Chemotherapy treatment

We hope that you will find this information useful. It will not answer every question about chemotherapy treatments. It is intended as a substitute for discussion with the doctors and nursing staff. We hope that after you have read this, you will find it easier to ask questions and to discuss your treatment and progress with your doctor and nurse. There are more details about your individual treatments available which the chemotherapy nurse will give to you.

The chemotherapy suite

This is an Outpatient Unit for patients receiving chemotherapy. Treatments may vary in length of time and the department is open from 8.30am to 6.00pm.

Number of beds

The suite has two bedrooms and eight treatment chairs. These areas are used to provide treatments, patient support and pre-chemotherapy assessments. The area is an open plan to allow patients to talk to each other and gain support, however, sometimes this can be a problem when discussing confidential information. Future plans to improve privacy and dignity are by developing single bedrooms into accommodation that will facilitate assessment and also allow for single-sex accommodation. 

Visiting times

There is no visiting time as this is an Outpatient Unit. Children under the age of 12 are not encouraged to come in the treatment areas but are welcome in the waiting area.

Mealtimes, drinks and snacks

Food and drink are provided in the unit for patients who are present at mealtimes. There is also the WRVS tea bar in the Outpatients Department and Tree Tops Restaurant. 

What is chemotherapy?

Chemotherapy means using medicines to treat cancer. Many types of medicines are used in chemotherapy, all of which attack cancer cells in different ways. For this reason, we often give several medicines in combination to increase the effectiveness of treatment. Chemotherapy can be used alone or with radiotherapy and surgery.

How does chemotherapy work?

The medicines are carried by the bloodstream to all parts of the body where they act by interfering with the growth of rapidly growing cells such as cancer cells. The cells of some normal tissues also grow rapidly, for example, the cells of the hair roots, mouth, bone marrow and lining of the bowel. These may be temporarily affected by chemotherapy.

How often is it given?

This depends on the type of treatment you are having. In most cases, each chemotherapy treatment is followed by a rest period of between one and four weeks. This is called a cycle. Depending upon your condition and the reason for giving you chemotherapy, the treatment will continue for a set period. The staff will discuss your individual treatment with you.

Consent to treatment

The doctors and chemotherapy nurses will discuss the treatment that is recommended for you and explain how it will affect you. Once you have had all your queries and concerns about your treatment answered to your satisfaction, you will then be asked to sign a consent form.

(External) Chemotherapy information sheets

The (External) chemotherapy information sheets give details about individual chemotherapy treatment. Your doctor will discuss this with you when you come to the department. Because we work closely with The Christie Foundation Trust, some of our information is produced by them.

Each card has:

• the name of drugs;
• the way the drugs are given, for example, injection or via a drip;
• treatment cycle (which days or weeks you have the treatment and how long treatment lasts);
• side-effects and how to cope; and
• contact numbers 

Sometimes it is necessary to have a central venous catheter inserted to enable you to have you chemotherapy administered. A central venous catheter is a long fine hollow tube with an opening at each end. One end provides access from outside your body to the other end which is situated in a large vein in the chest. It can remain in position for several months. There is a cuff on the line which anchors it in position under the skin and prevents it falling out, it also helps prevent infection. About 12 inches of the line remains outside the chest. It has a plastic clamp on it which must always be closed when the line is not in use. The end of the line always has a plastic bung or cap attached to it when it is not being used. If you need more than one drug at a time, you may have a central venous catheter with two or three lumens, that is, a line with two or three ends.

What are the benefits of having a central venous catheter?

The line may be used to give your chemotherapy, fluids, blood or other drugs directly into your bloodstream. Some chemotherapy drugs are not suitable to be given into the veins in your hand or arm, so these drugs must be given into a larger vein. It may also be used for taking blood samples which are needed regularly, avoiding the need for repeated needle stabs in your arm. Some patients are able to continue their treatment at home with a central venous catheter in place. People who have a phobia of needles may prefer to have a central venous catheter. 

