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Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is a common treatment for secondary cancer in the liver. The drugs used will depend on where in the body the primary cancer started. For example, if you have cancer of the breast| that has spread to the liver, you will receive chemotherapy designed to treat secondary breast cancer.
Unfortunately, it is not possible to completely cure a secondary liver cancer with chemotherapy. However it may slow or stop the growth of the cancer and may shrink it to reduce any symptoms it may be causing. Chemotherapy may also sometimes be used to shrink a liver tumour so that it can be removed by surgery|. Chemotherapy may also be used after surgery.
Chemotherapy drugs are sometimes given as tablets or, more usually, by injection into a vein (intravenously).
Chemotherapy is usually given as cycles of treatment. Each cycle involves having the chemotherapy drugs for a few days, followed by a rest period of two or three weeks to allow your body to recover from any side effects of the treatment. The number of cycles you have will depend on the type of cancer you have and how well it is responding to the treatment.
Intravenous chemotherapy is usually given in the hospital outpatient department, but you may need to spend a few days in hospital.
Sometimes, chemotherapy drugs are given using a pump which gives a continuous dose of chemotherapy. The pump is attached to a tube which is channelled through the skin of your chest into a vein near the heart – this is called a central line or skin-tunnelled catheter. This way of giving the chemotherapy is known as continuous infusion and allows you to stay at home while having the treatment. The drugs in the pump are changed every week or couple of weeks by staff at the hospital.
People having more intensive chemotherapy or a continuous infusion may find it easier to have a central line| or a PICC line|. These tubes (lines) make it easier for the doctor or nurse to give chemotherapy and collect blood samples, and save you having repeated injections.
A central line is a narrow, flexible, plastic tube, which is inserted into a main vein and then comes out through the skin of the chest. Central lines can be put in under local or general anaesthetic.
Chemotherapy and other medicines can be given through the tube and blood samples can also be taken from it. The central line stays in place throughout your treatment. Once your treatment is finished, the line is taken out. This is usually easy to do. Local anaesthetic can be used if necessary.
A PICC line (peripherally inserted central catheter) is like a central line, but it goes into a vein in the crook of your arm, instead of through the chest.
You can have a PICC line put in as an outpatient, using local anaesthetic. The line can stay in place throughout your treatment. Once your treatment has finished, the PICC line is easily removed.
An implantable port| is a thin, soft, plastic tube (catheter) that is put into a vein and has an opening (port) just under the skin on your chest or arm. This allows medicines to be given into the vein through the port, or blood to be taken.
The catheter is usually inserted (tunnelled) under the skin of your chest. The tip of the catheter lies in a large vein just above your heart and the other end connects with the port which sits under the skin on your upper chest. The port is a disc about 2.5–4cm (1–1½ inches) in diameter and will show as a small bump underneath your skin. You will be able to feel it, but nothing will be visible on the outside of your body.
Chemotherapy can sometimes cause unpleasant side effects|, but it can also make you feel better by relieving the symptoms of the cancer. Any side effects that occur can often be well controlled with medicines. The main side effects are described here, along with some ways in which they can be avoided or reduced.
Chemotherapy can reduce the production of white blood cells by the bone marrow, making you more prone to infection|. Contact your doctor or the hospital straightaway if:
You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if your blood count is still low. We can send you information about how to avoid an infection if you have reduced immunity.
The chemotherapy can also reduce the production of platelets, which help the blood to clot. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.
While having chemotherapy you may become anaemic. This may make you feel tired| and breathless|.
Some of the drugs used to treat secondary liver cancer may make you feel sick (nauseous) and possibly be sick (vomit). There are very effective anti-sickness drugs (anti-emetics) to prevent or greatly reduce nausea and vomiting|. Your doctor can prescribe these for you.
Chemotherapy drugs can make your mouth sore|, so regular mouthwashes are important; the nurse will show you how to do these properly. If you don’t feel like eating at any time during your treatment, you can replace some meals with nutritious drinks| or a soft diet. It might be helpful to speak to the hospital dietitian.
Some people find that the taste of food and drink changes.
Hair loss| is another common side effect of some − but not all − chemotherapy drugs. Your doctor can tell you if the drugs you are taking are likely to make your hair fall out. You can cover up by wearing wigs, hats or scarves. You may be entitled to a free wig from the NHS. You can discuss this with your doctor or nurse at the hospital. If your hair does fall out, it will grow back over a period of 3–6 months once the treatment has ended.
Chemotherapy affects people in different ways. Some are able to lead a fairly normal life during their treatment, while others find they become very tired| and have to take things more slowly. Just do as much as you feel like and try not to overdo it. For some people, the fatigue continues for quite some time after their treatment has ended.
Although they may be hard to bear at the time, these side effects will begin to disappear once your treatment is over.
It is not a good idea to become pregnant or father a child while taking chemotherapy drugs, as they may harm an unborn baby (foetus). It is important to use effective contraception during your treatment and for some months afterwards. You can discuss this with your doctor or specialist nurse.
People having chemotherapy should use condoms for a few days after chemotherapy treatment. This is to protect your partner from any of the drug that may be present in semen or vaginal fluid.
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