Chemotherapy Health Article

Clinical trials

Some patients may be eligible to participate in clinical trials, research programs conducted with patients to evaluate a new drug, medical treatment, device, or combination of treatments. The purpose of clinical trials is to find new and improved methods of treating different diseases and special conditions. More information is available at the National Institutes of Health's clinical trials Web site, <www.clinicaltrials.gov> or by calling (888) FIND-NLM, (888) 346-3656 or (301) 594-5983. Another resource is the National Cancer Institute's Web site, <www.cancer.gov/clinicaltrials>.

Precautions

There are many different types of chemotherapy drugs. Oncologists, doctors who specialize in treating cancer, determine the drugs that are best suited for each patient. This decision is based on the type and severity of cancer, location of the cancer, patient's age and health, and other drugs the patient takes. Some patients should not be treated with certain chemotherapy drugs. Age and other conditions may affect the drugs selected for treatment. Heart disease, kidney disease, and diabetes are conditions that may limit the choice of treatment drugs. In 2003, research revealed that obesity appears to reduce the effectiveness of high-dose chemotherapy. Researchers said further study was needed to determine the best dosage for obese patients receiving therapy.

How chemotherapy is given

Chemotherapy is administered in different ways, depending on the drugs to be given and the type of cancer. Doctors determine the dose of chemotherapy drugs based on many factors, including the patient's height and weight.

Chemotherapy may be given by one or more of the following methods:

• orally (by mouth)
• injection
• through a catheter or port
• topically (via the skin)

Oral chemotherapy is given by mouth in the form of a pill, capsule, or liquid. This is the easiest method and can usually be done at home.

Intravenous (IV) chemotherapy is injected into a vein. A small needle is inserted into a vein on the hand or lower arm. The needle usually is attached to a small tube called a catheter, which delivers the drug to the needle from an IV bag or bottle.

Intramuscular (IM) chemotherapy is injected into a muscle. Chemotherapy given by intramuscular injection is absorbed into the blood more slowly than IV chemotherapy. Because of this, the effects of IM chemotherapy may last longer than chemotherapy given intravenously. Chemotherapy also may be injected subcutaneously (SQ or SC), which means under the skin. Injection of chemotherapy directly into the cancer is called intralesional (IL) injection.

Chemotherapy also may be given by a catheter or port permanently inserted into a central vein or body cavity. A port is a small reservoir or container that is placed in a vein or under the skin in the area where the drug will be given. These methods eliminate the need for repeated injections and may allow patients to spend less time in the hospital while receiving chemotherapy. A common location for a permanent catheter is the external jugular vein in the neck.

Intraperitoneal (IP) chemotherapy is administered into the abdominal cavity through a catheter or port. Chemotherapy given by catheter or port into the spinal fluid is called intrathecal (IT) administration. Catheters and ports also may be placed in the chest cavity, abdomen, bladder, or pelvis (intracavitary or IC catheter), depending on the location of the cancer to be treated.

Topical chemotherapy is given as a cream or ointment applied on the surface of the skin. This method is more common in treatment of certain types of skin cancers.