list should include the name of each
drug, how often you take it, the reason you take it, and the dose.
Remember to include over-the-counter drugs such as laxatives, cold pills,
pain relievers, and vitamins. Your doctor will tell you if you should stop
taking any of these medications before you start chemotherapy. After your
treatments begin, be sure to check with your doctor before taking any new
medicines or stopping the ones you already are taking.
Will I Be Able To Work During Chemotherapy?
Most people are able to continue working while they are being treated
with anticancer drugs. It may be possible to schedule your treatments late
in the day or right before the weekend, so they interfere with work as
little as possible.
If your chemotherapy makes you very tired, you might want to think
about adjusting your work schedule for a while. Speak with your employer
about your needs and wishes at this time. You may be able to agree on a
part-time schedule, or perhaps you can do some of your work at home.
Under Federal and state laws, some employers may be required to allow
you to work a flexible schedule to meet your treatment needs. To find out
about your on-the-job protections, check with your local American Cancer
Society, a social worker, or your congressional or state representative.
The National Cancer Institute's publication "Facing Forward: A Guide
for Cancer Survivors" also has information on work-related concerns.
How Will I Know If My Chemotherapy Is Working?
Your doctor and nurse will use several methods to measure how well your
treatments are working. You will have frequent physical exams, blood
tests, scans, and x-rays. Don't hesitate to ask the doctor about the test
results and what they show about your progress.
While tests and exams can tell a lot about how chemotherapy is working,
side effects tell very little. (Side effects--such as nausea or hair
loss--occur because chemotherapy harms some normal cells as well as cancer
cells.) Sometimes people think that if they don't have side effects, the
drugs aren't working, or that, if they do have side effects, the drugs are
not working well. But side effects vary so much from person to person, and
from drug to drug, that having them or not having them usually isn't a
sign of whether the treatment is effective.
If you do have side effects, there is a lot you can do to help relieve
them. The next section of this booklet describes some of the most common
side effects of chemotherapy and gives you some hints for coping with
them.
Cancer Information Search Ends Here
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