How is chemotherapy given?

You will have your chemotherapy at the hospital as an outpatient, so you won’t need to stay overnight.

You may be given medicines to take at home, such as anti-sickness medicine. It is important to tell your oncologist or nurse about any other medicine, vitamins or supplements you are taking before starting your chemotherapy.

Chemotherapy can be given in different ways.

• You may have it through a drip. This is called an infusion, which can take between 5 minutes and a few hours.
• Fluorouracil (5FU) may be given through a small pump, which you can carry with you and take home. This is used if you are having chemotherapy that takes longer than a few hours.
• Capecitabine is taken as a tablet, that you take at home.
• You may have a cannula or central line put in to have the chemotherapy.

What is a cannula?

A cannula is a thin, plastic tube that is put into a vein in the back of your hand or lower arm. The chemotherapy can be given through a drip attached to the cannula, or through an injection into the cannula. The cannula will be removed after each treatment.

A diagram of a cannula:

What is a central line?

You may be given chemotherapy through a central line, such as a PICC line, Hickman line or a portacath. These are long, thin tubes that are put into a vein in your chest or arm. Central lines can stay in place for as long as your chemotherapy lasts.

A diagram of a central line:

• PICC line (Peripherally Inserted Central Catheter). This is the most common type of central line. It is a tube that is put into a vein in your upper arm. The line runs along the vein and into a large vein in your chest. The other end of the tube stays outside the skin on your arm, and is sealed with a cap.
• Hickman line. This is a long tube that is put under the skin of your chest. The tube goes into a large vein above the heart. The other end of the tube stays outside the skin on your chest, and can be sealed with a cap.
• Portacath. This is a tube with a small rubber disc at the end. This disc is called a ‘port’. The tube is put into a vein in your chest, and the port is placed just under your skin. A special needle is passed through your skin into the port to give you your chemotherapy.

You will have a local anaesthetic to numb your chest or arm, so you shouldn’t feel any pain when you are having a central line put in.

The line will need to be flushed regularly with a small amount of liquid, even if it’s not being used. This is to make sure the line doesn’t get blocked. The area where the line goes into your body will also be cleaned and dressed when the line is flushed. You will need to keep the area clean and dry. You may be given a covering to use when showering or bathing.

Advantages and disadvantages of central lines

Advantages

• The line stays in place through your chemotherapy treatment.
• You don’t need to have a needle put in each time you have chemotherapy.
• The line can also be used for blood tests or giving fluids or antibiotics.
• The line can be used to give blood transfusions.

Disadvantages

• The line may get blocked. Flushing the line will help prevent this. If it does get blocked, the line can be replaced.
• You may get an infection. This can be treated with antibiotics, and the line may be replaced, if needed.
• A blood clot can form. Flushing the line will help prevent this. If a blood clot does form, you will be given medicine for this.

What is a chemotherapy cycle?

Chemotherapy is normally given in cycles. A cycle is the number of treatments planned over a set time, including a break before the next cycle. The break allows your body to recover between treatments. You may have a longer break if you need more time to recover from side effects or an infection.

A cycle normally lasts two, three or four weeks, but this will depend on the chemotherapy you are having. It is common to have three to six months of chemotherapy. This will depend on how well the treatment is working and how chemotherapy affects you. Your oncologist or nurse can tell you more about this.

Check-ups before and during treatment

You will have check-ups and blood tests before each cycle to make sure it’s safe to have the next cycle. The tests check your kidneys and liver are working properly, and that your blood count has recovered enough from the last cycle.

You will also have regular CT scans to check the chemotherapy is working.

• For chemotherapy after surgery, you will have a scan before treatment starts and another after it is completed.
• In every other situation, you will have a scan before treatment starts, then in the middle and at the end of treatment.

Updated May 2024

Review date October 2026