Chemotherapy and how it helps to fight cancer

Chemotherapy treatment ^{Footnote [2]} destroys cancer cells by damaging the way they grow and divide.  But, because it affects all rapidly dividing cells in the body, it also affects healthy cells, in particular cells that grow fast like hair and cells in your bowels.

There are many different chemotherapy drugs, and each of them has unique abilities that makes them good at fighting cancer. Which drugs you will be treated with depends on your diagnosis, how aggressive the cancer is and whether it has spread to other organs. You may be given one of these drugs, or several in combination. 

A course of chemotherapy treatment (regimen) will usually be given over several months in a series of cycles. Each cycle is made up of a day or multiple days of treatment depending upon the regimen. Following each cycle, you have a short break for your body to recover before starting the next cycle. 

Chemotherapy is just one form of cancer treatment, and it’s often used alongside other types. 

Your specialist will choose the most appropriate chemotherapy drugs for you and your condition. They will perform tests to understand the type of cancer you have; how aggressive it is and if it has spread to other organs in your body. They’ll also look at your overall health as chemotherapy drugs can affect your body. You’ll need to be fit enough to manage the side effects of the treatment they choose.

The tests they’ll do may include: ^{Footnote [2]}  

• Checking your overall health.
• Scanning and x-raying your body.
• Blood tests.

They’ll also need to weigh you and measure your height. This is so they can give you the correct dose of chemotherapy for the size of your body.

Finally, depending on the drugs you’ll be given, you may also need additional tests before starting treatment.

• A lung function test to check how well your lungs work.
• An electrocardiogram or ultrasound to check your heart.
• A blood test to check your liver and kidneys.
• Blood tests to check for viruses, as chemotherapy may weaken your immune system, predisposing you to some viral illnesses.
• A hearing test.

This is to ensure that your organs are healthy and able to withstand the treatment because chemotherapy can affect these organs.

The way in which your body responds to treatment is individual to you, so might differ from  those experienced by others. 

Common side effects can include: ^{Footnote [2]}  

• Hair loss or thinning. 
• Feeling and being sick. 
• Diarrhoea or constipation. 
• Difficulty thinking, a lack of concentration, and poor short-term memory. 
• Loss of hearing or tinnitus. 
• Pins and needles in your hands or feet. 
• An increased risk of infection.
• Difficulty breathing or problems with the rhythm of your heartbeat. 
• Some types of chemotherapy can also affect your fertility. If you want to have a child in the future, speak to your doctor before you start your treatment.

Your doctor will work with you to make any side effects as manageable as possible.

Chemotherapy is usually administered in a hospital, but depending upon your diagnosis, this could be as an inpatient, an outpatient or during a daypatient admission. It is also possible that you could have treatment at home, if your specialist agrees. Before each cycle of chemotherapy treatment, you will have blood tests to ensure you are well enough to receive treatment. 

If your blood tests show abnormalities, you may need to delay treatment. Depending on your side effects and how your blood has been affected by chemotherapy treatment, the dose of the drug, or the drug may change.

If your blood tests are fine, your doctor will prescribe your next cycle of treatment.

Chemotherapy drugs come in different forms, ^{Footnote [2]} and the drugs you are offered and the way in which you are treated will depend on your diagnosis and what medicines will work best for you.

Tablets and capsules

If you are offered this type of chemotherapy, you may be able to be treated at home, having blood tests and check-ups with the nursing team, if your specialist agrees.

A doctor or chemotherapy specialist nurse will explain how often and when to take the tablets. You should swallow them whole without crushing or chewing them.

Chemotherapy tablets and capsules can be dangerous as they contain strong drugs. To prevent the risk of anybody getting ill, you should:

• Ask anybody helping you to wear gloves.
• Only touch them when you need to.
• Wash your hands after touching them.
• Keep them away from children, pets, and anyone who is pregnant or planning to become pregnant soon.
• Take unused tablets or capsules back to the pharmacy. Do not throw them away or flush them down the toilet.

If you miss a dose or vomit after taking them, contact your doctor or specialist. 

Injection

Injections of chemotherapy under the skin (subcutaneous) or into the muscle (intramuscular) can usually be administered as an outpatient.  Injections into a vein (intravenous) are usually given during a day admission where a nurse inserts a needle (cannula) into the back of your hand or your arm and then slowly injects the drug (bolus) through a fast-running drip.

Drip or pump

Intravenous chemotherapy can also be administered from a bag of fluid which flows into your body through a vein.  The rate of the flow is controlled by a machine and can take from a few minutes to a few hours to complete.

Instead of a drip infusion, you might have a pump fitted that slowly administers chemotherapy over 24 – 48 hours. You’ll have this fitted at a hospital, but you’ll then be able to take it home and have your treatment there. A nurse may change or remove it for you at home, or you may need to return to hospital to have it changed or removed.

There are several different ways to administer intravenous chemotherapy, including:

• A cannula, which is put into your arm or hand. It can be securely taped down for safety, making it easier to give you a drip or several injection treatments.
• A central line is a tube that sits in a large vein close to your heart. If it’s only needed for a short while, it can be inserted through a vein in your neck. If it’s needed for longer, it is inserted through your chest and stitched in place so that it can be used for several months. You can go home with a central line.
• A portacath is a type of central line tube that is tunnelled away from the chest wall  under the skin, to make a convenient injection site through which chemotherapy drugs can be injected. 
• A PICC line, or Peripherally Inserted Central Catheter is a tube that is inserted in your arm and runs up to a vein in your chest. This can be left in place for several months.

Cream

If you have skin cancer, chemotherapy may be administered as a skin cream.

Intrathecal 

Intrathecal chemotherapy is administered via an injection into the fluid around the spinal cord. This  is used to treat disease within the central nervous system (brain and spine).

Intravesical 

Intravesical chemotherapy is administered via a urinary catheter inserted into your bladder. The drugs flow through the catheter and sit in the bladder for a set period of time.  The chemotherapy can then either be withdrawn back into the catheter bag, or the catheter can be removed, and you can pass the chemotherapy as you urinate.

Treatment with chemotherapy has various associated risks which your specialist will discuss with you so that you may provide informed consent.  For example, if you take Warfarin, you may need regular blood tests during and after your chemotherapy to monitor how easily your blood is clotting. 

You will also need regular blood sugar tests if you are diabetic and take steroids.  

Other associated risks can include mild, moderate, or severe side effects; complications of chemotherapy administration, for example, blood clots or extravasation (chemotherapy burn from leakage outside a vein) or a second primary cancer. 

If you’re worried about any of the risks of chemotherapy, speak to your doctor or nurse, so they can address your concerns and answer your questions. 

Recovery from chemotherapy is an individual experience. Different chemotherapy drugs can have different effects on the body, and people recover at different rates.  

Some people may still have side effects and feel tired for months or years after chemotherapy, so it may take a while before you feel ready to return to work or resume responsibilities and/or hobbies. Remember to be kind to yourself and take things as slowly as you need to. Recovery takes time, and it’s different for everyone. Remember that many people find their way back to doing the things they love.

You could claim for chemotherapy treatment using your health insurance cover. The first step is to get a referral from your specialist. Then you can make a claim through MyAviva, online or over the phone.

If we confirm that your claim is eligible, we’ll pay for the treatment directly subject to policy terms and conditions. Just be sure to tell us if you need more tests or change treatment hospital or specialist.

It’s good to have one less thing to worry about. It takes Aviva.