Your care team
Many hospitals use multi-disciplinary teams (MDTs) to provide chemotherapy treatment.
MDTs are teams of specialists that work together. Members of your MDT may include a:
- medical oncologist – a specialist in the non-surgical treatment of cancer using techniques such as radiotherapy and chemotherapy
- pathologist – a specialist in diseased tissue
- haematologist – a blood specialist
- psychologist – who can provide support and advice about the psychological and emotional impact of chemotherapy
- clinical nurse specialist (CNS) – who will offer you support throughout your care, from diagnosis.
As well as having a specialist MDT, you may also be assigned a key worker (this is often the CNS). You will be given their details so that you can get in touch with your team at any point during your treatment. They will also be involved in coordinating your care.
Deciding what treatment is best for you can often be confusing. Your care team will recommend what they think is the best treatment option, but the final decision will be yours.
Before going to hospital to discuss your treatment options, you may find it useful to write a list of questions to ask the doctor in charge of your care.
For example, you may want to find out:
- what the purpose of your chemotherapy is – for example, whether it’s being used to cure your cancer, relieve your symptoms or make other treatments more effective
- what side effects you’re likely to experience and whether anything can be done to prevent or relieve them
- how effective the chemotherapy is likely to be at curing your cancer or at least slowing it down
- whether any alternative treatments can be used instead of chemotherapy
Blood tests
Before chemotherapy begins, you will need to have a number of blood tests to assess your health and to make sure you can cope with any side effects.
Blood tests are useful for assessing the health of your liver and kidneys. This is important because chemotherapy medications will pass through your liver and kidneys, where they will be broken down. The medication can harm the liver. Therefore, if you have liver damage, it may not be suitable for you until your liver and kidneys have recovered.
Another important role of blood testing is to assess your blood count. This is a measurement of how many blood cells you have.
There are three types of blood cell:
- red blood cells – which carry oxygen around your body
- white blood cells – which help fight infection
- platelets – which help the blood to clot (thicken)
Chemotherapy reduces the number of all three types of blood cells.
If you have a low blood count, treatment may be delayed until your blood count has returned to normal. Alternatively, medication can be used to raise your blood count. In some cases, a blood transfusion may be required.
You will have regular blood tests during your chemotherapy so that your liver, kidneys and blood count can be carefully monitored.
You may also need other tests to check how well the cancer is responding to treatment. The tests you require will depend on the type of cancer you have.
Types of chemotherapy
Chemotherapy is usually given in one of two ways:
- as a tablet – which is known as oral chemotherapy
- injected directly into a vein – which is known as intravenous chemotherapy
The type of chemotherapy you have will depend on the type of cancer and how advanced it is.
Oral chemotherapy
If you are in good health, you may be able to take your tablets at home. However, you will still need to go to hospital for regular check-ups.
It is very important that you only take your tablets on the days specified in your chemotherapy protocol. If you forget to take a tablet, contact your care team for advice. Also contact your care team if you are sick shortly after taking a tablet.
Intravenous chemotherapy
A number of different devices can be used to give chemotherapy medication into a vein.
The type of device used will often depend on the type of cancer you have and your general health. You may be able to choose which device you have, although this is not always possible.
Intravenous chemotherapy is not like having a vaccine, where you are given one quick injection. Instead, chemotherapy medications are slowly released into a vein over a period of time. The time it takes to give one dose can range from several hours to several days.
Occasionally, some people need a continuous low dose of chemotherapy medication over several weeks or months. If this is the case, you may be given a small portable pump that you can take home with you.
The devices used for intravenous chemotherapy are described below.
Cannula
A cannula is a small tube that is placed into a vein on the back of your hand or lower arm. Chemotherapy medication is slowly injected through the tube into your vein. Once the dose of medication has been delivered, the tube can be removed.
Skin-tunnelled catheter
A skin-tunnelled catheter is a fine tube that is inserted into your chest and connected to one of the veins near your heart. The catheter can be left in place for several weeks or months, so that you do not have to have repeated injections. The catheter can also be used to carry out blood tests.
Peripherally inserted central catheter
A peripherally inserted central catheter (PICC) is similar to a skin-tunnelled catheter except the tube is connected to your arm rather than your chest.
Implanted port
An implanted port is a chamber that can be inserted under your skin and connected to a nearby vein. A special needle is placed into the chamber and connected to a drip or used for blood tests.
Other medication
If you are having chemotherapy, check with your care team before you take any other medication, including over-the-counter (OTC) medicines and herbal remedies. Other medication could react unpredictably with your chemotherapy medication.
Pregnancy
You should avoid becoming pregnant while having chemotherapy. This is because many medications used in chemotherapy can cause birth defects.
You will need to use a barrier method of contraception, such as condoms, while having chemotherapy and for a year after your treatment has finished.
Contact your care team immediately if you think you may have become pregnant while having chemotherapy.
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How chemotherapy is performed
