A Guide to Chemotherapy

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How will the chemo be given to me?

Into a vein

Most chemo drugs are put right into your bloodstream through a tiny, soft, 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 (IN-truh-VEEN-us) 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 from 30 minutes to a few hours. A mixed drug solution flows from a plastic bag through tubing that’s attached to the catheter. The flow is often controlled by a 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 that’s put into a large vein in the chest or upper arm. It stays in as long as you’re getting treatment so you won’t need to be stuck with a needle each time. With a CVC, 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 their doctor even before starting treatment. Some find out during treatment that they need a CVC because their hand and arm veins are not going to last to complete the planned chemo. Your doctor can help you decide if you need a CVC and the right type of CVC for you.

Other routes

Depending on the drugs and where the cancer is, chemo also may be given in one or more of these ways:

  • Orally or PO – This means by mouth. You swallow the chemo as a pill, capsule, or liquid – just as you do other medicines. This is usually more convenient because the chemo can often be taken at home. If you take chemo drugs by mouth, it’s very important to take the exact dosage, at the right time, for as long as you’re supposed to do so. For more information, please see Oral Chemotherapy: What You Need to Know.
  • Intrathecal or IT – The chemo 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 or CSF. Chemo put into the CSF is carried throughout the brain and spinal cord. 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 into the CSF in a cavity of your brain. The Ommaya stays in place under your scalp 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 helps limit the effect the drug has on other parts of the body and is called regional chemo.
  • Intracavitary – Chemo drugs may be given through a catheter into the abdominal cavity (the space around the bowels and other organs in the belly; this is called intraperitoneal chemo) 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 an injection or 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 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 medicine on your skin. And you’ve probably felt the brief discomfort of a shot 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.

Last Medical Review: 06/09/2015
Last Revised: 06/09/2015