People requiring treatment for cancer are treated with us at St Luke’s. This includes Chemotherapy, Immunotherapy and Supportive care. Treatment can be delivered either as an in-patient, as a day case or as an out-patient with oral treatments.
Chemotherapy is a type of cancer treatment, with medicine used to kill cancer cells. Chemotherapy works by either killing the cancer cells directly, or by stopping their ability to divide and reproduce.
Less commonly, chemotherapy is used to treat non-cancerous conditions. For example, low doses have been used to treat lupus and rheumatoid arthritis.
Different cancers are sensitive to different chemotherapy. Tests taken at your diagnosis stage will help guide your consultant in what treatment will work best for you. There are many different types of chemotherapy medication but they all work in much the same way. Depending on the type of cancer you have, you may be treated with one medicine (monotherapy) or with a combination of medicines (combination therapy). There are several ways in which chemotherapy medication can be given, including tablets and injections directly into a vein (Intravenous therapy).
The team caring for you will help come up with a treatment plan for your specific circumstances.
Immunotherapy works by using your own immune system to fight cancer. It teaches your immune system to recognise and kill cancer cells.
Immunotherapy may also be referred to as targeted therapy or biological therapy. It can be given in isolation or in combination with traditional chemotherapy agents.
Our immune system works to protect the body against infection, illness and disease. It can also protect us from the development of cancer.
The immune system includes the lymph glands, spleen and white blood cells. Normally, it can spot and destroy faulty cells in the body, stopping cancer from developing. But a cancer might develop when:
(Cancer Research UK 2019)
Most chemotherapy and Immunotherapy treatment is administered on Chilworth, our Chemotherapy Day Unit. The Unit is open from 08:30 to 18:00 Monday to Friday. We have 55 chairs and 4 beds.
Supportive care measures are also given on Chilworth, including Blood and Platelet transfusions.
Procedures are undertaken on the unit, with a designated room for Peripherally Inserted Central Catheter.
When you first start treatment, you will be shown around the day unit and introduced to some of the staff. An appointment will be given to you for your chemotherapy attendance.
Oral chemotherapy is dispensed from the pharmacy department within St Luke’s Cancer Centre.
Prior to treatment, all patients are reviewed in clinic. This is usually within Outpatients 12, in St Luke’s Cancer Centre. You will be seen either by a member of the medical team, your clinical nurse specialist or a chemotherapy sister, as a member of the nurse-led team.
For patients receiving chemotherapy or immunotherapy, you will need to have a blood test taken prior to being seen in clinic. Your blood test result is needed before the doctor can authorise your chemotherapy to be prepared by pharmacy.
This blood test can either been taken at your local hospital or GP practice the day before your appointment or at St Luke’s.
If you do choose to have a blood test at St Luke’s, please ensure you arrive 1.5hours before your clinic appointment to enable the blood results to be ready for when the doctor sees you.
If your latest blood results are not available when you are seen by your doctor, this can lead to delays in prescribing and preparing your treatment.
Chemotherapy and Immunotherapy can cause a number of side effects. It is unlikely you will experience them all. It is important to remember that many side effects can be managed. So you must tell your clinical team or clinical nurse specialist if you are experiencing any side effects.
Changes to Bone Marrow:
Chemotherapy can affect the number of red blood cells, white blood cells and platelets made in the bone marrow. A blood test is taken to monitor the levels of these. If your blood count is low, you will be given a blood or platelets transfusion on the Chilworth day unit.
Increased Risk of Infection:
Chemotherapy temporarily lowers your white blood cells, these are involved in your immune system and protect you against infections. Whilst your white blood cells are reduced, you are more susceptible to infection. You should stay away from friends or family that have open infections, such as a chesty cough or heavy cold. You will also need to monitor your temperature for any signs of fever. Developing an infection during chemotherapy will require prompt action and treatment with antibiotics. As such you should inform your medical doctor as soon as you have any signs of infection.
Sometimes a growth factor is given as an injection under your skin to boost your white blood cells and reduce the risk of infection. This is called Granulocyte-Colony Stimulating Factor (GCSF).
Nausea and Vomiting:
Sometimes Chemotherapy or Immunotherapy can cause nausea (feeling sick) and vomiting (being sick). There are many anti sickness medications that can be given to effectively manage this side effect. Often you will be started on one or two different anti sickness medications that are given prior to your treatment and for a few days afterwards. If these are not sufficient, additional, stronger anti sickness can be added to your treatment.
Diarrhoea and Constipation:
Chemotherapy can affect the lining of your Gastrointestinal Tract (Mucous membranes) and this can affect anywhere from your mouth to your anus. This may result in a dry or sore mouth (Mucositis) or in diarrhoea and/or constipation. These can also be worsened by some of the medication you are given. For example, anti-sickness can cause constipation. Such side effects can be resolved with medication, so please do alert your team if you have any diarrhoea or constipation.
As well as cancer cells, chemotherapy kills rapidly dividing cells. This includes hair follicles. Not all chemotherapy will cause hair loss (Alopecia).
For some chemotherapy agents, we can offer scalp cooling. This reduces the risk of hair loss. By temporarily reducing the blood flow to the scalp, this involves being attached to a cold cap machine for a limited time before and after your chemotherapy is administered.
Please ask your team if you can have scalp cooling with your treatment. Not all chemotherapy treatment is appropriate for cold cap use.
Immunotherapy related side effects:
Immunotherapy works by triggering your immune system. As such this can lead to increased inflammation around your body as your immune system starts working harder. Different immunotherapy agents can cause different side effects. Information will be given to you at your first appointment, plus an alert card will be given to you to show you are receiving Immunotherapy. Additionally please click on the link below: https://www.macmillan.org.uk/information-and-support/treating/targeted-biological-therapies.
For Health Professionals: