Chemotherapy

Traditionally when people think of treatment for cancer they think of chemotherapy however there are now a number of forms of treatments which may be given, these are referred to as systemic anti- cancer treatments  or SACT, chemotherapy is one of these. Historically chemotherapy was given predominantly through a vein however nowadays, your treatment can be given in a variety of different ways including as a tablet, an injection under the skin, an injection into a vein or into the spinal area.

We offer a wide variety of SACT or drug treatments. These include: 

• cytotoxic chemotherapy
• immunotherapy
• molecular targeted agents
• monoclonal antibodies
• hormone therapy. 

The longer standing treatments of this kind are called cytotoxic chemotherapy. “Cyto” means cell, and “toxic” means poisonous. The aim of these drugs is to poison and destroy the cancerous cells in your body. They may also affect non-cancerous cells, causing potentially unpleasant side effects.

As well as the longstanding chemotherapy treatments, we also use newer drugs. These work in a more targeted way to kill cancer cells, while reducing the impact on non-cancer cells in the body. These newer drugs are sometimes referred to as monoclonal antibodies, immunotherapy and biological agents.

Each type of SACT can be given alone but commonly cancer is treated with a combination of different drugs. Combining treatments enables more cancer cells to be killed and increases the chance of a good outcome of your treatment.

What kind of cancer treatment is recommended for you will depend on a number of factors. These include:

• What kind of cancer you have
• The extent to which the cancer has progressed
• Other factors revealed in laboratory tests

We tailor your treatment, taking all these factors into account. Before you start chemotherapy, your treatment team will discuss your treatment plan with you face to face, explaining exactly what will be done. This will also give you the opportunity to ask any questions you may have.

As your treatment progresses, you will always be able to ask your team whatever you need to know.

The majority of SACT treatments are given as a day treatment. This means that you come in for your treatment and can go home on the same day. We also have clinics in some GP surgeries enabling you to have treatment closer to home.

In some cases, eg where a longer treatment is required or because of the nature of a particular cancer, patients need to be admitted to hospital as an inpatient for treatment.

Outpatients

As an outpatient, you’ll be seen by your consultant and their team in a clinic in our outpatient suite. They’ll discuss your treatment with you and give a prescription to take away.  You'll then take this medication as directed by the team caring for you.

There are usually between six and seven clinics held each day, adding up to a total of 28 sessions per week seeing over 500 patients.

Day case treatments

Your chemotherapy treatment as a day case, will take place in one of two environments:

• The oncology day unit at the hospital
• One of our outreach surgeries, based in GP practices

The oncology day unit

In the oncology day unit we administer treatments to patients with all types of cancers. On a daily basis between fifty and seventy patients are treated with many different types of treatments.

We have a very experienced team of nurses and healthcare assistants, overseen by a senior sister. We know that this is a very difficult time for you and always have your best interests at heart. We aim is to administer your treatment safely, expertly and with the minimum of discomfort possible. We are here to help and support you throughout your treatment journey and you’re always welcome to ask us about anything you need to know or that may be bothering you.

On arrival a nurse will explain everything to you and guide you through what is going to happen to you for your treatment day. The nurse will be able to answer any questions you may have to help put your mind and ease and allow you to be comfortable throughout your treatment.

Outreach treatment

In March 2012, we launched the first phase of a new service that enables people to receive cancer treatments closer to home, in a less stressful environment than the hospital. Under this service, our chemotherapy trained nurses travel to GP surgeries to administer chemotherapy and other supportive treatments.

We currently offer this service at East Barnwell Health Centre in Cambridge, running clinics on Tuesdays and Fridays respectively.

The launch of this service took place after clinical trials showed that patients preferred to be treated closer to where they live. We are hoping to add further GP surgeries to the service, as we believe that it genuinely improves the quality of life for our patients who have this opportunity.

If you would like further information please speak to your nurse. 

Round the clock help

We offer a 24/7 service for our patients who require urgent advice or admission as a result of their cancer, suspected cancer or treatment.

Everyone puts in so much effort here, and we give real support to people when they need it the most.

We have a team available 24 hours a day to provide advice to our existing patients if you are concerned about how you are feeling because of your illness or treatment.

When you start your treatment with us, you will be given a card with the contact details on it for this service.

The team caring for you will have given you advice about when to contact the hospital for help. We would always advise you to call if:

• you think you may be developing an infection
• you develop other worrying symptoms eg bleeding
• you need advice about managing the side effects of your treatment eg feeling sick, having bowel difficulties, experiencing pain
• You, or the people caring for you can ring the number on the card at any time of the day or night if you feel you need urgent advice:

Please do not use this number for routine questions or appointment enquiries.

We also provide a round the clock service to ensure that emergency patients who need to be admitted because of the effects of cancer or cancer treatments, receive timely and appropriate treatment and care.

Infections

While you are having chemotherapy you will be susceptible to infection when your white cells (the regulators of the immune system) are low (neutropenic). Any infections you pick up during this time can make you seriously ill and you may need to be admitted to hospital to have the infection treated. Common symptoms of an infection include:

• feeling generally unwell
• feeling hot then cold and clammy
• feeling shivery or fluey
• having a raised temperature

Some patients may feel unwell without having a raised temperature. There are many possible reasons for this. One is that some medications you may be prescribed can mask a temperature. It is important to contact the hospital for advice if you feel unwell, even if you do not have a temperature. 

Some medication eg  Paracetamol, aspirin or steroids can mask or hide a temperature. If you have taken any medication, please tell us when you call us.

Bleeding

Chemotherapy can also cause the platelet levels in your blood to fall. The platelets are responsible for helping your blood to clot. Low platelets levels can cause bruising or bleeding.

If you are experiencing bruising, bleeding from the gums, in the urine or stools, or have red spots or rashes in your skin, or an uncontrolled nosebleed, please contact us immediately for advice.

Side effects of treatment

You will have received advice about possible side effects of your treatment and how to control these. If you have any questions about how to deal with any side effects which may be troubling you, please call us.

Inpatients

Occasionally you may need to be admitted to hospital your treatment needs to be given over a longer period, making it impractical to receive it on the day or outreach units.

Most of our patients have their chemotherapy as outpatients. However, it may happen that you need to have planned treatment as an inpatient. If you are having planned chemotherapy as an inpatient, we may ask you to go to the Oncology Clinic first, or you may be asked to go straight to the ward.

Regardless of which ward you are booked onto please ring the Oncology Patient Bed Manager after 08:00, on the morning of your planned admission: 01223 216319.

We ask you to ring in to check that there is a bed available for you. While we make every effort to ensure that beds will always be available, sometimes situations beyond our control mean that we cannot admit you on the planned day. In this case we will tell you what to do next when you ring in and ensure that we find a bed for you as soon as possible.

You could also be admitted to hospital if your cancer or the effects of your treatment make you too ill to remain at home.