Chemotherapy

The term chemotherapy is used to mean cytotoxic (i.e. toxic to cells, including cancer cells) drug treatment. It works by affecting the DNA of cancer cells and enables the patients natural defence systems to hopefully eradicate the cancer cells, whilst repairing damage caused to normal cells.

There are many different types of chemotherapy, which can also be used in different combinations. Usually a number of cycles of chemotherapy are suggested. Some of the chemotherapy drugs are given as injections, usually via a plastic tube (cannula) in the back of the hand, others are available as tablets. Sometimes a plastic tube stays in place for the whole course of intravenous chemotherapy, and these are inserted at the crook of the elbow or under the collar bone (Picc or Hickman lines). Another option is to have a Portacath inserted, a device positioned under the skin on the chest in a small operation (usually under local anaesthetic) which has a reservoir and a thin tube to deliver treatment in to a large vein just above the heart. This can stay in place with no tubes coming out of the body to give treatment into the vein and to take blood tests. The injections may be given as a day case (out patient) or involve a stay on the ward (in patient) if a longer course is required. The oncology ward at the Royal Cornwall Hospital is called Lowen ward, a specialised haematology/oncology ward, with trained staff present at all times.

Some cancers respond better to chemotherapy than others, so chemotherapy may or may not form part of the treatment plan for a particular cancer patient. If appropriate, the actual chemotherapy selected will usually be based on drugs that have a proven clinical benefit. This will be weighed up against the expected side effects, along with the patients overall health, views and expected ability to cope with chemotherapy, before a final decision on whether to proceed with chemotherapy or not is made.

The expected side effects will depend on the type of chemotherapy used. For example, some, but not all chemotherapy drugs will cause hair loss (which if it does occur, will usually grow back, but might be thinner). Nausea also varies between the different drugs used, with some being less prone to causing vomiting than others. There is a wide range of effective anti sickness medications available, and these are given routinely before each course of chemotherapy to reduce the risk of significant nausea.

Another very important side effect, common to most chemotherapy drugs, is a temporary increased risk of infection that can become very serious and cause a septicaemia (infection in the bloodstream). Anyone having chemotherapy that is feeling unwell or has a temperature of 38º Centigrade should contact the oncology department immediately. In Cornwall, there is a 24 hour chemotherapy advice line on 07833 057447 which should be called. Otherwise the chemotherapy unit or Lowen ward at the Royal Cornwall Hospital should be telephoned, and are available via the main hospital switchboard on 01872 250000. This will enable the patient to be assessed and, if required, treated promptly.

Due to the diversity of both cancer and the chemotherapy drugs, a patient with a cancer diagnosis should discuss the potential benefits and side effects of a course of chemotherapy for their specific disease in detail with an oncologist.