Chemotherapy is the treatment of cancer using drugs to destroy cancerous cells. As NCCT is the regional treatment centre for the North of England, we treat a wide range of diseases and use some very complex chemotherapy treatments, many of which are not available in other cancer units. 

We have a dedicated team of expert staff who will take good care of you. You will be assigned a nurse for the duration of your treatment, to provide the best possible personal care. We also work closely with the community MacMillan nurses and district nurses, to ensure you get as much support as you need when away from the hospital.

Patients having chemotherapy can always access to our complementary therapies, notably the arts therapy service, “Room for You” and our specialist headwear designer, “Headlines”.

Above all, we know you want to be seen as quickly as possible. NCCT is fortunate not only in the quality of care, but also in offering you appointments approximately two weeks after being referred for chemotherapy.

How does chemotherapy work?

Chemotherapy drugs work by damaging cancer cells so that they can't grow and multiply. The cells eventually die, and the cancer may then shrink, or go away completely.

Chemotherapy can be given in a number of different ways, depending on what kind of cancer you have, and how long you need treatment.
Most chemotherapy is injected into a vein and then spreads through the blood stream to reach cancer cells in whatever part of the body they may be. Injecting the drugs into the blood stream may be done in a number of ways:

• One way is through a cannula, which is a fine tube inserted into a vein usually in the back of the hand or forearm.  This tends to be for shorter cycles of treatment.
• A longer tube may be inserted through a vein in the arm or the chest. These can stay in place for the whole treatment course which means you do not need to have a needle inserted into a vein each time you attend.
• These longer tubes can be called:

‘Midline catheters’ are inserted in the arm

'Peripherally Inserted Central Catheters’ (shortened to PICC line) are also inserted in the arm

‘Hickman lines’ are inserted via the chest

If a longer line would be more appropriate for your chemotherapy you will be given full information about it

Who will look after me?

Oncologists: A consultant clinical oncologist is a doctor who specialises in treating cancer with drugs and radiotherapy. A consultant medical oncologist specialises in the use of drugs only. The oncologist will decide what treatment you need to have, and will review you regularly.

Nursing Team: Nurses will be available to help look after you and offer advice, support and any nursing care you may need.

Clinical Nurse Specialists: There may be a clinical nurse specialist working with your team who can give you expert advice about the type of cancer you have.

Specialist Palliative Care Team (SPCT): The Specialist Palliative Care Team consists of nurses (sometimes called Macmillan nurses), doctors and social workers, all of whom are experienced and trained in specialist symptom control. They also offer advice and support for patients and their families.

Outpatient reception staff: The outpatient reception staff welcome patients, family and carers to NCCT and provide a friendly and helpful support service to all.

There are many other people who can help you too. Sometimes you may want to talk to a dietician, speech and language therapist, clinical psychologist or physiotherapist. Or perhaps a social worker who can help with practical matters such as the financial benefits you might be able to claim. Just ask a member of our staff.

All of our team is committed to providing high quality care to you, your family and carers. We are continually looking at ways to improve what we do and always welcome any comments, ideas or suggestions.

It is important that your programme of chemotherapy is planned specifically for you. However, to help you get an idea of what to expect, we have outlined below one of the common journeys through chemotherapy treatment.

• You will be introduced to a designated nurse, who will look after you when you come in for chemotherapy. Your nurse will answer any questions you have about your treatment, and will tell you what to expect.
• We will need to take a blood sample from you at each visit, to check that you are still able to have your chemotherapy. The blood sample is  processed immediately to check your white blood cells, your red blood cells, and your platelets. Platelets help your blood to clot.
• Your white blood cells fight infections, so we need to ensure the numbers of the cells in your blood are high enough for chemotherapy to be given safely. If for some reason, your tests come back telling us we can’t treat you that day, you will be given another appointment date before you leave.
• Other tests may be required to check that your liver or kidneys are functioning well. Not everyone needs this type of test. If you do require one of these tests, the blood samples are sent to the laboratory to be checked and the result may take up to 2 hours to come back.  There may, therefore be a delay before we know if you are able to have your chemotherapy. It may be more convenient for you have this test the day before your treatment so that you do not have to wait.  Your nurse or doctor will advise.
• The nurse or doctor who has seen you will have confirmed that you are fit to have you chemotherapy and as soon as we have the blood results we can ask pharmacy to prepare your drugs. This may take a little while but as soon as the drugs are ready your treatment will begin.
• Chemotherapy can take from between an hour to several hours to deliver, so you may want to bring a book or some magazines to keep yourself entertained.
   

