Oncology

Frequently Asked Questions

This page provides answers to questions patients and their families often have.

How often do patients receive chemotherapy?

That depends on the type of cancer and the schedule the doctor has prescribed. Most people receive chemotherapy in cycles, which is a period of treatment followed by a period of rest.

For example, a patient may receive one week of daily chemotherapy followed by three weeks of rest. These four weeks make up one cycle. The rest period gives the body a chance to build new, healthy cells.

Can patients take over-the-counter and prescription medications while undergoing chemotherapy?

Patients should take only drugs that their health care provider approves.

Tell the doctor what over-the-counter and prescription medications currently taken, including laxatives, allergy medicines, cold medicines, and pain relievers.

How much will chemotherapy cost?

If you have private health cover, it will usually cover the cost of your treatment but you will need to pay for any discharge medications.

Alternatively, you may wish to be treated privately and do not have private health cover so you have the option to self fund. Our patient accounts staff will arrange a quote for you so that you are aware of the costs prior to commencement of therapy. If you are part of an access program or having medication that is not Pharmaceutical Benefit Scheme (PBS) you may be required to pay for all the medication. Your Oncologist will talk to you about this during your first consultation if that is pertinent to you.

What happens before chemotherapy?

The doctors and chemotherapy nurses will discuss the treatment recommended for you and explain how it will affect you. Once all your questions and concerns have been answered, you will be asked to sign a consent form with your treating Oncologist confirming you understand the aims, side effects and potential risks and benefits of treatment.

You can change your mind about treatment at any stage.

Before you start chemotherapy you will have a detailed 'pre-treatment information appointment' with a chemotherapy nurse. 

What is chemotherapy?

Chemotherapy is the use of medicines to treat cancer. Chemotherapy may be used alone or in combination with radiotherapy and/or surgery and/or other anti-cancer drugs. 

How does chemotherapy work?

Chemotherapy circulates in the bloodstream to all parts of the body. The drugs attack rapidly growing cells, including cancer cells. Chemotherapy also tauses temporary damage to normal cells which leads to side effects, most of which are short term and reversible. 

What are the benefits of chemotherapy?

The benefits of treatment vary for different patients depending on the type of cancer and how advanced it is.

Chemotherapy can be used to:

  • Cure the cancer – chemotherapy destroys cancer cells.
  • Reduce the chances of a cancer coming back – chemotherapy can kill cancer cells that may be present in the body but are too small to detect; killing these cells prevents future recurrence of the cancer for some patients.
  • Relieve symptoms – chemotherapy may shrink a tumour and therefore ease some or all of the symptoms it causes.

How often is chemotherapy given?

This depends on the type of treatment you are having.

You may require:

  • Weekly treatments; or
  • Chemotherapy treatment that is followed by a rest period of three weeks; or
  • Treatment that requires hospital based treatment followed by treatment that continues at home.

Each treatment episode is called a cycle. Some treatments require more than one visit per cycle. Depending upon your condition and the reason for the chemotherapy, the treatment may continue for between 9 and 24 weeks. Your Oncologist and Nurses will discuss your individual treatment with you before it starts. 

Can I drive to my appointments?

For your first chemotherapy treatment, if you travel to hospital by car, it is a good idea for a relative or friend to drive you home again after treatment, as we sometimes give premedications that make you drowsy or you might feel unwell.

If you are having treatment with a monoclonal antibody e.g. Herceptin you can drive as normal. 

Will I have to be admitted to hospital?

The majority of treatments are administered as an inpatient / day patient so you are admitted. Occasionally you may need to stay in hospital if you are unwell, but this is rare.

How is chemotherapy given?

Chemotherapy can be given:

By mouth (oral): as a tablet or capsule which can be taken at home. Your treating Oncologist will monitor your treatment carefully.

By injection into a vein (intravenous): as either a short injection or a longer infusion over some hours in hospital, usually as a day case.

