Chemotherapy

Chemotherapy image

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Systemic anti-cancer therapies (SACT)

Systemic anti-cancer therapies are the medicines that are given to cancer patient as part of their treatment. This includes chemotherapy, hormone therapy and immunotherapy. Depending on the type of cancer you have, depends on the treatment or may or may not need. As part of our commitment to local care for local people, we provide chemotherapy on our three hospital sites – Redditch, Kidderminster and Worcester. In addition, we are actively seeking ways of delivering treatments even closer to home – for example, in community hospitals.

If you have been recommended for a cancer-related treatment, there may be many questions which arise through this process. Our staff are here to help you. If you are worried in any way, you can contact us and we will do our best to sort out any problems you may have and answer your questions. Our policy is to be open and honest and accessible. Your doctor will be happy to discuss any queries or worries with you when you are seen at the clinic.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Unfortunately, chemotherapy also affects some normal cells which can cause side effects but these are nearly always temporary and can usually be managed following advice.

If you would like more information about the specific chemotherapy that you are going to be receiving, you can go to www.macmillan.org.uk or www.cancerresearchuk.org and search for the drug that you are looking for. Information is always given to you by a qualified practitioner at your hospital prior to you receiving any treatment.

Emergency contact numbers

If you are receiving chemotherapy and you experience problems, please contact the 24 hour, 7 days per week on Tel: 01905 760158.

Other useful numbers:

Garden Suite, Alexandra Hospital Redditch, Tel. 01527 512092

Millbrook Suite, Kidderminster Hospital and Treatment Centre, Tel. 01562 513093

Rowan Suite, Worcestershire Royal Hospital, Tel. 01905 733023

The Worcestershire Oncology Centre, Tel. 01905 761400

Macmillan Cancer Information and Support Centres

Alexandra Hospital Redditch, Tel. 01527 503030 ext 44238

Kidderminster Hospital and Treatment Centre, Tel. 01562 513273

Worcestershire Royal Hospital, Tel. 01905 733837

The Worcestershire Oncology Centre, Tel 01905 760674

Chemotherapy side effects

There are many different types of chemotherapy and combinations of chemotherapy so the side-effects you experience will depend very much on which treatment/s you are having. No two people receiving chemotherapy will feel exactly the same, even when they are receiving the same drug. More detailed written information about individual chemotherapy drugs will be provided or can be requested from your key worker. The information you receive may have a long list of side-effects but this does not mean that you will experience them all.

Some of the side-effects will have been discussed with you. The most important one medically is the effect of the chemotherapy on your blood count and how this can affect you. This is the reason for regular blood tests so we can monitor what your bloods counts are doing.

Low blood count

Your blood is made up of several different kinds of cells which have different jobs to do. Chemotherapy can have the effect of lowering your blood count and we need to keep a close eye on this and take urgent action if necessary. Some problems you may experience with having a low blood count are:

  • Infection (caused by a low white cell count)
  • Bruising or bleeding (caused by a low platelet count)
  • Anaemia (caused by a low red cell count)

Nausea and vomiting

This is caused by some chemotherapy and, if necessary, medication to control or reduce this will be given to you. If it is not controlled or, if you are unable to take your medication, please contact the chemotherapy helpline.

Irritation of vein

A lot of chemotherapy is given through a drip into a vein. Some drugs given this way can cause irritation to the vein. These drugs can also damage surrounding cells if they leak out of the vein. It is important to tell the nurse giving you your treatments if you experience any stinging, discomfort or pain whilst you are having your chemotherapy.

Hair loss

Some treatments with chemotherapy cause hair loss but not all of them. You will be informed if the chemotherapy you are receiving causes hair loss or thinning. It can take two to four weeks before for hair loss to occur; it will re-grow following completion of treatment. If the treatment you receive causes hair loss, then a referral can be made by the nurse to provide you with a £100 voucher to go towards the cost of your wig. You will receive a letter at your pre-chemotherapy consultation with a list of companies that provide wigs; you will be given a contact number for the voucher to be processed.  There is also written information available giving advice about dealing with hair loss.

