Ways of having chemotherapy

To damage and kill the cancer cells, the chemotherapy drugs must be absorbed into your blood and carried throughout your body. There are different ways of getting the drugs into your body. Doctors call these different ways routes of administration. The best way for you depends on

• The type of cancer you have
• Where the cancer is in the body
• The type of drug used, because some are injected and some are taken as tablets

The three most common ways of getting the drugs into your blood are by

• Injecting them or giving through a drip into a vein – intravenously
• Taking them as tablets or capsules – orally
• Infusion pump

These links will take you to other pages with more information about these ways of having chemotherapy.

Less often, drugs are injected into

• A muscle – intramuscular
• The layer of fat just under the skin – subcutaneous
• An artery – intra arterial
• The fluid around your spine or brain – intrathecally
• A body cavity – intracavitary, such as the bladder, chest cavity, or tummy (abdominal cavity)
• The space between the membranes that cover the lungs – intrapleurally
• Directly into the tumour – intralesional or intratumoral

For some types of skin cancer, chemotherapy creams may be used.

Sometimes your doctor may want to use two or more methods of giving chemotherapy at the same time. The links above are just to the brief information below on each of these ways of giving chemotherapy.

Injections into muscle

The muscles in your thigh and buttocks are the most common areas for giving intramuscular chemotherapy. Chemotherapy given this way is absorbed into the blood more slowly than intravenous chemotherapy. Because of this, the effects can last longer than chemotherapy that you have injected into a vein.

Injections under the skin

The skin of the abdomen, thigh and upper arm are the most common areas for giving subcutaneous chemotherapy. There is more about subcutaneous injections on CancerHelp UK's page about the different ways you can have cancer drugs.

The video below shows you how to give an injection just under your skin (subcutaneously).

View a transcript of the video showing how to give a subcutaneous injection (opens in new window)

Chemo into an artery

Intra arterial chemotherapy means giving the drugs directly into the arteries that are close to the cancer. This gives a very high dose of chemotherapy to the tumour, but less to the rest of the body. To have this treatment, you need to have a tube put into the artery under local anaesthetic. This is a highly specialised way of giving chemotherapy and not available in all hospitals in the UK. The most common type of cancer treated in this way is liver cancer. The artery used is the artery that supplies the liver. This is called the hepatic artery. Intra arterial chemotherapy is used more rarely for other types of cancers, but usually only within clinical trials because it isn't yet clear how effective it is.

The side effects of giving chemotherapy in this way are generally the same as for when it is given intravenously. There is a slightly increased risk of stomach irritation when you have this treatment for cancer in the liver. This is because some of the drug may get into the blood supply to your stomach. Your doctor may give you some tablets to help protect your stomach.

Chemo into the spinal canal

For most cancers, it is not necessary to inject chemotherapy drugs into the fluid around the spine and brain. But it is an important part of the treatment for some types of leukaemia and some types of brain tumour.

Chemo into a body cavity

Intracavitary chemotherapy means injecting chemotherapy through a tube (catheter), directly into a body cavity. It gives a very high dose of chemotherapy to the tumour, but only a very low dose to the rest of the body. Intracavity chemotherapy can be used for

• The bladder – intravesical
• The abdominal cavity – intraperitoneal
• The chest cavity  – intrapleural

Intravesical chemotherapy is having a solution of a chemotherapy drug put into your bladder. There is more about intravesical chemotherapy in the bladder cancer section of CancerHelp UK.

The peritoneum is a membrane that lines the abdominal cavity and covers the organs contained in the abdomen (tummy). Intra Peritoneal (IP) chemotherapy is chemotherapy injected directly into cavity within the peritoneum. This treatment is not used very often in the UK. When it is used, it is mainly for treating ovarian cancer that has spread to the peritoneum. There is more about intraperitoneal chemotherapy in the ovarian cancer section of CancerHelp UK. Intraperitoneal chemotherapy can also be used for a rare type of cancer of the abdominal lining called peritoneal mesothelioma.

Chemo into the pleura

Chemotherapy can be given directly into the space between the two layers of skin like tissue that cover the lungs (the pleura). This is called intrapleural chemotherapy. It is sometimes used to treat lung cancer or breast cancer that has spread to the lining of the lung.

Chemo into your tumour

If you have chemotherapy injected directly into your tumour, this is called intralesional or intratumoural chemotherapy. This method is used with a rare type of cancer called Kaposi's sarcoma, but is still very experimental and not widely used. Research is going on into using this type of chemotherapy for head and neck cancers and some other cancers.