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Understanding chemotherapy
and treatment changes
What is chemotherapy?
What chemotherapy will I have?
Chemotherapy is a way of treating cancers using
drugs (medicines). There are many chemotherapy
drugs and some newer drugs called “targeted
therapies” that work in different ways to kill
or damage the cancer cells. These drugs can also
damage normal cells, which may cause side effects.
Your treatment will be overseen by a specialist
doctor called a medical oncologist or a haematologist,
who is a member of the MDT.
Your treatment will be closely monitored by a team
of health professionals called a multidisciplinary cancer
care team, or MDT for short.
Chemotherapy can be given by:
infusion (into vein)
They will work with other health professionals,
including surgeons, radiologists, radiation oncologists
and pathologists, to recommend a treatment that
is right for you. The recommendation will take into
•the place in the body where the cancer started,
and whether it has spread
•the aim of the treatment—to cure the cancer
or to control it
•other treatments such as surgery, radiotherapy
and previous chemotherapy
•your general health.
mouth (tablets or capsules)
injection (under skin or in muscle)
Working together to lessen the impact of cancer
Your specialist will explain the purpose of the
chemotherapy and the expected benefits and risks
of the treatment. You will be involved in any decisions
about your treatment, and in some cases you may
have a choice of treatments with similar benefits
but different side effects.
What is a chemotherapy protocol?
What chemotherapy changes could I have?
A chemotherapy protocol provides detailed information
about the treatment and how to give it safely, based
on the best available research evidence. All doctors,
nurses and pharmacists will use this information
throughout your treatment.
It is important that you get the full course of
chemotherapy, according to the protocol. However,
everyone who has chemotherapy is different and it is
not possible to know how you will respond to treatment.
Some people get severe side effects that make it
difficult for them to continue with their initial treatment.
The protocol describes:
•the treatment schedule (drug names, drug doses,
the number of doses, the length of time between
doses, and how the drugs are given)
•any tests required before or during treatment
•information about possible side effects, and the
best way to prevent or treat these
•situations when doses may need to be changed.
Does everyone get the same dose?
Chemotherapy is personalised for each patient and
your specialist will manage the balance between
treatment effectiveness and side effects very carefully.
Doses of chemotherapy are different between
patients. Depending on the drug, the dose may
be calculated on your body weight, height, or how
your kidneys or liver are working. The calculation
information is provided in the protocol.
The calculated dose may need to be reduced for
patients who are at higher risk of severe side effects.
This can include those who:
•have already experienced problems with these drugs
Possible changes to chemotherapy include:
•treatment delays—the next dose is delayed
to allow the body longer to recover
•dose reductions—the dose is reduced to lower
the risk of severe side effects
•a change to a different treatment—this can
happen because a patient has severe side effects,
or because their scans or other tests show
that another therapy should be used.
If you have any concerns about changes
to your treatment, you should discuss these
with your medical oncologist or haematologist.
Things to ask your medical
oncologist or haematologist
•What chemotherapy treatment am I having?
•Is my treatment based on an eviQ chemotherapy
•What is the purpose (intent) of the treatment?
•are older
•What side effects might I get?
•are in poor general health
•Who should I contact if I have any questions
and concerns?
•have liver or kidney problems, or low blood counts
•are taking certain other medications
•are having, or have already had, radiotherapy.
•Have my doses been changed from the ones
in the protocol?
Your specialist will decide whether any changes to the
drug doses are needed, and discuss this with you.
•Why have any changes been made and how
could these affect me?
For more information:
Cancer Council
• Call 13 11 20 for cancer information and support
Cancer Institute
• Medical/radiation oncologist question list:
•Download the booklet Understanding Chemotherapy, a guide for people with cancer,
their families and friends:
• Haematologist question list:
Working together to lessen the impact of cancer
Cancer Institute NSW PO Box 825, Alexandria, NSW 1435
t +61 (0)2 8374 5600 f +61 (0)2 8374 3600 e [email protected]
© Cancer Institute NSW 2016. While every effort has been made to provide accurate information, this document is not intended as a substitute for medical advice.
Contact your doctor if you have any concerns.