Most chemo drugs are given through a tiny plastic tube called a catheter. A needle is used to put the catheter into a vein in your forearm or hand; then the needle is taken out, leaving the catheter behind. This is called intravenous, or IV treatment. Intravenous drugs are given in these ways:
- The drugs can be given quickly through the catheter right from a syringe over a few minutes. This is called an IV push.
- An IV infusion can last 30 minutes to a few hours. A mixed drug solution flows from a plastic bag through tubing that is attached to the catheter. The flow is often controlled by machine called an IV pump.
- Continuous infusions are sometimes needed and can last from 1 to 7 days. These are always controlled by electronic IV pumps.
The needles and catheters can scar and damage veins with ongoing chemo. Another option is the central venous catheter (CVC). The CVC is a bigger catheter, which is put into a large vein in the chest or upper arm. It stays in place through treatment so that IV medicines can be given more easily. Blood can also be drawn from CVCs.
Many different kinds of CVCs are available. Some are soft tubes that stick out of the skin and require no needles. Another type is a port, which is like a small drum with a thin tube going into the vein. Ports are permanently placed under the skin of the chest or arm during surgery. Special needles are then stuck through the skin into the port to use it.
Many people talk about CVC options with the doctor even before starting treatment. Some find out during treatment that they need a CVC because their hand and arm veins are not good enough to complete the planned chemo. Your doctor can help you decide if you need a CVC and the right type of CVC for you.
Depending on the drugs and where the cancer is located, your chemo also may be given in one or more of these ways:
- Orally or PO – This means by mouth. You swallow the drug as a pill, capsule, or liquid – just as you do other medicines. This is usually more convenient because the drugs can often be taken at home. If you take chemo drugs by mouth, it is very important to take the exact dosage, at the right time, for as long as it has been prescribed for you. For more information please see our document called Oral Chemotherapy: What You Need to Know.
- Intrathecal or IT – The drug is put into the spinal canal and goes into the fluid that surrounds your brain and spinal cord. This fluid is called the cerebrospinal fluid (CSF). You may either have a needle put right into your spine to quickly give the drug, or a long-term catheter and port can be put under the skin on your head during surgery. This port is called an Ommaya reservoir. The Ommaya is a small drum-like device that has a small tube attached to it. The tube goes in to the CSF in your spinal canal. It stays in place under your skin until treatment is done.
- Intra-arterial – The chemo drug is put right into an artery to treat a single area (such as the liver, an arm, or leg). This method limits the effect of the drug on other parts of the body.
- Intracavitary – Chemo drugs may be given through a catheter into the abdominal cavity (the space around the bowels and other organs in the belly) or chest cavity (the space around the lungs and other organs in the chest).
- Intramuscular or IM – The drug is put in through a needle into a muscle (as a shot).
- Intralesional – A needle is used to put the drug right into a tumor in the skin, under the skin, or in an internal organ.
- Topical – The drug is put right on to an area of cancer on the skin as a cream, gel, or ointment.
Does chemo hurt?
You already know how it feels to take a pill or rub a medicine on your skin. And you’ve probably felt the brief discomfort of a shot (or an injection) before. IV medicines should not hurt after the first needle stick to put in the catheter. If you feel pain, burning, coolness, or anything unusual while you are getting chemo, tell your doctor or nurse right away.
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