Chemotherapy drugs are typically given in cycles. The cycle consists of the day(s) the drug is administered followed by a rest and recovery period. A cycle usually lasts one to four weeks and is then repeated, which means a treatment is administered every one to four weeks. Each course of chemotherapy is different, but generally consists of four to six cycles. The actual administration of some chemotherapy drugs may take only seconds or minutes, while others may take hours or even days.

In the past, chemotherapy drugs were mainly administered into a vein (intravenous). Oral drugs may provide greater ease of administration since patients can take them at home rather than going to a clinic or hospital for treatments. Not all chemotherapy drugs are available in oral form. Sometimes intravenous (IV) administration is preferable because the doctor can be more certain that the patient received the appropriate dose as scheduled and they can monitor the patient during administration.

A VAD is a surgically implanted device that provides long-term access to a major vein. Although there are several different types of VADs, the two most commonly used for cancer treatment and taking blood samples are:

• Tunneled external catheters such as a Hickman® catheter where a plastic tube or catheter is attached to a major vein and then comes out of the body for external access.
• Subcutaneous implanted ports, called a port-a-cath, is implanted completely beneath the skin into a major vein under the collarbone. The port may then be accessed by a special needle through the skin to deliver chemotherapy, hydration and transfusions, and for taking blood samples.
   

Not every chemotherapy patient requires a VAD. For some chemotherapy treatment plans, the inconvenience of implanting and accessing a VAD may outweigh the benefits. You can ask your doctor if a VAD is an appropriate option for you, especially if you experience any of the following:

• You are extremely anxious about having needles inserted.
• Your veins are difficult to access or become inaccessible.
• You must have alternative veins in your foot or hand accessed, which may be associated with more discomfort.
• You are undergoing continuous infusion chemotherapy which takes more than an hour.
• You anticipate many months of chemotherapy treatments.
• You are receiving intravenous chemotherapy that requires multiple needle sticks.
• Your treatment requires frequent drawing of blood samples.
• Your treatment strategy involves chemotherapy agents that may cause vein pain when administered through the arm.
• Your physician or nurse recommends a vascular access device.
   

Your VAD must be flushed in order for it to work properly. Flushing your VAD requires placing a needle in your port and flushing it out with heparin. Heparin is a blood thinner that prevents the catheter (plastic tube) from becoming clogged. While you are on treatment, your VAD will be flushed after each treatment. When you are no longer on treatment you must still remember to have your VAD flushed regularly. This procedure needs to be done every four to six weeks. It is your responsibility to make the appointment to have your VAD flushed.

Unfortunately, most chemotherapy drugs cannot tell the difference between a cancer cell and a healthy cell. Therefore, chemotherapy often affects the body’s normal tissues and organs which results in complications of treatments, or side effects. 

Side effects not only cause discomfort and unpleasantness but may also compromise your chance of cure by preventing the delivery of therapy at its optimal dose and time.
 

All chemotherapy is associated with a wide variety of side effects. However, some side effects occur more frequently than others. Whether you will experience side effects, which ones, and their severity depends on a variety of factors, including your type of cancer, the type of chemotherapy drug or regimen you are taking, your physical condition, your age and others. However, the following side effects are typically associated with chemotherapy:

• Anemia
• Depression
• Fatigue
• Hair loss
• Infection/fever
• Low blood counts
• Mouth sores
• Nausea and vomiting
• Neutropenia
• Pain
• Reproduction/sexuality side effects
• Low platelet count (thrombocytopenia)
   

Fortunately, in the last 20 years, there has been a great deal of progress in the development of treatments to help prevent and control the side effects of cancer therapy. Your physician or nurse will help you come up with ways to manage your side effects.