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Chemotherapy is usually given in an outpatient setting known as a chemotherapy day care. The day-care unit will cater for patients who are receiving infusions over a short duration (generally 2-6 hours). Chemo is administered in cycles depending on the type of cancer, the goal of treatment and the way the body is responding.

Chemotherapy treatments may be given daily, weekly or monthly but is usually given in 3 weekly cycles. Chemo treatment is given based on schedule and 3 weeks rest period is given that enables the normal cells in the repair and regain strength.

How is chemotherapy given ?

Mostly chemotherapy is given directly into the blood stream through an intravenous catheter. Intravenous drugs may be given in different ways:

• Direct IV (intravenous) push. Quick administration of chemo treatment through a syringe over a few minutes.
• Infusion therapy which can last from a few minutes to a few hours. This could be a combination of drugs which is given in a controlled infusion through a pump.
• Continuous infusion given through a pump can last from 1-7 days.

Continuous chemo treatment can damage veins, therefore, chemotherapy can be given through different methods. Central venous catheters are larger than IV catheters and therefore can be put in larger veins. This eliminates repeated poking due to intravenous catheter as the central venous catheters are indwelling for longer periods (6months – 1 year). There are different types of central venous catheters(chemoports) which are inserted either in the chest or arm.

Other Routes of chemotherapy administration

1. By mouth: chemo which is taken in a pill, capsule or even a liquid. It is important that the exact dose is taken at the right time.
2. Intrathecal (IT):     IT chemo is given in the spinal canal so that chemo can reach the brain and the spinal cord.
3. Intra-arterial: chemo is given directly into an artery which would be delivering blood to the tumor
4. Intracavitary: chemo drugs which are given into an enclosed area of the body such as the chest or abdomen.
5. Intramuscular: given directly into the muscle tissue
6. Intravesical: chemo which is injected into the bladder to treat bladder cancers
7. Topical: applied on the skin in the form of a cream, gel or ointment.

During and after (48 hours) of chemotherapy

• Nutrition is essential post chemotherapy. Small frequent feeds are required in order to help the body repair.
• Usually there may be nausea and vomiting for which the doctor will prescribe medicines.
• As much as possible the patient should return to his routine daily activities with adequate periods rest
• Patients must avoid any kind of contact sports in order prevent injury and bleeding.
• Flush the toilet twice after it is used. Always keep the cover down whenever flushing
• If contact with patients body fluid is necessary, caregiver should wear two gloves and must wash their hands carefully twice with soap
• Any clothes or linen which have body fluids on them must be washed in the washing machine.
• There can be hair loss as a side effect of chemotherapy which is usually reversible. The hair will start growing after the completion of chemotherapy.

Authored By : Dr. Shiva Kumar Uppala