1. To destroy the cancer (combination chemotherapy). Chemotherapy can be used by itself or in combination with other treatments to cure many types of cancer.
2. To shrink a tumour before other treatments (neoadjuvant chemotherapy). Sometimes surgery or radiation therapy is more successful if chemotherapy is used first to reduce the size of the cancer tumour.
3. To destroy residual cancer cells after other treatments (adjuvant chemotherapy). Depending on the type of cancer, surgery and radiation therapy may not be able to remove all the cancer cells from the patient. Chemotherapy can be used as a follow-up to destroy any cancer cells that were missed.
4. To prepare the patient for a bone marrow or stem cell transplant (ablative chemotherapy). Some cancers can be treated with bone marrow or stem cell transplants from a donor. Before the transplants take place, the cancer patient’s original bone marrow is destroyed using high doses of chemotherapy drugs.
5. To relieve cancer symptoms (palliative chemotherapy). In some cases, chemotherapy can reduce the pain and other symptoms of cancer.

Chemotherapy treatment procedures

Most people receive chemotherapy drugs as outpatients. However, some people stay in hospital for treatment, most often when starting chemotherapy. The hospital staff might want to monitor the effects of the medication. This way, any reaction can be treated immediately.

How is chemotherapy given?

1. Orally

In a pill, liquid or gel form.

If you are taking chemotherapy drugs orally, you may be able to take them at work or at home. It is important that the patient takes the drugs as directed — to not do so could result in your treatment not working as well or could result in side effects that might not have happened otherwise.

Taking chemotherapy drugs orally is like taking any other medication orally. It is not painful.

There are a few simple instructions to follow:

• Always take the prescribed dose at the right time. If the prescription says to take the drug before or after meals, or with liquids, please do so.
• After you take the prescribed dose, wash your hands, especially if you touch the medication. Anyone helping you take the medication should not touch it. Your friend or family member should use a spoon or the container cap to give you the medication and then wash their hands right away. Chemotherapy drugs are very powerful medications. It would be hazardous for anyone else to ingest them.
• If you forget to take your dose, follow the instructions your healthcare providers have given you. You can always call them and ask what you should do.

If you are confused about any part of your treatment or have questions about what to do, make sure to call your doctor or other healthcare providers.

Asking questions is good and gives them the chance to help you.


2. By injection

Into a vein, into muscle or under skin with a needle.
 With this method of injection, the drugs can be given at your doctor’s office or at the Alberta Cancer Board outpatient clinics. Many patients can go home or back to work after their injection.

IV (intravenous) drip

Here the drug is given through the drip, often at a clinic, and the treatment can take anywhere from 15 minutes to several hours or even longer.

Neither the needle injection method nor IV drip should be painful. The injection feels like receiving a flu shot. The IV drip resembles giving blood.

Catheter
Sometimes inserting an IV is too difficult, so a catheter (a soft, flexible tube) is inserted into a large vein in one of your upper arms. The line can remain in your arm for as long as it is needed for your treatment.

Port-a-cath
Sometimes, instead of a catheter, a round, small metal or plastic disc (called a port), with a flexible tube attached, is inserted surgically into a large vein in the chest. The port goes under the skin. It also remains in place for the course of your treatment.

Usually, the catheter and port-a-cath are not painful to wear around. Your healthcare providers will tell you how to take care of either one.


Duration of Treatment

You might be wondering how long you will be receiving chemotherapy treatments for. The period of time varies. It depends on the type of cancer you have and how it is being treated. Please discuss your questions with your oncologist and your healthcare team.

Things to remember during treatment

• Provide your healthcare professional with a written list of any other medications you may be taking, including prescription drugs, vitamin or mineral supplements, over-the-counter drugs and any herbal medications or alternative therapies.
• Advise your healthcare team if you feel pain or burning during an IV injection.
• Wash your hands if you touch your medication. Make sure that no one else touches it or ingests it.
• Ask your healthcare team for advice if you forget a medication dose, miss a treatment or have any other concerns or questions.

What happens after the treatments are finished?

Although patients are usually relieved when chemotherapy is over, it’s common for people to have concerns about what comes next. Are they healed? Is there more treatment? Are there long-term effects from treatment?

You healthcare team will let you know if you require any further treatment and if you require follow-up care. Follow-up care depends on the following:

• your type of cancer
• when it was diagnosed
• how successful the chemotherapy was in treating the cancer
• your overall health and age

The healthcare team will assess how you are recovering from any treatment side effects. They will also monitor your progress by physical exams, blood tests and other imaging tests.

The schedule of follow-up visits is different for each person. Your family doctor or oncologist will monitor your health to check that the cancer has not returned.

Again, please discuss any questions with your doctor and healthcare team. They are happy to help you and to try to make this difficult time easier.