Infusion pumps, which can be attached to a belt around the waist, are sometimes used to give an intravenous infusion of drugs over a number of hours or days at home.

Some treatments involve a combination of intravenous and oral chemotherapy.

Will I need an intravenous line?

Most patients can safely receive their intravenous chemotherapy through a temporary drip (cannula) placed in the vein in the arm on the day of treatment. This is removed the same day, before the patient goes home. Occasionally a more permanent line may be required to administer chemotherapy. These lines usually stay in for the duration of the treatment.

Different types of lines are used:

PICC lines  (link to)(peripherally inserted central catheters) are similar to central lines but are placed in the arm.

Vascular Access Device (VAD) (link to) contain a small chamber placed under the skin inserted into a vein, usually the chest.
 

Will I receive anti-sickness drugs?

Depending on the chemotherapy drugs being used, most patients will receive anti-sickness medication before treatment (administered by the chemotherapy nurses) and will be sent home with a supply of anti-sickness tablets. 

Who will administer and supervise my treatment?

Specially trained chemotherapy nurses will administer the treatment, working closely with your Oncologist in the Oncology Centre.

All patients are assessed prior to each cycle of chemotherapy, by both the Oncologist and the chemotherapy nurses, in the oncology clinic.

Any necessary modifications to the treatment or anti-sickness drugs will be made in the clinic, so please let your Oncologist know which side effects you have experienced. 

Will I need blood tests?

A blood test is essential before every treatment.

Chemotherapy can temporarily lower the blood count and treatment may need to be delayed if the blood count has not recovered following the last cycle. 

How does chemotherapy affect my blood count?

Chemotherapy can temporarily lower one or more of the three main types of blood cells the body produces:

White blood cells fight infection: resistance to infection is lowered when the white blood count drops. White cell numbers usually improve without any treatment but injections may be prescribed to aid white cell recovery.

Red blood cells carry oxygen: occasionally chemotherapy causes mild anaemia, which might lead to tiredness, breathlessness and dizziness. This usually settles without treatment but sometimes requires a blood transfusion.

Platelets help the blood clot. Low platelet counts can cause nose bleeds, easy bruising or bleeding and gum bleeding when brushing your teeth. The platelet count usually recovers but very rarely a platelet transfusion may be necessary. 

Is there anything that can help my blood count?

Some combinations of chemotherapy drugs are more likely to cause a low white blood cell count. Patients on these treatments will be given a blood count injection (known as GCSF) routinely on the day after each cycle of chemotherapy to minimise the risks of infection.

In all other cases, GCSF may be given to patients who suffer repeated low white blood counts. 

What other tests might I need?

Depending on the treatment to be administered, the liver, heart or kidney function may need to be tested before chemotherapy.

Your treating Oncologist will discuss and arrange if this is necessary. 

What if I have other medical conditions?

Please tell your doctor or nurse if you have (or have in the past suffered with) any of the following:

  • Diabetes
  • Heart disease
  • Lung disease
  • Kidney problems
  • Bone marrow problems

Will chemotherapy cause side effects?

Chemotherapy can cause damage to normal cells and this may lead to temporary side effects, most of which are reversible.

The side effects of chemotherapy vary, depending on the drugs used. Patients receiving the same treatment may experience different side effects. Your treating Oncologist or nurse will tell you what to expect.

In very rare cases, the side effects of chemotherapy can be life threatening. Your treating Oncologist and Nurse will discuss this with you. 

What are the side effects?

Some of the side effects you may suffer after treatment are described in this booklet (link to booklet)

Febrile Neutropenia

Chemotherapy reduces the body’s resistance to infection. As a result, patients may become seriously unwell very quickly.

Urgent medical attention should be sought if any of the following develop:

  • Any sign of infection
  • Sore throat
  • Cough
  • Shivering
  • A temperature of 38 ºC or higher

Chemotherapy patients should go straight to their local Accident & Emergency or ring the ambulance if very unwell.

