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What you need to know

The clinical service at Spire Nottingham Hospital is led by a leading clinical oncologist supported by a dedicated specialist team, and uses some of the latest technologies. We aim to give you fast access to receiving systemic anticancer therapy - the collective name given to drugs used in the treatment of different types of cancer.

Prior to your first treatment, our chemotherapy nurse will give you specific information about your particular regimen, the drugs used, and any side effects. You will also be given “Your Chemotherapy Record”, which you can use to keep a record of when your treatment is given, any problems you may have following or during treatment and any questions you may wish to discuss with our nurses or consultant.

How does it work?

Chemotherapy drugs work by interfering with the ability of cells to reproduce or multiply. These affected cells eventually die from the damage caused by the drugs. Before you have any course of treatment you will most likely:

  • Have a blood test
  • Have a cannula placed into one of the veins in your hand or arm
  • Your treatment may be delivered by a syringe into a fast flowing drip or by a bag of fluid infused via a special infusion pump

How is it given?

The most common ways to give chemotherapy drugs are:

  • by mouth, as tablets
  • by injection – either just under the skin (subcutaneous) or by injecting into a vein (intravenous)

Who will give my treatment?

One of the chemotherapy nurses who have been trained to give treatment and offer specific advice to you will administer your treatment.

Why do I need frequent blood tests?

Most chemotherapy drugs cannot tell the difference between normal cells and cancer cells so they damage some normal cells as well. However, normal cells are replaced quickly. The cells most often affected are the blood cells and therefore regular tests help us to monitor and determine how to treat low blood counts.

When we test your blood we look at the three main types of cells which are:

Haemoglobin

This carries oxygen around the body. If you have low haemoglobin you are anaemic. This may cause increased tiredness or shortness of breath, and you may be pale. To correct this you may need a blood transfusion, which can be given as a day case.

White blood cells

These are the cells responsible for our ability to fight infection. If the white cell count is low you may be at increased risk of infection or fevers and may require antibiotics. Neutrophils in particular are the type of white cells that fight bacterial infection. When your neutrophil count is low this is referred to as “neutropenia” and you will be “neutropenic”. When this happens you may also need to have your chemotherapy treatment delayed to allow time for the count to improve. This will be the decision of your consultant.

We can prescribe a course of injections of a drug called G-CSF which stimulates the bone marrow where white blood cells are produced. These injections can be given daily for 3-4 days, or once every treatment cycle, depending on the chemotherapy regimen. They can either produce a dramatic increase/prevent a dramatic decrease in your
white cell count. The injections are given subcutaneously under the skin, not into a vein. We can teach you how to administer them yourself, you can come to the hospital to be given them, or occasionally your GP surgery may agree to do them.

We will teach you how to take your temperature and what is normal. It is important that you have a thermometer at home and that you get into the habit of checking your temperature regularly. An easy to use digital thermometer can be bought from most chemists/pharmacists. It is very important that you contact us immediately if you have a high temperature or if you feel unwell. A list of symptoms that you must inform us about can

Platelets

These cells are responsible for prevention of bleeding and bruising. If the platelet count is low you may notice increased bruising or prolonged bleeding if you cut yourself. The treatment for a very low platelet count is to give a platelet transfusion, however it is extremely unlikely that your count will fall to a level that requires this. It is very important that you contact the hospital if you have any unusual bruising or bleeding.

How often will I need treatment?

Before you have your first treatment your chemotherapy nurse will discuss the drugs and the regimen of treatment you will be having.

You will be given information on the specific drugs, as well as general information on chemotherapy. The frequency of your treatment will also be discussed.

You will have signed a consent form for treatment to proceed with your Consultant when you saw them in clinic. After each treatment you will be given the time and date of your next appointment. If you have holidays booked, or a special occasion, and your treatment clashes with this then please discuss this with your nurse/consultant so that alternative arrangements can be made for you wherever possible.