Your chemotherapy drugs will usually be given via a vein in your hand or arm through a tube called a cannula.  Treatment can take several hours.  Your nurse will tell you how long it is likely to take and will check regularly during your treatment to see how you are feeling .

Once your treatment is complete, the cannula will be removed, and you will be able to go home. Depending on how you feel, you may wish to go back to work after treatment, but most people take the rest of the day off. It is entirely up to you and how you feel.

It is important that you look after yourself during treatment, in particular:

• Drink lots of fluids, particularly water. Keeping hydrated will help to flush the drugs around your system and will help your body cope with the treatment.
• Eat a healthy diet and try to eat enough food, even if you don’t feel hungry. It may be better to eat smaller amounts more often.
• Take care of your mouth. Chemotherapy can make your mouth and gums sore, so try and keep your mouth moist by sipping water regularly. Jaw exercises help keep it from getting too stiff.
• Your treatment can make you tired so you may need extra rest. Gentle exercise can also help to overcome the sense of tiredness.
• Keep your skin safe. Chemotherapy can increase the risk of sun damage to the skin, so take care to stay out of direct sunlight and wear loose, comfortable clothes and a hat in warm weather.
• You may be advised not to drink alcohol following your chemotherapy. Check with your nurse or oncologist.
• Most importantly look out for signs of infection, particularly a raised temperature. If this occurs contact the unit straight away so that you can be checked and treatment given immediately if necessary. This is very important as the usual advice about having a hot drink with a paracetamol and not contacting a doctor does not apply to you.

Emotional effects

Being diagnosed and treated for cancer can lead to a wide range of emotions, including sadness, anxiety and anger. These emotions can occur at any time and are normal. You may find it helpful to talk about your feelings with a family member, friend or professional. Please feel free to discuss your feelings with any member of staff too, including your oncologist or nurse. If you would benefit from more time to discuss your emotions or how you are coping, you may like to see one of our specialist nurses.

Some people undergoing treatment for cancer find that their emotional distress continues for several weeks and affects most areas of their life. This may mean that they become clinically depressed or anxious. It is important to tell someone if this is happening, as there are psychological and medical treatments that can help.

Your nurse or oncologist can refer you to one of our clinical psychologists who will arrange to see you and assess your emotional difficulties more fully. Then you and your psychologist can discuss the options available to you.

After your treatment you will have follow up appointments so that your oncologist can check how you are getting on. Your oncologist or nurse will tell you about the arrangements for your follow up appointments.

In the meantime you may be concerned about side effects. Everyone is different and the type of drug you are being treated with also makes a big difference. While some people experience more side effects than others, a few people have no side effects at all.

Most side effects last for only a short time and gradually disappear. Some treatments can cause long-term, and occasionally permanent, effects. Your oncologist will have explained the possible side effects before getting your written consent to start treatment. Patients say that they usually feel better between treatments, particularly just before their next cycle begins.

Common side effects include:

Infections: Chemotherapy can leave your body less able to fight infections. If possible avoid contact with anyone with a severe infection, particularly chickenpox, Keep an eye out for early signs of infection, most importantly a raised temperature. We will give you a contact number to enable you to be seen quickly and get treatment if necessary.

Nausea: Some chemotherapy drugs may make you feel or be sick. You can be given anti-sickness drugs to help you feel better.

Mouth and eating problems: Chemotherapy may make your mouth sore, or dry. Food may taste different, or you may have a reduced appetite. Drink plenty of water and remember that these problems will pass.

Hair loss: Some chemotherapy drugs can cause your hair to thin, or fall out. This is almost always temporary, and your hair will begin to grow back a few weeks after treatment has ended. In the meantime, NCCT is fortunate to have the services of  "Headlines" which designs headwear – and will supply scarves for patients who want them. The nurse can also arrange for you to have a wig fitted before you lose your hair. Some patients wear a “scalp cooling cap” during their chemotherapy which can reduce hair loss. This is not suitable for everyone – please check with your oncologist.

Fatigue: Chemotherapy may make you feel more tired than usual. Take things easy until you start to feel well again.

Bowel problems: Chemotherapy sometimes causes diarrhoea or constipation. Your doctor can give you medication for these problems, but there are also steps you can take, like changing your diet, which will help you. Your doctor or nurse can give you further advice.

Please feel free to discuss any concerns about side effects with us.