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Chemotherapy treatment

Chemotherapy uses anti cancer drugs to destroy cancer cells. Read about having 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.

How you have chemotherapy

You might have chemotherapy into your bloodstream or as tablets.

Into your bloodstream

You can have the drug through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have it through a long line: a central line, a PICC line or a portacath.

These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.


You might have your chemotherapy as tablets, instead of having chemotherapy into a vein. The tablets you have are called capecitabine. Taking tablets means that you can have most of your treatment at home.

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

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 into your bloodstream 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 might be able to have some drugs through a small portable pump you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

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.

Advanced 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 or 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:

  • cisplatin
  • irinotecan
  • oxaliplatin
  • capecitabine
  • bleomycin
  • lomustine (CCNU)
  • carboplatin
  • taxol

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. It’s worked out based on your weight, height and general health.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

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 chemotherapy drugs. The team caring for you can help to 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.

Last reviewed: 
07 Jun 2016
  • Current management of anal canal cancer
    B. Czito and others
    Current Oncology Rep. 2009 May;11(3):186-92

  • Anal carcinoma therapy: can we improve on 5-fluorouracil/mitomycin/radiotherapy?
    Y.Jiang and others
    Journal of National Comprehensive Cancer Network. 2010 Jan;8(1):135-44

  • Cancer: Principles and Practice of Oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

  • Anal cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    R. Glynne-Jones and others
    Annals of Oncology 2014. 25 (Supplement 3)

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