Scalp cooling can also be discussed with you but there are some treatments where scalp cooling cannot be offered. The use of scalp cooling or ‘cold caps’ is proven to be an effective way of combatting chemotherapy-induced hair loss and can result in a high level of retention or completely preserve the hair.

Lymphoedema

Some cancer treatments can leave a patient at risk of developing lymphoedema. This is a swelling, usually in an arm or leg, caused by inadequate lymphatic drainage. It is not life-threatening but does require treatment to attempt to control swelling and/or prevent infection. Please ask your doctor, nurse or Key Worker if you are at risk or if you have any concerns about lymphoedema – they will be able to advise you and refer you on to a lymphoedema service, if appropriate.

Our local lymphoedema clinic (for all patients with a Worcestershire GP) is provided at: 

Pershore Hospital 
Queen Elizabeth Drive
Station Road
Pershore
WR10 1PS

Tel. 01386 502030

When to contact us

Some of the side effects you may experience can be very serious so prompt advice or treatment is important. You should contact the chemotherapy helpline if you are experiencing:

  • Temperature – above 37.5ºC (we recommend that you buy a thermometer and check you temperature daily)
  • Feeling generally unwell (even without a temperature)
  • Sore throat / mouth.
  • Shivering, shaking attacks, symptoms of a cold or flu.
  • Excessive bruising or bleeding from anywhere (blood in your urine or motions, nosebleed, appearance of a rash on your skin)
  • Diarrhoea.
  • Nausea and vomiting uncontrolled by anti-sickness medication
  • Redness, swelling, pain or blistering on the skin whereby the chemotherapy was given by injection.
  • Problems with any indwelling intravenous catheter such as a PICC, Groshong, Hickman or Port.

Other guidelines

Do not take Aspirin unless it has been cleared with your hospital Doctor. Aspirin can increase your risk of bleeding.

  • Please discuss it with us first if you need to visit a dentist during your treatment.
  • Seek advice from us if you intend travelling abroad.
  • Contact the helpline if you are unable to take any tablets that have been given to you.
  • It is important that relatives are aware of the information that has been given to you.
  • After chemotherapy, it is sometimes difficult to eat a full diet. It is important to drink plenty of fluids. You should eat whatever you feel able and small, regular amounts are often better tolerated. If you would like advice from the hospital dietician please ask the nurse to arrange this.

Chemotherapy: fertility and sex

Some people go through chemotherapy without it having any effect on their sex lives. Others find that their sex lives are temporarily or permanently changed in some way due to their chemotherapy or perhaps, to a change in body image.

Most changes that occur are temporary, and should not be long-term. There may be times when you feel too tired or not strong enough for the level of physical activity but these side effects should gradually wear off once your treatment has finished. Anxiety may also play a part in putting you off sex.

There is no medical reason to stop having sex at any time during your course of chemotherapy but we do recommend the use of a barrier method (condom) as chemotherapy can be present in bodily secretions. It is perfectly safe, and the chemotherapy drugs themselves will have no long-term physical effects on your ability to have and enjoy sexual activity. Cancer cannot be passed on to your partner during sex and it won’t make the cancer worse.

Contraception

It is very important to take effective contraceptive precautions when having chemotherapy, as the chemotherapy drugs might harm the baby if pregnancy occurs. Your doctor will advise you about reliable methods of contraception throughout your treatment and for a few months afterwards.

Fertility

Unfortunately, some chemotherapy treatments may cause infertility (the inability to become pregnant or to father a child). This may be temporary or permanent, depending on the drugs that you have. It is strongly advised that you discuss the risk of infertility fully with your doctor before you start treatment. If you have a partner, they will probably wish to join you at this discussion. Then you can both be aware of the facts and have a chance to talk over your feelings and options for the future. In some women, chemotherapy brings on an early menopause and your doctor or key worker will be able to discuss these issues with you in further detail.

A booklet on how surgery and treatment for cancer may affect close relationships, dealing with possible solutions to sexual problems, is available from Macmillan. Call free phone 0808 808 2020 or visit www.macmillan.org.uk.