DO NOT TAKE PANADOL AS THIS WILL MASK YOUR TEMPERATURE AND YOU MAY THEN BE SENT HOME.

Is it safe to have a flu injection whilst on chemotherapy?

Yes, the flu injection is safe though it may not provide quite as much protection against flu as usual.

Patients on chemotherapy during the winter months are advised to have the flu injection.

If you need a flu injection during chemotherapy it is best administered in the few days immediately before a cycle of treatment.

Other vaccinations are best avoided during chemotherapy – please check with your treating Oncologist first. 

Why might I have to wait for my chemotherapy on the day of treatment?

It is crucial that chemotherapy is delivered safely. Several important and complicated steps are required to ensure the correct drugs are given to every patient safely:

  • The blood count must be checked before every cycle of chemotherapy
  • If the blood count is low a repeat test will be required and this may delay the treatment
  • The treating Oncologist will pre-prescribe the chemotherapy
  • The pharmacist will double-check the prescription
  • The drugs are individually prepared in a sterile area using specialised equipment
  • The chemotherapy is delivered to the treatment unit for administration.

Inevitably this all takes time. Drugs are often ordered in advance but sometimes as a result, some patients may experience frustrating delays particularly if drugs are ordered on the day of treatment or a change of drug treatment is required before their treatment. 

What do I need to know about fertility and contraception?

Women

Although menstrual periods may become irregular or stop during chemotherapy some women do remain fertile.

It is very important not to become pregnant during chemotherapy so contraception is essential.

Periods may or may not return to normal after chemotherapy. Some patients lose their fertility after chemotherapy. Some patients who have not started or finished having a family may wish to be referred for fertility counselling. Please discuss this further with your treating Oncologist if you have any concerns or would like to access fertility counselling.

Men

Some chemotherapy drugs cause infertility in men. If this is likely, your doctor will discuss sperm banking before treatment.

Men can remain fertile during treatment. It is very important not to father children whilst receiving chemotherapy so contraception is essential. Please discuss this further with your Nurse or treating Oncologist if you have any concerns. 

Can I go on holiday during chemotherapy?

It may be possible to take a holiday in between cycles of chemotherapy. However, delaying the next cycle of chemotherapy for a holiday is usually not recommended so please discuss with your treating Oncologist.

Overseas holidays are best avoided until after chemotherapy is complete. Travel insurance for people being treated for cancer can be very costly; further information is available here

Can I continue to work during chemotherapy?

Chemotherapy affects people in different ways. Some patients are able to lead a near-normal life and continue to work. Some find it more difficult. Depending on your occupation you may need to make some modifications between day 7 and 14 of your treatment cycle as this is when your white cells may be lowered and therefore so is your resistance to infections.

Please ask your Nurse or treating Oncologist for more advice if needed.

Can I take my usual medicines?

Most medication can be continued safely during chemotherapy.

Please let your treating Oncologist know which medicines you are taking. 

Can I drink alcohol?

You may continue to drink alcohol in moderation during chemotherapy, though it is best avoided for the first few days after each treatment.

If alcohol is not allowed due to your particular treatment the treating Oncologist or your Nurse will inform you.

Can I take vitamins, herbal remedies and health supplements?

Some supplements and herbal remedies can interact with chemotherapy so please tell your treating Oncologist or nurse if you are taking any non-prescription supplements. 

Do I have to pay for prescriptions?

You will have to pay for any discharge medications. Unless you are self funding, part of an access program or having medication that is not PBS (Pharmaceutical Benefit Scheme) listed your health fund should cover the cost of your medications.

Please ask your nurse or treating Oncologist if you are unsure.

How do I contact you in an emergency?

If it is a true emergency please call 000.

For questions about side effect management you will be given a card with your treating Oncologist’s phone number and the contact details for the Burnside Hospital After Hours Hospital Coordinator who will triage your call and either give you advice or ring the on-call Oncologist on your behalf.

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