Chemotherapy

Chemotherapy is the use of 'anti-cancer' (also known as cytotoxic) drugs to destroy cancer cells in the body. Chemotherapy is used at different stages of treatment, and can be used in combination to make other treatments more effective:

• 'Neo-adjuvant' – to shrink the tumour(s) before surgery in order to get a better outcome following the operation.
• 'Adjuvant' – to destroy any microscopic cancer cells that may remain after the cancer is removed by surgery and reduce the possibility of the cancer returning.
• 'First-line' – chemotherapy that has been shown, through extensive clinical trials and research, to be the best option for the type of cancer being treated.
• 'Second-line' – chemotherapy that has been shown, through extensive clinical trials and research, to be the best option if the disease has not responded to first-line chemotherapy or has recurred.
• 'Palliative' – to relieve symptoms and slow the spread of the cancer, if a cure is not possible.

Administration of chemotherapy

In order for the chemotherapy to destroy cancer cells in the body, the drugs must be absorbed into your blood and carried throughout your body. The chemotherapy drugs can be given in different ways:

• Oral chemotherapy: If your chemotherapy drug is available as a tablet you can swallow, this can be taken at home. You only go to the hospital for routine outpatients' appointments, which include a blood test. As oral chemotherapies can cause side-effects it is important to keep a diary of how you are feeling and possible side-effects to ensure that you are able to identify and report them to your medical team immediately.
• Intravenous (IV) injection: The treatment is injected into a vein. There are a wide range of schedules for chemotherapy which can vary from a small injection over a few minutes, a short infusion of up to 30 minutes, or longer infusions over the course of a couple of hours or even a couple of days.

IV chemotherapy can be given via 4 different methods:

• Cannula: A small tube inserted into a vein in the back of your hand, or your arm.
• Central Line: A thin, flexible tube inserted though the skin of the chest into a vein near the heart. Hickman® or Groshong® lines are common types and can stay in place for many months.
• PICC Line: A thin, flexible tube passed into a vein in the bend or upper part of your arm and threaded through the vein until the end of the tube lies in a vein near the heart. PICC lines can stay in place for many months.
• Portacath: A thin, soft plastic tube that is put into a vein. It has an opening (port) just under the skin on your chest or arm.

If your oncologist believes you will benefit from chemotherapy, he / she will discuss the best treatment plan options with you. You may be prescribed one drug or a combination of drugs. Ask your specialist about which drug they recommend for you, how the chemotherapy will be given and the choices you have. 

The common chemotherapy drugs for bowel cancer are 5-FU, Oxaliplatin, Capecitabine, Tegafur-uracil and Irinotecan. Depending on the stage of your bowel cancer, you may also be recommended treatment with monoclonal antibodies.

For further information, please download our booklet 'Bowel Cancer Treatment - Your Pathway'.

Chemotherapy can affect your sense of taste and smell, dull your appetite and make you feel sick.  It may also make your mouth and throat sore or sensitive to hor and cold food and drink.  We have advice on ways to manage these side-effects in our booklet 'LIving with Bowel Cancer - Eating Well'.