How are chemotherapy and immunotherapy given?
How are chemotherapy and immunotherapy given?
It’s normal to feel anxious ahead of your first treatment session as for most people this will be their first experience with receiving treatment for cancer. As all drug therapies are slightly different the following gives a broad overview of how treatment is given and what to expect.
Before your appointment
Prior to your treatment you will receive a number of pre-medications to prevent nausea and vomiting and other unwanted side effects. These may be given as injections into your vein or as tablets that you may have to take at home in the days leading up to your treatment. You may also be given tablets to take at home after your treatment to prevent side effects.
When receiving immunotherapy alone (without chemotherapy) it’s unlikely you will need premedication or medication to go home with as it doesn’t cause traditional side effects associated with chemotherapy such as nausea and vomiting.
Receiving chemotherapy and immunotherapy
Chemotherapy and immunotherapy drugs are usually given as drip in a chemotherapy day unit. Some hospitals have a service where treatment can be given by nurses who come to your home. All drugs are administered over specific time frames and in a certain order (if receiving a combination of different drugs) and the total length of time will vary depending on what is prescribed for you ranging from less than an hour up to most of the day. If you need to wait for blood tests or wait to see the doctor on the day of treatment, this will lengthen the time you will be there.
Treatments are given by nurses specially trained in the administration of anti-cancer treatments. They will insert a small tube (cannula) into one of the veins in your hand or arm and the treatment will be given through the cannula. If nurses have trouble finding a vein or you are ongoing treatment, they may discuss a more permanent for of access into your veins such a longer more durable tube (Peripherally Inserted Central Catheter or PICC as it is known) or a little pocket under your skin where a needle can inject into it and subsequently flow into your veins (this is an implanted port or Port-a-cath).
Before starting, nurses will go through a series of checks to confirm that the treatment is safe to give based on blood tests looking at your kidney and liver function, your weight and a general screen to ensure you are well enough for treatment.
What happens after my infusion?
Side effects can be immediate or occur in the days to weeks that follow. Most people won’t feel any immediate side effects during the infusion however some can have a hypersensitivity reaction to treatment (symptoms include a feeling of panic, facial flushing, itching, back pain, and your heart rate and breathing may become faster). This usually resolves quickly by stopping the infusion and administering some extra medication which helps to resolve the reaction and prevent it happening again. In the majority, the infusion can be restarted at a slower rate.
The other immediate side effect that can occur is localised changes or pain around the site of the cannula when the drug is being infused. If you notice any pain at the site, you should let the nurse administering the treatment know straight away as some drugs can cause damage to the surrounding tissue if they leak out from the vein.
Going home
Once all the treatment has been given the nurse will remove the cannula from your arm again and you will be able to go home. They will let you know when your next appointment will be and when and where to have any blood tests in preparation. Before leaving, ensure you check your next appointment time and that you have all the necessary medications. Be sure to find out who you can contact if you feel unwell or have uncontrolled side effects as you may not have any further appointments until just before your next cycle.
October 2022
Ms Sophie Robson does not have any disclosures to report.