Other ways of having chemotherapy
There are different ways of getting chemotherapy into your body. These are called routes of administration.
The best way for you depends on:
- the type of cancer you have
- where the cancer is in the body
- the drug or drugs you're having
Most common ways of having chemotherapy
The most common ways of getting the drugs into your body are:
- intravenously - into the bloodstream as an injection or a drip, often using an infusion pump
- orally - taking them as tablets or capsules
Less common ways of having chemotherapy
Here are some of the less common ways of having chemotherapy. Sometimes your doctor may need to use 2 or more methods of giving chemotherapy at the same time.
Injections into muscle (intramuscular)
You have some chemotherapy drugs as an injection into a muscle (intramuscular). This is usually into your buttocks, upper thigh or upper arm.
You might have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much.
Injections under the skin (subcutaneous)
Some chemotherapy is given as an injection into the layer of fat just under the skin (subcutaneously). The skin of the tummy (abdomen), thigh and upper arm are the usual areas for giving subcutaneous treatment.
You may be able to give these injections yourself. It is important to wash your hands well before giving yourself an injection.
The video below shows you how to give an injection just under your skin. It is 3 minutes and 22 seconds long.
Nurse: This is a short film showing you how to give an injection just under your skin. This is called a subcutaneous or sub cut injection. This does not replace what your doctors and nurses tell you, so always follow their advice.
Voiceover: Subcutaneous injections may be part of your cancer treatment. Or, you may need them to prevent side effects of treatment, such as blood clots after surgery. Or to help control cancer symptoms, such as pain or sickness.
Most injections come in prefilled syringes.
Nurse: So, today I am going to show you how to give a subcutaneous injection. I am going to start by giving it into a practice cushion and then you can have a go at giving one yourself. Before you start, you need to get your equipment together. What you are going to need is an alcohol wipe to clean your skin, some cotton wool, a prefilled syringe and a sharps bin. It is important that you wash your hands with soap and water and dry them thoroughly before you start. Check that you have got the correct drug and that it is in date.
You can give the injection into the back of your arm, your tummy, your thigh or the outer part of your bottom. It is important that you vary where you give the injection. So it may be that you give it one day in your tummy and the next in your thigh.
So you start by cleaning the skin with the alcohol wipe and allowing it to air dry. Then you take the cover off the needle and pinch the skin up and hold it a bit like a pen and in an upright position, in a quick dart like motion pop it straight down into the skin. Then you press the plunger right to the end, quickly pull the needle out, dab it with cotton wool, pop the needle into the sharps bin. And then you need to wash your hands again.
So here’s what you are going to need. If you start by checking the drug and the expiry date. And then with the alcohol wipe give your skin a clean. That’s it give it a few seconds for the air to dry it. Ok and then if you want to pick up the syringe and take the cover off the needle. Then pinch your skin up and at a ninety degree angle gently push the needle in...then press the plunger...and then quickly remove it... dab your skin with the cotton wool and put the syringe in the sharps bin.
Chemotherapy as a cream (topical)
For some types of skin cancer, you may have chemotherapy as a cream (topically). It treats the cancer cells where you apply it. Very little of the drug is absorbed into the rest of your body.
Chemotherapy into the spinal canal (intrathecal)
For some cancers, you have chemotherapy injected into the fluid around the spine and brain.
To have chemotherapy in this way, you have an injection into your spine, in your lower back. It is similar to having a lumbar puncture.
Chemotherapy into an artery (intra arterial)
Intra arterial chemotherapy means having chemotherapy injected directly into arteries close to the cancer. This gives a very high dose of chemo to the tumour, but less to the rest of the body.
To have this treatment, you need to have a tube put into the artery under local anaesthetic. This is a highly specialised way of giving chemotherapy and not available in all hospitals in the UK.
Intra arterial chemotherapy is most commonly used for:
- liver cancer
- cancer that has spread to the liver
- retinoblastoma
Chemotherapy into the pleura (intrapleural)
You can have chemotherapy injected directly into the space between the 2 layers of skin-like tissue covering the lungs (the pleura). This is called intrapleural chemotherapy.
Chemotherapy into the bladder (intravesical)
Intravesical means having a solution of a chemotherapy drug through a tube (catheter) into your bladder.
It gives a very high dose of chemotherapy to the tumour, but only a very low dose to the rest of the body.
Chemotherapy into the peritoneum (intraperitoneal)
The peritoneum is the tissue that lines the abdomen (tummy). Intraperitoneal chemotherapy is injected into the space between the peritoneum and the organs in the abdomen.