How are chemotherapy treatments usually given?
Only one FDA-approved drug for colorectal cancer– Xeloda® (capecitabine) — is available in pill form. All the other drugs– both chemotherapy and biologic treatments–are given directly into your veins through a needle or tiny plastic tube as an intravenous (IV) infusion.
When treatment will be given repeatedly over weeks or months, you may get a implanted port. A soft, flexible tube is placed in one of your veins, usually in an arm or your chest. The indwelling catheter is attached to a small disk just underneath your skin where needles can be easily inserted without having to find a vein for each treatment. Your oncology nurse will teach you how to watch for signs of infection or blood clots in your port. Report redness, pain, or fever to your doctor or nurse right away.
What happens during a treatment session?
Intravenous treatments are given either at a doctor’s office or hospital. Before your treatment, you’ll get blood tests to be sure that it is safe to go ahead with the planned therapy.
If you have a port, a special needle will be inserted for blood tests and for the infusions that are part of your specific chemotherapy regimen. If you don’t have a port, you’ll have an IV needle in a vein in your hand or arm.
You may have anti-nausea or other medications to treat side effects before your chemotherapy begins either as an infusion or sometimes as pills that you take before you arrive at your doctor’s office.
Infusions may be given as:
- Bolus injection Drugs are injected into your vein over a short time, a few minutes at most.
- Infusion Drugs are mixed with IV fluids and infused into your veins over one to several hours. In most situations, you’ll sit comfortably in a recliner during the infusion.
- Continuous infusion Some drugs, particularly 5FU, are also given by a continuous infusion that is slowly fed through your port over several days using a small portable pump that you wear at home in a fanny pack.
During your infusion, a nurse or doctor will watch for any reactions or problems. It is important to tell them if you feel sick or dizzy or are having problems breathing.
After your treatment, you may be given medicine to take at home. This medicine may help to prevent or treat side effects such as nausea or diarrhea.
Between treatment sessions, you may need to blood tests to measure how you are responding to treatment. It’s important to keep lab appointments so your doctor can get test results in time to decide about any adjustments before the next treatment.
How often will my chemotherapy treatments be scheduled?
A treatment regimen describes which drug or drugs you get, in what doses, and how often. Treatment sessions might happen every day for a week or more, once a week; continuously over a few days, or once every few weeks. You will have a rest or recovery period after each series.
One cycle is a one sequence of treatment sessions plus the rest period. The number of treatment cycles depends on your specific situation.
How will my drug treatment be chosen or changed?
Your treatment plan depends on the stage of your cancer, its location, spread to nearby lymph nodes or other parts of your body, your overall health, and your ability to cope with side effects. Doctors and cancer centers may follow treatment guidelines such as the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology™ for colon cancer and rectal cancer, which describe treatment options for different stages of colorectal cancer, along with the research that shows why an option is recommended.
If you have colorectal cancer that has spread to distant organs (metastatic), you will be given one treatment or combination of treatments for as long as your cancer responds (shrinks) or stays stable. You may pause treatment with some of the drugs to recover from side effects. If your cancer progresses (starts growing) or the side effects become intolerable, you may change to another treatment regimen.
Why do drugs have different names?
Every drug has a scientific name, and a trademark name used in marketing Some also have nicknames used earlier in development. Throughout this site, we use brand names, familiar to consumers, sometimes followed by generic names or nicknames in parentheses.
Treatment combinations with multiple drugs have nicknames taken from the first letters of the drugs they contain such as FOLFOX or FOLFIRI.