Ways of having chemotherapy

• Choosing how you have treatment
• Three main ways
• Less common ways of having chemotherapy

To damage and kill the cancer cells, the chemotherapy drugs must be absorbed into your blood and carried throughout your body. There are different ways of getting the drugs into your body. Doctors call them 'routes of administration'. The best way for you depends on

• The type of cancer you have
• Where the cancer is in the body
• The type of drug used (for example, some are injected and some are taken as tablets)

The three most common ways of getting the drugs into your blood are by

• Injecting them or giving through a drip into a vein (intravenously)
• Taking them as tablets or capsules (orally)
• Infusion pump

The links above will take you to other pages with more information about these ways of having chemotherapy.

Less often, drugs are injected into

• A muscle (intramuscular)
• The layer of fat just under the skin (subcutaneous)
• An artery (intra-arterial)
• The fluid around your spine or brain (intrathecally)
• A body cavity (intracavitary) such as the bladder, chest cavity, or tummy (abdominal cavity)
• The space between the membranes that cover the lungs (intrapleurally)
• Directly into the tumour (intralesional or intratumoral)

For some types of skin cancer, chemotherapy creams may be used.

Sometimes your doctor may want to use two or more methods of giving chemotherapy at the same time. The links above are just to the brief information below on each of these ways of giving chemotherapy.

Injections into muscle 

The muscles in your thigh and buttocks are the most common areas for giving intramuscular chemotherapy. Chemotherapy given this way is absorbed into the blood more slowly than intravenous chemotherapy. Because of this, the effects can last longer than chemotherapy that you have injected into a vein.

Injections under the skin

The skin of the abdomen, thigh and upper arm are the most common areas for giving subcutaneous chemotherapy. There is more about subcutaneous injections on CancerHelp UK's page about the different ways you can have cancer drugs.

Chemo into an artery

Intra arterial chemotherapy means giving the drugs directly into the arteries that are close to the cancer. This gives a very high dose of chemotherapy to the tumour but less to the rest of the body. To have this treatment, you need to have a tube put into the artery under local anaesthetic. This is a highly specialised way of giving chemotherapy and not all hospitals in the UK will offer it. The most common type of cancer treated in this way is liver cancer. The artery used is the artery that supplies the liver. This is called the hepatic artery. Intra arterial chemotherapy is used more rarely for other types of cancers, but usually only within clinical trials because it isn't yet clear how effective it is.

The side effects of giving chemotherapy in this way are generally the same as for when it is given intravenously. There is a slightly increased risk of stomach irritation when you have this treatment for cancer in the liver. This is because some of the drug may get into the blood supply to your stomach. Your doctor may give you some tablets to help protect your stomach.

Chemo into the spinal canal 

For most cancers, it is not necessary to inject chemotherapy drugs into the fluid around the spine and brain. But it is an important part of the treatment for some types of leukaemia. It is usually a very safe procedure. Out of thousands and thousands of patients treated in this way, on occasion the wrong drug has been injected, and very sadly, the patients died. Over roughly 40 years of cancer treatment in the UK, this has happened about 13 times with anti cancer drugs. It understandably receives a lot of media coverage when it does happen and so people can be nervous about having this treatment. We must stress that it is highly unlikely that this mistake will ever be made again. Extra safety precautions have been put in place to prevent it. But if you are worried, please do ask your doctor to reassure you by telling you about the checks they carry out before giving you the drug.

Chemo into a body cavity 

Intracavitary chemotherapy means injecting chemotherapy through a tube (catheter), directly into a body cavity. It gives a very high dose of chemotherapy to the tumour but only a very low dose to the rest of the body. Intracavity chemotherapy can be used for

• The bladder (intravesical)
• The abdominal cavity (intraperitoneal)
• The chest cavity (intrapleural)

Intravesical chemotherapy is having a solution of a chemotherapy drug put into your bladder. There is more about intravesical chemotherapy in the bladder cancer section of CancerHelp UK.

The peritoneum is a membrane that lines the abdominal cavity and covers the organs contained in the abdomen. Intra Peritoneal (IP) chemotherapy is chemotherapy injected directly into cavity within the peritoneum. This treatment is still experimental and not used very often. When it is used, it is mainly for treating ovarian cancer that has spread to the peritoneum. There is more about intraperitoneal chemotherapy in the ovarian cancer section of CancerHelp UK. Intraperitoneal chemotherapy can also be used for a rare type of mesothelioma called peritoneal mesothelioma.

Chemo into the pleura

Chemotherapy can be given directly into the space between the two layers of skin-like tissue that cover the lungs (the pleura). This is called intrapleural chemotherapy. It is sometimes used to treat lung cancer or breast cancer that has spread to the lining of the lung (the pleura).

Chemo into your tumour

If you have chemotherapy injected directly into your tumour, this is called intralesional or intratumoural chemotherapy. Not many doctors use this method and it is still very experimental. An example where it is used is with a rare type of cancer called Kaposi's sarcoma. Research is going on into using this type of chemotherapy for head and neck cancers and some other cancers.