ABOUT CHEMOTHERAPY. For more information, call PENN (7366) or visit our web sites: pennmedicine.org/abramson and oncolink.

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1 ABOUT CHEMOTHERAPY This Helpful Facts sheet is designed to give you basic information on chemotherapy. More detailed information can be provided by your doctor or nurse. If you have other questions, or would like additional information, please talk to your doctor or nurse. What is chemotherapy? Chemotherapy is the use of drugs to kill cancer cells. Depending upon the kind of cancer and its stage of development, chemotherapy can be used to: Cure cancer Prevent the spread of cancer to other parts of the body Kill cancer cells that have spread to other parts of the body Decrease the size of a cancerous tumor Relieve symptoms caused by the cancer How does chemotherapy work? Cancer cells go through many steps to grow. Chemotherapy drugs attack cancer cells and slow or stop the cell s ability to grow and multiply. There are many types of chemotherapy drugs and each interferes with cell growth at a different step. Certain chemotherapy drugs are given only for certain diseases. How is chemotherapy given? Chemotherapy drugs travel throughout the body in the blood stream. The most common ways to give chemotherapy are: Oral (taking pills or capsules by mouth) Intravenous (IV) (injecting medication into a vein) Intramuscular (IM) (injecting medication into the muscle) Subcutaneously (injecting medication into the skin) Chemotherapy drugs can be delivered to specific body areas by using special techniques. Some examples are: Intrathecal: Chemotherapy is placed directly into the central nervous system (brain /spinal cord) Intra-arterial: Arteries are used to deliver chemotherapy directly to the organs Intraperitoneal: Chemotherapy is delivered directly into the abdomen Intravesical: Chemotherapy is placed in the bladder

2 What if my veins are hard to find? If you require frequent IV insertions, have veins that are hard to find or need to receive multiple drugs a semi-permanent type of IV called a vascular access device (VAD) may be recommended by your doctor or nurse. Examples of these devices include portacaths, PICC lines and hickman catheters. Chemotherapy, IV fluids and blood products can be administered through the VAD. Blood can be drawn from them as well. These devices are removed after all your treatments are completed. Will it hurt to receive the chemotherapy? Most chemotherapy drugs do not cause discomfort during the IV administration. Some people report a feeling of coolness as the drug is started. A few drugs can irritate the veins causing pain at the IV site or along the vein. A few drugs are capable of causing skin blisters and damage if the drug leaks into the skin. Tell your nurse or doctor immediately if you experience any feelings of pain, burning, discomfort or skin changes at the IV site. How long will I receive chemotherapy? Chemotherapy is given in cycles. Each cycle consists of the days of your treatment followed by a set time for normal cells to recover. Then the cycle is repeated. Your doctor will select the best chemotherapy schedule for you based on factors including: The type of cancer and its stage The chemotherapy drugs received Other treatments received The goals of treatment The response to treatment How much chemotherapy will I receive? Most chemotherapy drug doses are based on the patient s height and weight, while others are based only on weight. Doses occasionally need to be adjusted during your treatment depending on side effects. Will chemotherapy be the only treatment I receive? Chemotherapy may be the only treatment. Sometimes it is used with surgery, radiation therapy, immunotherapy or hormonal therapy. What are the side effects of chemotherapy? Your reaction to chemotherapy will depend on : The specific chemotherapy drug(s) received The chemotherapy dose received Other treatments received

3 Normal cells of your GI tract, skin, hair and bone marrow grow rapidly, like cancer cells, and are also affected by chemotherapy. Consequently, the most common side effects of chemotherapy are: low blood counts, nausea, vomiting, diarrhea, hair loss, mouth sores and skin changes. Other side effects include: fatigue, allergic reactions, infertility/changes in sexual function, nerve damage, secondary cancers and damage to heart, lung, kidney, bladder or liver. Most side effects from chemotherapy are temporary. Many patients have few or no side effects. Your doctor and nurse will discuss ways to prevent or control many of these side effects. Why do I need regular blood tests? Since many chemotherapy drugs can significantly lower blood counts your doctor and nurse will be watching for changes in your White Blood Count (WBC), Red Blood Count (RBC), and platelet count. A low WBC indicates a risk for developing an infection. A low RBC may indicate anemia. A low platelet count may indicate a risk for bleeding. A Complete Blood Count (CBC) checks the WBC, RBC and platelet count. A CBC is usually done at the beginning of each treatment cycle. If the WBC, RBC or platelet counts are too low, your chemotherapy treatment may need to be delayed until your blood counts have normalized. A CBC is also sometimes checked between treatments. Where are chemotherapy treatments given? Most chemotherapy can be given in the outpatient chemotherapy suites (14 and 15 Penn Tower, and 9 Ravdin-Gynecologic Oncology). These chemotherapy suites provide settings where patients can receive their treatment and can be carefully watched by their chemotherapy nurse, who is specially trained and certified in giving chemotherapy. You may be hospitalized if your chemotherapy treatment requires long infusion times, is given for multiple days in a row or requires close monitoring. Some chemotherapy treatments are given at home. What can I do to make the chemotherapy visit more pleasant? Bring reading materials, books on tape, small hand crafts (needlepoint, knitting, drawing materials), CD player or radio with headphones, and other items that can help pass the time. Some of the chemotherapy rooms have TV s and VCR s so feel free to bring a video. Some patients get a metal taste in their mouth as a result of the chemotherapy; mints or mint-flavored gum can help relieve this taste. You may also want to bring a sandwich, small packets of crackers or cookies, and something to drink depending on the length of your visit. Family members and friends are welcome. It is helpful to have a friend or family member drive you to and from treatment in case you are not feeling well.

4 When do I see my doctor? You will see your oncologist throughout your chemotherapy treatment, usually just before your chemotherapy treatment. Your oncologist will discuss with you how often your doctor appointments will occur. What happens if I need to cancel an appointment? It is very important for you to stick to your treatment schedule. Treatment schedules can sometimes be adjusted for holidays and special events; just let your doctor or nurse know. What happens if I miss an appointment? If you miss an appointment, call your doctor or nurse immediately. Your Chemotherapy Treatment Plan The chemotherapy you will receive is:. Your treatment will be day(s) every weeks. You will receive a total of treatments. You will receive chemotherapy by: (i.e., injection, pill, port catheter) Other Other Resources Chemotherapy and You Radiation Therapy and You What You Should Know About (NCI series) Feeling Better Again What You Should Know About Low Blood Counts Information sheets on: Constipation, Diarrhea, Hair Loss, Mouth Sores, Nausea and Vomiting, Fatigue, Pain, Vascular Access Devices Copyright 2002 by the Trustees of the University of Pennsylvania. All rights reserved. No part of this publication may be reproduced without permission in writing from the Trustees of the University of Pennsylvania

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