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Chemotherapy treatment

When, where and how you have chemotherapy for bowel cancer, and the possible side effects.

When you have it

You usually have chemotherapy every 2 to 3 weeks depending on what drugs you have. Each 2 to 3 week period is called a cycle. You may have up to 8 cycles of chemotherapy.

You might have chemotherapy after surgery for bowel cancer. This is to reduce the chance of the cancer coming back and is called adjuvant chemotherapy.

You might have chemotherapy before surgery for cancer of the back passage (rectal cancer). The chemotherapy aims to shrink the cancer and make it easier to remove during surgery. Chemotherapy before surgery is called neo adjuvant chemotherapy (pronounced nee-oh-ad-joo-vant). You are likely to have this alongside radiotherapy (chemoradiotherapy).

Advanced cancer

You might also have chemotherapy if you have advanced bowel cancer.

Types of chemotherapy

Usually you have a combination of 2 or 3 drugs, the most common types are:

Other drugs that you may have include:

How you have it

Most of the chemotherapy drugs you have for bowel cancer are given into your bloodstream (intravenously). Capecitabine is a tablet.

Into your bloodstream

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

Or you might have treatment 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.

Diagram showing a central line


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.

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.

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 your 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.

Most side effects only last for the few days that you’re having the chemotherapy drugs. Your treatment team can help to reduce your side effects.

When you go home

Chemotherapy for bowel 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: 
09 Sep 2015
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