How you have cancer drugs
This page tells you about the different ways you can have medicines or cancer drugs. There is information about
You have some cancer drugs as tablets or capsules that you swallow. If you have problems swallowing, some medicines can be given as a liquid that you drink.
Drugs given this way usually work very quickly. An injection into a vein is called an intravenous injection. The injection is given through a drip needle (cannula) that is put into a vein in one of your arms. This can stay in for a few days if needed.
A nurse or doctor attaches a syringe to the cannula to inject the drug. The cannula has a rubber bung on it and the drug may be injected through the rubber bung. Some cancer drugs are diluted in a bag of fluid and you have them as a drip. Your nurse or doctor attaches the drip bag to the cannula or your central line and the drug drips into your vein over 20 minutes or a few hours. Some drugs are given in this way for a few days and the rate you have the drug is kept constant by an electronic pump.
Instead of having an injection every time you have your treatment, your doctor or nurse may inject the drugs through a tube put into a vein in your chest - a central line, PICC line or portacath.
Central lines usually go into your body in the centre of your chest. Then they run up, under your skin, to a large vein by your collarbone. The only bit you can see is the length of line that hangs out of the small entry hole in your chest. This is a picture of a central line in place.
The central line can stay in your vein for many months. So you won't need to have needles into your hand or arm each time you have your chemotherapy treatment.
You have a general or local anaesthetic before the central line is put in. When it's in place, the central line is stitched in place or special dressings may be put over it so that it can't come out. Your doctor and nurse can take blood from the line for tests. They can also use the line to give you fluids or other treatment such as antibiotics if these are needed.
PICC stands for Peripherally Inserted Central Catheter. It is put into a vein in your arm, under local anaesthetic. It can be put in during an outpatients appointment. The line runs up the vein, inside your arm and ends up in a large vein in your chest (where the central line goes too). PICC lines can be left in for several months and are used in a similar way to central lines.
A Portacath is a small chamber or reservoir that sits under your skin at the end of your central line. You can feel it, but unless you are very thin you cannot usually see it. When you need treatment, your nurse puts a needle into the chamber and gives you injections or attaches a drip. This stays in place for as long as you need treatment. Then your nurse will remove the needle until your next treatment.
The main advantage of a Portacath is that you can't see it on the outside of your body. You don't have to have a tube coming out of your chest as you do with a central line. But some people prefer a central line because they don't like having a needle put through the skin each time they need treatment. If you prefer, you can have the area over the portacath numbed with a local anaesthetic cream before the needle is put in.
Some drugs are injected into a muscle (intramuscular injections), usually in your buttocks or upper thigh. You may have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much.
Injections under the skin (subcutaneous injection) are usually given into the stomach, thigh or top of your arm. You may have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much. The skin in the area may go red and itchy for a while.
You are most likely to have a syringe driver if you need a constant dose of a particular drug but find swallowing difficult. A syringe driver is a battery operated or clockwork pump. Your drug is put into a syringe. The pump gives the drug from the syringe through a soft plastic tube to a needle that goes in just under your skin. Your nurse will fix the needle in place with a see through plastic dressing stuck over the top.
The pump can give tiny amounts continuously. Sometimes more than one drug is given. The nurse who sets up the pump will work out the dose of the drug to put in and how to set the pump so that you get exactly the dose you need each hour.
People who are very ill and may be dying at home often have syringe drivers. Drugs given this way can give very good pain and sickness control. It is a very efficient way of having regular medicines at home. A nurse comes to change the syringe every 24 or 48 hours. Some drugs can't be used in syringe drivers. They are not suitable if they irritate the skin or don't completely dissolve in water.
Suppositories are small, smooth and slightly pointed wax objects that contain drugs. The suppository goes into your back passage, where the wax melts and releases the drug. Drugs are absorbed very quickly through the lining of the back passage and it is a very efficient way of taking them. Unfortunately, for many people the thought of having anything put into their back passage is frightening and embarrassing. But it doesn't hurt and you can do it yourself if you find the idea of someone else doing it off putting. Your nurse will give you a disposable glove, some lubricating gel and explain what you have to do.
This is probably the newest way of giving drugs. HRT and nicotine patches are probably the best known, but painkillers and anti sickness drugs can be given in this way too.
You stick the patches onto your skin like a plaster. The drug is inside the patch and slowly passes through your skin into your body. The patches last between 1 and 2 days. You throw away the old patch each time you change it. They are waterproof so you can shower, bathe or go swimming while you are wearing it.
If you find it hard to swallow tablets, you may be able to have your drugs in a tablet that you put under your tongue. You just leave it there to dissolve. This type of tablet is called 'sub lingual' - which means under the tongue. You can have some painkillers in this way.
It is quite usual to have cancer treatment in cycles. A cycle means that you have a single cancer drug or a combination of drugs and then have a rest to allow your body to recover. So, you may have some chemotherapy injections over a day or two and then have the rest of that week and another 2 weeks with no treatment.
The treatment and rest time make up one treatment cycle - in this case, 3 weeks. When you get to the end of the cycle, it starts again with the next cycle. If you're having some cancer drugs as tablets you may take smaller doses daily for a few days or weeks and then have a rest period.
The aim of giving treatment in this way is to kill the cancer cells without causing harm to normal, healthy cells. Cancer cells are most at risk of damage when they are dividing. By giving treatment every few weeks, the doctors hope to catch cancer cells in the middle of dividing that were resting the last time you had treatment. The rest period also gives your healthy cells time to recover between treatments
Depending on the drug or combination of drugs, an individual treatment may last from a few hours to a few days. Your treatment cycles may be weekly or take 2, 3 or 4 weeks, depending on the drugs and your treatment plan. Some treatment cycles are quite complicated. You could have treatment on days 1, 8 and 15 of a 4 week treatment cycle, for instance.
A series of cycles of treatment is called a course. A treatment course often takes between 3 to 6 months, but can be more or less than that. During that time, you would probably have between 4 to 8 cycles of treatment.
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