To damage and destroy cancer cells, chemotherapy must get into the bloodstream and spread throughout the body. Selection of the route of administration will depend on the type of cancer, tumor location, the particular drug or combination thereof.

Less common ways:

  • intramuscularly;
  • subcutaneously;
  • intraarterially;
  • intrathecally (into the cerebrospinal fluid);
  • into the cavity (the bladder, the chest or the abdominal cavity);
  • intrapleurally (in the zone between the lungs);
  • directly into the tumor - in the lesion;
  • by cream (for some types of skin cancer).

Sometimes doctors need to use multiple methods of administration of chemotherapy. So, depending on how the following types of chemotherapy.

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intramuscular injection

Intramuscular injection of chemotherapy made mainly in the thigh muscles and buttocks. The formulations with this method are absorbed into the blood is slower than in the case of intravenous chemotherapy, but the effect lasts on.

subcutaneous injection

The most common areas is the skin of the abdomen, hips and shoulders. The patient is also able to make their own injections.

types of chemotherapy

intraarterial

Cytotoxic drugs are administered into an artery, located close to the tumor. This provides a high dose of cytostatics directly malignant tumors and minimal impact on the rest of the body. The doctor sets the catheter under local anesthesia.

This is a highly specialized technique, which is available only in some hospitals. Most often it is used to treat liver cancer. The drug is injected into the hepatic artery, which supplies it to the tumor. Intra-arterial chemotherapy is rarely used in other types of cancer, and, as a rule, within the framework of clinical trials because insufficient information on its effectiveness.

Side effects of chemotherapy are basically the same as in the case of intravenous. There is an increased risk of stomach irritation in the treatment of liver cancer. This is due to the fact that some drugs fall in blood supply to the stomach. Doctors prescribe medicines to protect the body from the effects of chemotherapy.

intrathecal

The introduction of chemotherapy into the cerebrospinal fluid - an important part of the treatment of certain types of leukemia, lymphomas and brain tumors. With this method, doctors injected into the spine in the lower back. The procedure is similar to a spinal tap.

intracavitary

Intracavitary chemotherapy means the administration of cytostatics by catheter into the body cavity. This method provides a high tumor dose of the drug and little effect on the rest of the body. Medications administered into the bladder (bladder cancer), the abdominal cavity (in ovarian cancer, mesothelioma - intraperitoneal chemotherapy) and the chest cavity (for lung cancer, breast cancer that has spread to the lungs).

intratumoral

Cytotoxic agents are injected directly into the lesion. This method is used in the form of a rare cancer - Kaposi's sarcoma. However, the technique is still experimental and not widely used. Ongoing research aimed at its use in head and neck cancer and some other types of cancer.

intravenous chemotherapy

Time of intravenous chemotherapy depends on the type of drug and oncology. For example, it can be:

  • injection into a vein - for minutes;
  • by intravenous drip or pump - from thirty minutes to several days;
  • the use of a small pump for a week or more.

If chemotherapy is carried out over several weeks or months - called continuous infusion.

When treatment lasts several hours and is generally performed in an outpatient hospital. If the duration of therapy than a few hours, hospitalization may be necessary. With the pump it is possible to be treated on an outpatient basis.

Types of intravenous chemotherapy

There are several ways to introduce drugs into the bloodstream:

  1. Cannula - a catheter into a vein set.
  2. Central venous catheter placed in a vein in the neck or chest area.
  3. PICC line placed in a vein in the chest.
  4. Portacath - implantable venous access device.

types of chemotherapyCannula

The nurse enters a small hollow tube into a vein in the hand or on the surface of the hand. If necessary, leave it for a few days.

If the operation was conducted in breast cancer or lymph node dissection, the catheter will set the arm on the side where the surgery was performed. cannula is also used in lymphedema.

drop counter

For administration of chemotherapy used dropper. In its composition includes needles that mate to a reservoir for liquid plastic tube. The drug solution is supplied into the vein slowly for a predetermined time period.

Currently, drugs through the flow almost always come with a pump or a pump which controls the speed. Nurse adjusts to the required number of hours to the drug enters the body the right pace.

