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CHEMOTHERAPY

An Overview

RelaxationChemotherapy agents are used as one type of treatment for Cancer . Chemotherapy can be administered in a number of ways , however the primary route of administration in the Chemotherapy Day Centre is intravenous, into the vein. There are many varied types of cancer and because of this not all people will receive the exact same type of Chemotherapy. Through clinical trials it has been identified that certain types of Cancer respond better to different types of Chemotherapy.

It is simplest definition, Chemotherapy is an agent that is given with the intention of stopping cell growth. Cancer cells and normal healthy cells are affected by Chemotherapy as the agents used are unable to differentiate between healthy and malignant cells.

Chemotherapy is usually administered as a course over a period of several weeks or months. Following each course you may be given a rest period to allow your body to recover fully from the side effects of the treatment. Before each cycle of treatment it may be necessary for you to have a blood test which the Nursing staff of the Chemotherapy Day Centre will review prior to administering your treatment. This blood test will allow the nursing staff to confirm that your body has recovered enough from the previous treatment to proceed with the next treatment.

Chemotherapy side effects are unique to the type of drugs given and each individual patient. The nursing staff of the Chemotherapy Day Centre are happy to discuss side effects with you in detail on your treatment day.

Should you wish to visit the Chemotherapy Day Centre before your treatment , please feel free to do so, but we suggest a call to our department first . The Chemotherapy Day Centre can be contacted directly on

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On this page you will be able to find information on the following:

Introduction
Treatment Planning
Delivering Treatment
Chemotherapy Treatment
  Where is it given?
  How is it given?
  How often will it be given?
  Hormones
Side effects & how they can be reduced
  Nausea and Vomiting
  Mouth Ulcers
  Constipation
  Diarrhoea
  Hair Loss
  Infections and Fevers
Cost

Introduction

Chemotherapy is the use of drugs for the treatment of cancers. "Chemo" means drugs or medicines and "therapy" means treatment. Chemotherapy drugs are often called cytotoxic drugs - "cyto" means cells and "toxic" means capable of killing cells. It can be just one drug or several drugs, taken from a choice of about 50 different drugs available. Drug treatments prescribed by the medical oncologists could include hormone therapy. These are drugs that interfere with hormone production or hormone action. Immunotherapy is the use of treatments that promote or support the body's immune system response to a disease such as cancer.

Treatment Planning

Your doctor will take several factors into consideration when planning your treatment. The most important of these are the type of cancer you have, where in the body it is situated, how far it has spread (if at all), and your general health. This means you will find other patients at the hospital are having different chemotherapy. They will give the oncology nurses and pharmacists instructions about your treatment - which drugs, what dose of drugs and what pattern (regimen) of giving the drugs. In addition your oncologists will work out with other doctors how chemotherapy may be combined with other cancer treatment, particularly surgery and radiation.

Delivering Treatment

Chemotherapy is administered on an outpatient basis in the 'Chemo' Day Centre in the Cancer Therapy Centre. Depending on the drugs, the length of treatment could be anywhere from half an hour to 6 hours. Some patients will need to have their treatment as an inpatient in the Oncology/Haematology ward because it needs to run overnight or to monitor for particular side effects.

It will usually be necessary for you to have blood tests and to see the doctor before you are given your chemotherapy, and this will obviously all take time. On some occasions you may need x-rays or scans. All chemotherapy drugs are prepared in a special way and you may have to wait while the CTC pharmacy department prepares them. Patients may sometimes be asked to wait. To help pass the time, it can be helpful to take a book, newspaper, crossword or perhaps some letters to write. You can bring a relative or friend to sit with you whilst you receive treatment.

Chemotherapy is prescribed by a doctor called a Medical Oncologist or Haematologist. The chemotherapy is given by oncology nurses in the Cancer Day Centre or the Oncology/Haematology ward. This will often involve the nurse setting up a drip and using a cannula to access a vein in the patient's arm. Please feel free to ask the oncology nursing staff any questions about your chemotherapy they can also provide information about side effects.

Chemotherapy may be given by different routes, depending on the type of cancer you have and the drugs used. Most often it is given by injection into a vein (intravenously). When chemotherapy is given via an infusion pump it can be given continuously over a period varying from several days to several weeks. Less commonly used ways are by mouth (orally) or injection into a muscle (intramuscularly) or under the skin (subcutaneously). Some patients on oral chemotherapy take smaller doses of chemotherapy daily for several weeks or months, before they have a rest period. In special cases chemotherapy may be injected into the fluid around the spine (intrathecally). Sometimes, two or more routes may be used together. Whichever way the drugs are given, they are absorbed into the blood and carried around the body so they can reach all the cancer cells.

Chemotherapy is usually given as a course of several sessions of treatment. Depending on the drug or drugs given, each session is usually followed by a rest period of a few weeks, which allows your body to recover from any side effects of the treatment. It may take several months to complete all the chemotherapy needed for the treatment of your cancer.

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Chemotherapy Treatment

Treatments for cancer depend on where the cancer is situated in your body and the opinion of your specialist as to what is the best treatment. This could include surgery, radiation, chemotherapy or hormone treatment. These cancer treatments may be used to cure the cancer. If your surgeon has completely removed the cancer, extra adjuvant treatment may be recommended to reduce the risk of the cancer recurring. If the cancer is inoperable or has returned these treatments may be used to improve symptoms and quality of life. This is palliative treatment.

