The high-dose treatment
High-dose treatment (the conditioning regimen) is given to remove any cancer cells that remain in your body.
The treatment usually lasts a few days and involves being given high doses of chemotherapy. Some people may also have radiotherapy to the whole body, known as total body irradiation, or TBI.
While you’re in hospital, you will have regular doses of medicines and many blood tests over several weeks. To make this easier and to prevent you from having frequent injections, a soft, plastic tube (central line) can be put into a vein in your chest. Different types of central lines are available including Hickman® lines or Groshong® lines.
Central lines can be used to:
give drugs and fluids
give the stem cells
collect blood samples.
The tube is inserted under a general or local anaesthetic. Usually a small cut (incision) is made in the skin over your chest, and the flexible plastic tube is placed under your skin and into a large vein in your chest. The other end of the tube stays outside your body and has a screw cap at the end, to which a drip or syringe can be attached.
Position of a central line
The area may feel sore for a couple of days after the line has been put in, but it should then be painless. The line can stay in for months, and the nurses will show you how to look after it to help prevent blockages or infections.
Other types of central lines include:
PICC lines (peripherally inserted central catheter) – This is a thin, flexible tube that’s passed into a vein in the bend or upper part of the arm and threaded through until the end of the tube lies in a vein near the heart.
implantable ports – This is a thin, soft plastic tube that’s put into a vein in the chest and has an opening (port) just under the skin on your chest.
Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. You’ll probably already have had some chemotherapy as part of your original treatment, so you may have some idea of what to expect.
The high-dose chemotherapy is given through your central line or implantable port together with plenty of fluids. The treatment is usually given over several days and often involves a combination of different chemotherapy drugs.
We have more information about the individual chemotherapy drugs and some of the different combination treatments, including detailed information about their side effects.
Radiotherapy is the use of high-energy rays to destroy cancer cells. You may be given total body irradiation (TBI) as part of the high-dose treatment for some types of cancer.
If you’re going to have radiotherapy as well as chemotherapy, you’ll probably go to the radiotherapy department for a planning session a few days before the treatment begins. The doctor will explain what will happen during your course of radiotherapy, and you can ask any questions you may have.
Someone having radiotherapy
Total body irradiation may be given twice a day for 6–8 sessions over 3–4 days. Each session lasts about 40 minutes. It can also be given in a single session over several hours. You can bring some CDs in with you to listen to during your treatment.
Before each session, the radiographer will position you carefully and will make sure that you’re comfortable. You’ll have to change position a few times during the session, and the radiographer will explain this to you.
During the treatment you’ll be left alone in the room, but you’ll be able to talk to the radiographer, who will be watching you from the next room. Radiotherapy isn’t painful, but you do have to keep still while your treatment is being given.
Many people find that they don’t have many side effects from total body irradiation. This is because the treatment only gives a relatively low dose of radiation to any one part of the body. Common side effects are tiredness, feeling sick (nausea), diarrhoea and a sore mouth.