Possible problems associated with the use of intravenous

Doctors prefer central venous catheters for chemotherapy for the following reasons:

  1. In the process of moving the hands of the drug delivery may stop if a dropper.
  2. Incoming easier to control the rate of drug via a central catheter.
  3. Some people are very fragile wrists, making it difficult to install the cannula.
  4. When using the cannula has a high risk that the drug to leak into the surrounding tissue, rather than to enter the vein, which leads to inflammation and tissue damage. Therefore it requires careful monitoring to prevent leakage.

Central venous catheter

intravenous chemotherapyThis is another way of intravenous chemotherapy, is used for central venous catheterization - jugular and subclavian. There are several types of such catheters. One is connected to the jugular vein in the neck - for short-term treatments. Another type - a subclavian vein. Distinguish tunneled catheters and netunneliruemye. Tunneled installed in a tunnel under the skin to provide a more solid grip and reduces the likelihood of infection. Other types of catheters are PICC lines and portacaths.

Central venous catheter may remain in the vein for many months. No need to introduce a needle into a vein every time when it is necessary to undergo treatment. It is possible to move, and the catheter is left in place, such as when a person is sleeping or dresses. Small cuff under the skin keeps it in place.

Central venous catheters are inserted under local or general anesthesia. It is fixed in place either by means of joints or in special cuffs. After the procedure, the doctor makes an X-ray to make sure everything is placed correctly.

Such catheters are used not only for administration of chemotherapy. With their help can take blood for tests, to introduce liquid into the organism, other medications, such as antibiotics.

Portacaths (-port catheters)types of chemotherapy

This device is fully implanted under the skin. Chemotherapy drugs are introduced into the tank by piercing the skin with a non-cutting Huber needle. At the port-catheter requires less maintenance, it is less noticeable, is suitable for treatment at home. During operation it is implanted in the subclavian fossa area is carried into the vein near the right atrium. Port catheters are used when you need a multiple venous access for long-term treatment.

PICC line

How is chemotherapyPeripherally administered central catheter is inserted into a vein in the arm under local anesthesia in the framework of out-patient treatment, it ends in an artery in the chest. PICC line is used for several months.

Possible side effects of central venous catheters

Sometimes problems can occur:

  • There is a risk of infection.
  • Lock catheter.
  • There is the risk of a blood clot.
  • PICC line can be divided, that happens very rarely.

Catheters are periodically washed with heparin (drug counteracting clotting process) or saline. Sometimes the doctor may also prescribe treatment with a low dose of warfarin.

You must immediately consult a doctor if in introducing the catheter into the body appeared redness, swelling and pain, which is a sign of infection.

Daily life with a catheter

There is small enough restrictions in everyday life with this kind of catheter. The patient may take a bath or shower. If you use a PICC line, waterproof covers are used. Nurses must give full instructions for catheter care.

Pumps for chemotherapy

Pumps (mikroinfuzionnye pump, infusion pump) are used for chemotherapy. In the case of using PICC line or central venous catheter pump attached to it, which provide a slow delivery of controlled amounts of drugs in the bloodstream. There are different types of pumps.

Passage through chemotherapy pump mikroinfuzionnoy

If the patient is being treated at the hospital, there are individual pump, which is placed on a tripod for a dropper.

There are pumps that can take home with them. To ensure their work does not need batteries. They are in a special bag or belt, which is provided in the hospital.

There is a small pump, battery operated, they can carry. The nurse advises the patient about the different types of pumps, their use in different situations. Also gives information on her care.

Chemotherapy tablets or capsules

Acceptance of cytostatic agents is possible in tablets or capsules of the house. This may be the only treatment needed. Nurses advise:

  • when to take;
  • how often;
  • taken with or without food;
  • taken before or after a meal;
  • Is there anything that you can not eat or drink during the treatment, for example, some chemotherapy drugs can not be combined grapefruit.

With cytostatics need as little as possible come into contact and to wash their hands after the interaction with them. If someone helps in this regard, it should use gloves.

In the case where the patient forgot to take a tablet, you can not take a double dose the next day. It is also contraindicated to take longer than originally planned. It is necessary to consult a doctor in this situation, what to do.

Chemotherapy drugs are excreted in the urine and stool, so it is important to lower the water after every use.

Storage of chemotherapy

A doctor or pharmacist will tell what the tablets or capsules should be stored in the refrigerator. Make sure that children or pets can not take them.

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