Chemotherapy uses anti cancer drugs to destroy cancer cells. Read more about how you have chemotherapy for anal cancer, types of chemotherapy drugs, and their possible side effects.
You might have chemotherapy alongside other types of cancer drugs or treatments. Chemotherapy combined with radiotherapy is called chemoradiotherapy.
For anal cancer you might have chemotherapy tablets or chemotherapy into a vein. The drugs circulate throughout the body in the bloodstream.
When you have it
Doctors usually give chemotherapy and radiotherapy together (chemoradiotherapy) to try and cure anal cancer. Chemotherapy makes the cancer cells more sensitive to radiotherapy, so it works better. Research shows that chemoradiotherapy works better than surgery for most stages of anal cancer.
Some people have chemotherapy to control symptoms of advanced cancer. This is to shrink or slow down the cancer. It can also relieve your symptoms. The treatment you have depends on which treatment you've already had. You might have chemotherapy with radiotherapy and surgery.
Types of chemotherapy for anal cancer
There are many different chemotherapy drugs. The most common type of drugs for anal cancer are:
- fluorouracil (5FU)
- mitomycin C
You usually have these drugs together with radiotherapy (chemoradiotherapy).
Doctors might also use:
- lomustine (CCNU)
How you have chemotherapy
For anal cancer, you might have chemotherapy into a vein (intravenously) through a drip into your arm. A nurse puts a small tube into one of your veins and connects the drip to it.
Or you may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
You might also have a tablet to treat anal cancer. Tablets are a form of 5FU chemotherapy called capecitabine to treat anal cancer, which are given instead of giving chemotherapy into a vein. Taking tablets means that you can have most of your treatment at home.
Taking your tablets or capsules
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Never stop taking a cancer drug without talking to your specialist first.
Where you have chemotherapy
You usually have treatment at the cancer day clinic. You’ll sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time.
You have some types of chemotherapy over several days. You may be able to have it through a pump that you can go home with.
For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.
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 ok?
Before you have each treatment you’ll need to have a blood test to check your bloods are ok 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.
Before you start chemotherapy
You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
The pharmacists make chemotherapy for each person individually. They do this once your blood test results have come through and it’s worked out based on your weight, height and general health.
Common chemotherapy side effects include:
- feeling sick
- loss of appetite
- losing weight
- feeling very tired
- a lower resistance to infections
- bleeding and bruising easily
Side effects depend on:
- which drugs you have
- how much of each drug you have
- how you react
Tell your treatment team about any side effects that you have.
The side effects can be different when you have chemotherapy and radiotherapy together.
You have regular blood tests during your treatment to make sure your blood cells aren’t too low. A low white blood cell count means you are more at risk of picking up infections. A low red blood cell count causes anaemia, with tiredness and breathlessness.
Most side effects only last for the few days that you’re having the drugs. The team caring for you can help reduce your side effects.
Dietary or herbal supplements and chemotherapy
Let your doctors know if you take any supplements or if you’re prescribed them by alternative or complementary therapy practitioners.
It’s uncertain how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful.
When you go home
Chemotherapy for anal cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.