Find out about having chemotherapy and radiotherapy together for anal cancer, how you have it and the possible side effects.
What it is
Chemoradiotherapy means having chemotherapy and radiotherapy treatment together.
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
Radiotherapy uses high energy waves similar to x-rays to kill cancer cells.
You usually have treatment in the chemotherapy day unit or you might need to stay in hospital for a day or more.
Clare Disney (nurse): Hello, my name is Clare and this is a cancer day unit.
So when you arrive and you’ve reported into with the receptionist, one of the nurses will call you through when your treatment is ready, sit you down and go through all the treatment with you.
Morning, Iris, my name is Clare. I am the nurse who is going to be looking after you today. We’re going to start by putting a cannula in the back of your hand and giving you some anti sickness medication. And then I am going to come back to you and talk through the chemotherapy with you and the possible side effects you may experience throughout your treatment. Is that okay?
Before you have each treatment, you’ll need to have a blood test to check your bloods are okay. And you’ll also be reviewed by one of the doctors to make sure you’re fit and well for your treatment. Sometimes you’ll have the blood test taken on the day of your treatment; other times you’ll have it the day before your treatment when you see the doctor.
Each chemotherapy is made up for each individual patient, depending on the type of cancer they have and where it is and depending their height, weight and blood results.
So, depending on where your cancer is some people have their chemotherapy drug, their cancer drug by drip, some will have an injection and other people will have tablets.
So, Iris, your chemotherapy is going to be given to you in what we call cycles and the cycles are given every three weeks for a period of six cycles. So, you will be coming in for approximately five months for your chemotherapy.
Depending on where your cancer is and what type of cancer you have will be dependent on how often you come in for treatment. An example of a treatment cycle would be for you to come in on Day 1, Day 8 and Day 15 then to have a week’s break before you come back again for Day 1 treatment.
Depending on the type of treatment that you are having, we will also give you some anti sickness tablets to take alongside your chemotherapy and also some drugs to prevent any reactions if that’s appropriate.
All chemotherapy is given over different time periods, so it’s best to check with your nurse about how long you are likely to be in the unit for. This can range from anything up to an hour to an all day treatment slot, so please be prepared to bring along some bits to keep you occupied books and music.
So, before you go home it’s important to make sure you have got the tablets you need to go home with your anti sickness medications and any other symptom control tablets that you may require. Also, to make sure that you’ve got the telephone numbers for the oncology unit to phone if you have a temperature or you are experiencing any other symptoms at home that you need to ask advice about.
So, please make sure when you leave the unit that you’ve got all the information you require and if you’ve got any questions at all don’t hesitate to ask the nurse, who will be able to answer them for you.
Before your next cycle of treatment you will come in and see the doctor in the clinic room. You’ll have a blood test and an examination to make sure you are fit and well for treatment. You will then come back the following day or later on that week for treatment.
Your exact treatment plan will depend on what your treatment team thinks is best for you. The most common treatment is a combination of the drugs mitomycin C and fluorouracil (5FU). You have the chemotherapy over 4 to 5 days. You usually have 2 cycles. The second treatment is 4 weeks after the first.
A nurse puts a small tube into one of your veins and connects it to the drip or you might need a central line. This is a long plastic tube that gives the drug into a large vein, either in your chest or in your arm. It stays in while you’re having treatment, which might be for a few months.
You might need to stay in hospital while you have your chemotherapy treatments. But some hospitals give people a portable pump to take home that gives the fluorouracil. The pump is attached to a PICC line (a long tube that goes into a vein in your arm).
Instead of having fluorouracil through a vein, you might have a tablet form called capecitabine. Then you can have most of your treatment at home.
On the first day of chemotherapy you also have your first radiotherapy treatment. You’ll continue to have radiotherapy every weekday, from Monday to Friday for 5 to 6 weeks. As long as you are well enough you have your radiotherapy as an outpatient. So you need to travel to hospital each weekday for about 6 weeks.
Planning your treatment
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they'll ask how you are and ask about any side effects
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Before you begin treatment, the radiotherapy team work out how much radiation you need. They divide it into a number of smaller treatments. They call each treatment a fraction.
After your planning session
Your treatment starts a few days or up to 3 weeks after the planning session.
You lie under a large machine to have radiotherapy.
You will have side effects from your treatment. These can be more severe than either radiotherapy or chemotherapy on their own.
You can feel very tired, and might have frequent diarrhoea. Most people have soreness around their anus and groin, and the skin becomes red. Your skin might peel and break down. This can be painful, particularly when you open your bowels. Tell your nurse or doctor if this happens. They can give you painkillers and tell you about how to look after your skin.
Use only creams or dressings on your skin that your nurse or doctor recommends.