Insertion site - jugular vein in the neck

An alternative to a central venous catheter is a PICC. A PICC is a peripherally inserted central catheter. It is a thin flexible tube that is inserted into a vein, usually in the bend of your arm. The PICC is then threaded along the vein so that the tip lies in one of the large veins in the chest. It can remain in position for up to six months. A specially trained nurse or doctor will insert your PICC. Not all patients are suitable for a PICC, so a doctor or nurse will assess you before one is inserted.

The illustration below shows the PICC line, and where it enters the vein at the inside of the elbow.

For oncology patients, these devices are inserted at The Christie Hospital. guidelines for district nurses are included to enable him or her to care for central venous catheters.

One of the most unpleasant effects of chemotherapy is losing all your hair. We offer a confidential wig fitting service here in the centre. This service is available each Tuesday morning. Any chemotherapy patient from East Cheshire NHS Trust wanting a referral to this service needs to contact the chemotherapy team on 01625 663198, or for clients who travel further, we liaise with companies in Stockport and Manchester.

Hudson & Co
Lloyds House
1st floor
18 Lloyd Street
Manchester
Lancashire
M2 5WA

Telephone for an appointment: 0161 834 6151

• Ladies and gents wigs hairpieces
• Human and synthetic hair
• Private consulting rooms
• Custom ready-made selection

Other services offered in the department

Scalp cooling is a method used to lower the temperature of the scalp, which restricts the amount of blood reaching the hair follicles. This then protects the hair follicles from the effects of the concentrated chemotherapy and can result in a high level of hair retention or complete hair preservation.
 
Fatigue is the most common side effect of cancer treatment. Fatigue is when you have less energy to do the things you would normally do or want to do. This is different from the fatigue of everyday life. Fatigue-related to cancer treatment can appear suddenly and can be overwhelming.

It is not relieved by rest and can affect you physically, psychologically and emotionally.
 
What to look for:

• Feeling as if you have no energy.
• Sleeping more
• Feeling tired even after sleeping.
• Not wanting to or being able to do normal activities.
• Less attention to personal appearance.
• Difficulty thinking or concentrating.

What you can do:

• Balance rest and activities.
• Plan important activities for when you have the most energy.
• Try to do things you have to do throughout the day rather than all at once.
• Get enough rest and sleep, perhaps with short naps.
• Remember that fatigue caused by treatment is short-term and that your energy will slowly return after treatment ends.
• Ask for help when you need it.
• Eat a balanced diet and drink plenty of water.
• Exercise regularly at light-to-moderate intensity. 

Why exercise?

Regular exercise reduces the risk of heart disease, improves lung function, reduces being overweight and minimises the impact of ageing. This message applies as much to cancer patients as to anyone else – perhaps even more.

It is important to try and exercise a little if you can, even when you are not feeling too well. Research shows that exercise can help with the side effects of treatment such as fatigue, pain, nausea and vomiting. It can also improve your mood and feelings of confidence. Too much exercise can make you tired, so can too little. It’s important to find your own level.
Exercise as much as you can to keep muscles working as well as possible. Exercise helps prevent problems caused by long-term bed rest, such as stiff joints, weak muscles, breathing problems, constipation, fragile skin, poor appetite and low moods.
 
Benefits of regular exercise:

• Maintains or improves physical abilities.
• Improves balance, reducing the risk of falls and fractures.
• Prevents muscle wasting caused by inactivity.
• Reduces the risk of heart disease.
• Prevents osteoporosis.
• Improves blood flow to legs and reduces the risk of blood clots.
• Less dependence on others to do normal activities of daily living.
• Improves self-esteem.
• Reduces anxiety and depression.
• Decreases nausea
• Increases ability to maintain social contact.
• Reduces symptoms of fatigue.
• Better able to control weight
• Improves the quality of life.