Ways in which chemotherapy can be given

Chemotherapy is usually given as an injection or as a drip (infusion) directly into a vein, or as tablets. Sometimes you have it through a small pump you can carry in a bag and take home with you. Your nurse will show you how to take care of it.

Chemotherapy into a vein is given through a cannula (small tube), line or port inserted into a vein in the back of your hand, arm, chest or neck. A line or a port stays in until treatment is over. Your nurse will show you how to look after it.

When you have chemotherapy through a cannula, your nurse will be careful to prevent the drug leaking into surrounding tissue. If you have swelling, pain, stinging or redness during or after treatment tell them immediately.

Depending on the type of cancer, chemotherapy is sometimes given in other ways, such as directly into the fluid around the spine or into a specific body space. It can also be given by injection into muscle, under the skin, or as a cream.

How chemotherapy is given

Chemotherapy can be given in different ways depending on the type of cancer you have and your treatment plan. Your chemotherapy nurse will explain what’s involved.

It’s standard for nurses to wear gloves and a plastic apron when they give you chemotherapy. This is just a precaution to protect themselves from any spillage of the drugs.

Chemotherapy can be given:

  • by injection or a 'drip' directly into a vein (intravenous chemotherapy)
  • by mouth as tablets or capsules (oral chemotherapy).
  • by injection into the fluid around the spine and brain (intrathecal chemotherapy)
  • directly into a body space, for example the bladder
  • by injection into muscle or under the skin
  • directly to the skin as a cream for some skin cancers.


Giving chemotherapy into a vein

Chemotherapy given into a vein (called intravenous) goes directly into your blood and is carried to all areas of your body.

It can be given through:

  • a cannula - a short thin tube put into a vein in your arm or the back of your hand
  • a central line put in through the skin of your chest or neck into a vein in the chest
  • a PICC line put into a vein in the arm and threaded through to a vein in the chest
  • an implantable port (portacath) put into a vein and has an opening (port) under the skin on your chest or arm.

When your cannula, line or port is in place the chemotherapy drugs can be given into it by injection, as a drip on its own or through a pump.

Your nurse checks that the cannula, line or port is working properly before giving you the chemotherapy.

Cannula

Having a cannula put in can be a bit uncomfortable or painful, but it shouldn’t take long and any pain soon wears off. Your nurse might put anaesthetic cream or spray onto the skin to numb the area first.

The cannula is put into a vein in the back of your hand or lower arm. Your nurse will place a see-through dressing over it to make sure it stays in place. The cannula is removed before you go home.

If you feel any discomfort or notice redness or swelling around the cannula, or along your arm, during or after chemotherapy let your nurse or doctor know immediately.

If you feel any discomfort or notice redness or swelling around the cannula, or along your arm, during or after chemotherapy let your nurse or doctor know immediately.

Having chemotherapy into a vein

Having chemotherapy into a vein

How chemotherapy can be given into a vein and other people's experiences.

About our cancer information videos

Having chemotherapy into a vein

How chemotherapy can be given into a vein and other people's experiences.

About our cancer information videos


Receiving intravenous chemotherapy

Chemotherapy drugs given into a vein (intravenously) can be delivered in different ways.

As an injection

The chemotherapy drugs are injected directly into a vein through your cannula or central line over a few minutes. Sometimes a bag of clear fluid is attached to plastic tubing and connected to the cannula or line in your vein first (called a drip or infusion). The drug is injected into a connection or tap on the plastic tubing and flushed into your vein with fluid from the bag.

A cannula for chemotherapy
A cannula for chemotherapy

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A drip through a pump

The chemotherapy drugs are dissolved in a bag of fluid and given to you as a drip that runs through an infusion pump. The nurses set the pump to give you a controlled amount of chemotherapy over a fixed time. This can be from 20 minutes to several hours depending on the chemotherapy you’re having.

A drip on its own

Sometimes chemotherapy is given through a drip without a pump. The nurses set the rate and check it regularly to make sure it’s at the right speed.

Through a small pump

Some types of chemotherapy are given over a few days and are set up at the hospital so you can go home with it. A nurse puts the chemotherapy into a small pump and connects it to your central or PICC line. The pump is small enough to fit into a pocket, or can be carried in a bag or belt holster.

You, and sometimes a relative or friend, will be taught how to look after it. Some pumps are battery-operated so you need to be careful not to get them wet when you’re washing. There are also disposable pumps which are operated by a balloon mechanism or spring control.

Your nurse or pharmacist will explain how to look after the pump and who to contact if you have any problems.

When the infusion is finished there may some fluid left in the pump. Some pumps need to be overfilled to get the correct dose so this may be usual. Your nurse or pharmacist can tell you if you should expect this.


If a chemotherapy drug leaks

If a drug leaks into the area around the vein while being given, it’s called extravasation. This is uncommon but can happen if a cannula dislodges so that is isn’t correctly positioned in the vein.  It rarely happens with a central line.

Your nurse will be very careful to prevent extravasation when giving your chemotherapy. But, if you notice any swelling, pain, stinging or redness during your treatment session tell them immediately. Or, if any of these problems develop after you get home, contact the hospital straight away. Some chemotherapy drugs can damage the tissues and it’s important that extravasation is dealt with straightaway.


