How is Chemotherapy Given?

What to Expect for Different Chemo Injection Methods and Oral Chemotherapy

chemotherapy
Mark Harmel/Photographer's Choice/Getty Images

Chemotherapy is the most common method of treatment for blood cancers such as leukemia, lymphoma, and myeloma. Depending on the type of disease you have, there are a few different ways that chemotherapy is given.

Intravenous Injection of Chemotherapy

It is very common for chemotherapy medications to be injected into a vein, or intravenously. In many cases, a nurse or doctor will insert a needle into your vein, often in your hand or arm, and the chemotherapy will be given through there.

The poke of the needle can cause a burning or stinging sensation when it is inserted. It should be similar to what you have experienced in the past when you have had your blood drawn in the lab.

If you are going to be having chemotherapy over a long period of time, or if you are a candidate for a blood or marrow transplant, your healthcare provider may choose to insert a central venous catheter (CVC) or central line. A CVC is a catheter that is inserted into your chest or your arm in a surgical procedure. The end of these catheters is located in a large vein near your heart. This vein is capable of tolerating large volumes of irritating solutions without harming the blood vessel. These catheters can be kept in place for long periods of time, and can be used to administer medications and blood products, as well as to draw blood samples.

During the intravenous infusion of chemotherapy, you should not feel any pain or discomfort.

Some medications can cause damage to the tissues if they are administered incorrectly. If you are experiencing discomfort at your intravenous site during your infusion, you should let your nurse know immediately.

Intramuscular Injection of Chemotherapy

Intramuscular chemotherapy is an injection that is given into your muscle, often in your arm, backside or upper leg.

The process is very similar to receiving an immunization or vaccine. Your healthcare provider will swab the injection area with an antiseptic, then inject the medication into your muscle with a needle and syringe.

It is possible to have a mild discomfort during the injection and afterward.It is helpful to keep using your muscles as you would normally and try to avoid favoring the limb that your chemotherapy was injected into. Ask your health care provider what they recommend to minimize any discomfort following intramuscular chemotherapy.

Subcutaneous Injection of Chemotherapy

Subcutaneous chemotherapy is an injection that is given into your fatty tissue, often in your abdomen. These medications are injected with a small needle just under the skin, and you will likely experience a pinch sensation or a small amount of stinging or burning while the medication is being injected.

After you have received this type of chemotherapy, keep an eye on the skin around the injection site and note any redness, swelling, or rashes that may develop.

It is also common to get some bruising in the area, especially if you have low platelet counts. Let your healthcare provider know what side effects you noted.

Intrathecal Injection of Chemotherapy

Intrathecal chemotherapy is used to treat blood cancers that may spread to the fluid surrounding your spine and brain, or cerebrospinal fluid (CSF). Most chemotherapy drugs can not pass from the blood stream into the CSF, so it is necessary to inject the medication directly into the fluid.

The administration of intrathecal chemotherapy may be similar to what you experienced if you needed to have a lumbar puncture, or spinal tap, as part of your diagnosis. If it is necessary for you to receive a number of these types of treatment over a long period of time, your doctor may recommend an "Ommaya reservoir," which is a special catheter that is implanted in your scalp that allows you to receive intrathecal chemotherapy without the lumbar puncture.

Oral (Pills, Capsules, and Liquids by Mouth)

Some chemotherapy used to treat blood cancers is given by mouth, or orally. Receiving your chemotherapy this way can be very convenient since you do not need to go to the hospital or cancer center for treatment.

However, being responsible for taking your own chemotherapy requires a great deal of education about how to take these medications safely, and how to manage your own side effects. Patients sometimes miss the support of seeing their healthcare provider frequently.

If you are having side effects that you are unable to control, having a hard time remembering when to take your medications, or finding it difficult to cope with the responsibility of treatment, it is important to contact your healthcare provider for support. They may be able to offer suggestions to make oral chemotherapy easier for you.

The Bottom Line

There are many ways to receive chemotherapy for your blood cancer. No matter how it is administered, chemotherapy medications have the potential to cause serious side effects. Whether you receive your treatment in a clinic, cancer center, hospital, or at home, it is important to have good information about the drugs you will get and what to expect. Keep track of any side effects or sensations that you experience, so that you can report them to your healthcare provider.

Sources

Burke, M. Chemotherapy. In Varrichio, C. (ed.) (1997) Cancer Source Book for Nurses 7th ed American Cancer Society, Jones and Barlett: Sudbury , MA (pp.103- 122)

Goodman, M. Chemotherapy: Principles of Administration. In Yarbro, C., Frogge, M., Goodman, M., Groenwald, S. eds(2000) Cancer Nursing: Principles and Practice 5th ed American Cancer Society, Jones and Bartlett: Sudbury, MA.

Continue Reading