There are different ways of getting chemotherapy into your body. These are called routes of administration.
The best way for you depends on:
- the type of cancer you have
- where the cancer is in the body
- the particular drug or drugs you're having
Most common ways of having chemotherapy
The most common ways of getting the drugs into your body are:
- directly into the bloodstream as an injection or through a drip (intravenously), often using an infusion pump
- taking them as tablets or capsules – orally
Less common ways of having chemotherapy
Here are some of the less common ways of having chemotherapy. Sometimes your doctor may need to use 2 or more methods of giving chemotherapy at the same time.
Injections into muscle (Intramuscular)
The muscles in your thigh and buttocks are the most common areas for giving intramuscular chemotherapy.
The body absorbs the drugs you have this way more slowly than intravenous chemotherapy. This means that the effects can last longer than chemotherapy that you have injected into a vein.
Injections under the skin (subcutaneous)
The skin of the tummy (abdomen), thigh and upper arm are the most common areas for giving subcutaneous treatment. You may be able to give these injections yourself.
The video below shows you how to give an injection just under your skin (subcutaneously). It's important to wash your hands well before giving yourself an injection.
Nurse: This is a short film showing you how to give an injection just under your skin. This is called a subcutaneous or sub cut injection. This does not replace what your doctors and nurses tell you, so always follow their advice.
Voiceover: Subcutaneous injections may be part of your cancer treatment. Or, you may need them to prevent side effects of treatment, such as blood clots after surgery. Or to help control cancer symptoms, such as pain or sickness.
Most injections come in prefilled syringes.
Nurse: So, today I am going to show you how to give a subcutaneous injection. I am going to start by giving it into a practice cushion and then you can have a go at giving one yourself. Before you start, you need to get your equipment together. What you are going to need is an alcohol wipe to clean your skin, some cotton wool, a prefilled syringe and a sharps bin. It is important that you wash your hands with soap and water and dry them thoroughly before you start. Check that you have got the correct drug and that it is in date.
You can give the injection into the back of your arm, your tummy, your thigh or the outer part of your bottom. It is important that you vary where you give the injection. So it may be that you give it one day in your tummy and the next in your thigh.
So you start by cleaning the skin with the alcohol wipe and allowing it to air dry. Then you take the cover off the needle and pinch the skin up and hold it a bit like a pen and in an upright position, in a quick dart like motion pop it straight down into the skin. Then you press the plunger right to the end, quickly pull the needle out, dab it with cotton wool, pop the needle into the sharps bin. And then you need to wash your hands again.
So here’s what you are going to need. If you start by checking the drug and the expiry date. And then with the alcohol wipe give your skin a clean. That’s it give it a few seconds for the air to dry it. Ok and then if you want to pick up the syringe and take the cover off the needle. Then pinch your skin up and at a ninety degree angle gently push the needle in...then press the plunger...and then quickly remove it... dab your skin with the cotton wool and put the syringe in the sharps bin.
Chemotherapy into an artery (Intra arterial)
Intra arterial chemotherapy means having drugs injected directly into arteries close to the cancer. This gives a very high dose of chemo 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 drugs are injected into the artery that supplies the liver (the hepatic artery). Intra arterial chemotherapy is used more rarely for other types of cancers. It’s usually only used within clinical trials, because it isn't yet clear how well it works.
The side effects of having chemotherapy in this way are generally the same as having it intravenously. When you have this treatment for cancer in the liver, there’s a slightly increased risk of stomach irritation. This is because some of the drug may get into the blood supply to your stomach. Your doctor might give you some tablets to help protect your stomach.
Chemotherapy into the spinal canal (Intrathecal)
For most cancers, it isn’t necessary to inject chemotherapy drugs into the fluid around the spine and brain. But it’s an important part of the treatment for some types of leukaemia and lymphoma, as well as for some types of brain tumour.
To have chemotherapy in this way, you have an injection into your spine, in your lower back. It is similar to having a lumbar puncture.
Chemotherapy into a body cavity (Intracavitary)
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.
You might have intracavitary chemotherapy into:
- the bladder – intravesical
- the abdominal cavity – intra peritoneal
- the chest cavity – intrapleural
Intravesical chemotherapy means having a solution of a chemotherapy drug into your bladder.
Intra peritoneal (IP) chemotherapy means having the drugs injected directly into the cavity inside the peritoneum. The peritoneum is a membrane that lines the abdominal cavity and covers the organs in the abdomen (tummy).
We don’t use IP chemotherapy very often in the UK. When we do, it’s mainly for treating ovarian cancer that has spread to the peritoneum.
Doctors might also use it to treat a rare type of cancer of the abdominal lining called peritoneal mesothelioma.
Chemotherapy into the pleura (intrapleural)
You can have chemotherapy injected directly into the space between the 2 layers of skin-like tissue covering the lungs (the pleura). This is called intrapleural chemotherapy.
Doctors sometimes use it to treat lung cancer or breast cancer that has spread to the lining of the lung.
Chemotherapy into the tumour (Intralesional)
You can have chemotherapy injected directly into your tumour. This is called intralesional or intratumoural chemotherapy.
Doctors may suggest this for a rare type of cancer called Kaposi’s sarcoma. But it 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.
Chemotherapy as a cream
For some types of skin cancer, you may have chemotherapy as a cream.