Having chemotherapy by mouth (oral chemotherapy)

Some chemotherapy drugs are taken as tablets or capsules. This is just as effective as other types of chemotherapy. The drug is absorbed into your blood and carried around your body just like intravenous chemotherapy.

You’ll be told when to take your chemotherapy tablets or capsules and given other instructions, such as whether or not to take them with food.

It’s very important to:

  • read the labels on the boxes before you leave the hospital and if instructions are unclear, ask your nurse, doctor or pharmacist.
  • take your drugs exactly as prescribed as missing tablets or not taking them at the right times can affect how well treatment works
  • contact your nurse or doctor at the hospital immediately for advice if you can’t take your medicines for any reason or are sick after taking them.

Chemotherapy by mouth can cause side effects, just like chemotherapy into a vein, and it’s important to know what they are. You also need to know how to store your drugs safely.

Oral chemotherapy

Oral chemotherapy

Chemotherapy can be given as tablets or capsules. We explain how to look after them and what to expect.

About our cancer information videos

Oral chemotherapy

Chemotherapy can be given as tablets or capsules. We explain how to look after them and what to expect.

About our cancer information videos


Other ways of having chemotherapy

There are other ways you might be given chemotherapy, depending on the drugs that are being used and the type of cancer you have.

Injection into muscle or skin

Some chemotherapy drugs are given by injection into a muscle (intramuscular) of the leg or buttock. This might feel a bit painful or uncomfortable for a short time.

Some drugs are given by injection under the skin (subcutaneous) using a very fine needle.

Injection into the spinal fluid (intrathecal)

In some leukaemias, lymphoma or some brain tumours cancer cells can pass into the fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF).

Intrathecal chemotherapy can be used to destroy these cancer cells or to try and prevent this from happening. Chemotherapy into a vein or by mouth can’t reach these cancer cells.

Your cancer doctor and nurse will explain it all so you know what to expect. They’ll make sure you’re comfortable and you can have a relative or friend with you.

The doctor numbs an area of skin over your spine with local anaesthetic. After a few minutes they will gently insert a needle between two of the spinal bones into the CSF (called a lumbar puncture). Your doctor then injects the chemotherapy through the needle into the CSF.

The most common side effect of a lumbar puncture is a headache. To help prevent this you need to lie flat for a few hours afterwards and to drink plenty of fluids

Into a body space (intracavitary)

Chemotherapy drugs can be given into a space (cavity) in the body, such as the bladder. This can cause irritation or inflammation in the area the drugs are given but it doesn’t usually cause side effects in other parts of the body.

A fine tube (catheter) is usually inserted into the body cavity and chemotherapy is put in through this tube. It may be drained out again after a set period of time.

Into the bladder

This may be done to treat early bladder cancer. Liquid chemotherapy drugs are given directly into the bladder through a catheter, which is removed when it’s over. Our section on early (superficial) bladder cancer has more information.

Into the abdominal cavity (intraperitoneal chemotherapy)

This is very occasionally used to treat ovarian cancer and there’s more information in our section on ovarian cancer. It may also be used to treat mesothelioma in the abdomen (peritoneal mesothelioma).

Between the two layers of the pleura (tissue that covers the outside of the lungs)

Chemotherapy is sometimes put in between the two layers of the pleura to treat cancer cells that have spread there.

Into a limb (Isolated limb perfusion)

Chemotherapy is very occasionally given directly into the blood vessels in a limb to treat a skin cancer called melanoma that has come back.

Chemotherapy creams

Chemotherapy creams are used to treat some types of skin cancer. You put the cream on the affected skin in a thin layer and cover the area with a dressing. Your specialist nurse or pharmacist will show you and explain how often you apply the cream. Although the cream can irritate the skin in the area or make it sore it won’t cause side effects in other parts of the body.


Chemotherapy at home

If you’re having chemotherapy at home as tablets or through a pump, there are certain things to remember:

  • Chemotherapy tablets, capsules or injections may need to be stored in a particular way, such as in the fridge. Always follow the instructions given by your nurse or pharmacist.
  • Other people in your household should avoid direct contact with your chemotherapy drugs and avoid picking them up with bare hands.
  • All drugs must be stored out of the reach of children as they could cause serious harm if taken by accident.
  • If you’re having intravenous chemotherapy by pump and you notice the drug leaking from the pump or tube, you should close the clamps on the pump, wrap it in a plastic bag and wash your hands. Some hospitals provide a ‘spill’ or ‘leakage’ kit, which includes instructions on what to do if your pump leaks. You should then contact the nurse or doctor at the hospital immediately.
  • If you feel unwell at any time, contact the hospital straight away on the contact number you’ve been given (day or night) for advice.


Back to Being treated with chemotherapy

Central lines

A central line is a long, thin hollow tube. It is inserted into a vein in your chest to give chemotherapy and other drugs.

Implantable ports

An implantable port is a tube with a rubber disc at the end. It is inserted into a vein to give chemotherapy or other medicines.

PICC lines

A PICC line is a long, thin, flexible tube known as a catheter. It’s put into the arm to give chemotherapy and other medicines.

Lumbar punctures

A lumbar puncture involves inserting a hollow needle between two of the spinal bones. This may be used to give chemotherapy.