Cancer cells divide quicker than the normal cells in the body.

Chemotherapy is the use of chemicals to stop or slow the cancer cells from dividing. If the cancer cells slow down or are destroyed by the chemotherapy an individual cancer may stop growing or even disappear. Whether this can occur in an individual case needs to be discussed with the doctor looking after you. These treatments can have side-effects which are different for each treatment used

Where is it given?

Day only treatment can be given at the Cancer Therapy Centre's, or you may need to be in hospital for a period of a few days.

Liverpool Cancer
Therapy Centre

Elizabeth St
Liverpool NSW 2170
Southern Highlands
Diagnostic Centre

cnr Bowral & Holmhale St
Bowral NSW 2576
 
Macarthur Cancer
Therapy Centre

Therry Rd
Campbelltown NSW 2560
Bankstown Cancer Centre
Eldridge Road
Bankstown NSW 2200Therry Rd

these facilities provide ambulatory chemotherapy for patients within the South West and Southern Highland areas. Open 08:00 - 17:00 Monday to Friday. You need to discuss treatment locations with your doctor.

How is it given?

The chemicals can be tablets or injections given in a vein or under the skin. If it is given in the vein you will attend the Cancer Therapy Day Centre and you will sit in a treatment chair. The chemotherapy nurse will put a needle in your arm. Medication designed to lessen the feeling of sickness will be given in the vein and then the chemotherapy is given. When the treatment is finished the needle will be removed and you can go home.

How often will it be given?

The frequency and number of treatments vary. You need to discuss this with your doctor.

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Hormones

Hormones are naturally occurring substances in the body. They have many roles including growth of cells and helping cells divide. When hormones are used to treat cancer they can replace hormones that are missing or block the action of other hormones in the body.

Hormones are mostly tables taken daily. Some hormone treatment require an injection under the skin every month. Please ask your doctor how your hormone treatments will be given.

What are the side effects? How can they be reduced?

Not all chemotherapy drugs cause the same side effects, and some may have very few. Cancer treatments produce different reactions in different people and any reaction can vary from treatment to treatment. It may be helpful to remember that almost all side effects are only short term and will gradually disappear once the treatment has stopped.

The main areas of your body that may be affected by chemotherapy are those where normal cells rapidly divide and grow, such as your mouth, digestive system, skin, hair and bone marrow (the spongy material that fills the bones and produces new blood cells). The changes in your blood will be monitored by regular blood tests. Once of the more visible side effects may be hair loss. whether treatments will cause hair loss differs with the individual chemotherapy drugs. The Cancer Therapy Centre offers an excellent wig service and also the 'Look Good Feel Better' program which assists with appearance changes associated with treatment Chemotherapy can have a number of side-effects. Not everyone gets these. Your doctor will give you medicines to reduce the chances of these happening.

Nausea and Vomiting
You will receive injections before the chemotherapy to reduce the chances of feeling sick. You will also be given tablets and maybe suppositories to use if you feel sick after treatment. Eat small meals, and avoid spicy, fatty foods. Our dietitian can help.

Mouth Ulcers
Try to keep your mouth clean by brushing your teeth well. Rinsing your mouth with baking soda (bicarbonate of soda) reduces the risk of ulcers. Occasionally preparations can be bought 'over the counter' at the pharmacy to reduce pain. Please notify your doctor if you have problems swallowing or have fevers.

Constipation
Some chemotherapy will cause constipation. It is important to prevent this from happening. Changing your diet to include fruits, vegetable and fibre will help. Drinking fluid will also help. Occasionally your doctor may advise medications to soften the motions.

Diarrhoea
Some chemotherapy will cause diarrhoea. This can be improved with changing your diet, or your doctor may advise medications to help. If the diarrhoea is severe you may get very sick. It is important that you tell your doctor if the diarrhoea is not improving with treatment.

Hair Loss
Not all chemotherapy causes hair loss. Please ask your doctor if the drugs that you are receiving cause hair loss. You may lose hair from your head, but also eyebrows, eyelashes and other body hair. You can use make-up to help, our Look Good Feel Better program will tell you how. Our Wig Library at Liverpool can provide wigs and scarves to help. The hair will grow back when the chemotherapy stops.

Infections and Fevers
The body's immune system can be affected by chemotherapy. This makes you prone to infections and fevers. You can get sick and it is important that you tell your doctor if you develop fevers, shivering, chills or temperatures.

Cost

The procedure of giving Chemotherapy is covered by the Medicare System, whereby the Medical Oncologists charge the Medicare scheduled fee - there is no 'gap'. You will be required to sign a medicare form on the day you receive the chemotherapy, and you will be bulk-billed. If you do not sign your Medicare voucher on the day of treatment, you will receive an account from the Hospital. You will need to take this account to a Medicare office and deliver or post the Medicare cheque to: Billing Clerk, Cancer Therapy Centre, Locked Bag 7103, Liverpool, NSW, 1871.

The Chemotherapy drugs are available on prescription (like other drugs such as antibiotics, blood pressure or cholesterol tablets). The cost of this prescription depends on whether you have a pension or Health Care card or not. You will receive a bill for the prescription costs by the Pharmacy that fills out the prescription.

Privately insured patients do not pay a 'gap' payment for chemotherapy.

McBeath Patient Information Sheet

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Page last updated: 18 May, 2017