Peripheral Intravenous Chemotherapy

GENERAL INFORMATION:

What is it?

• Peripheral (pe-RIF-er-al) intravenous (in-trah-VEE-nus) (IV) chemotherapy (kee-moh-THER-ah-pee) is one way to give chemotherapy. There are many ways to give chemotherapy, and there are many different types of chemotherapy medicines. Depending on the medicine you need, peripheral IV chemotherapy may be the best way to treat you.
  
  
• An IV (small plastic tube) will be placed into your hand or arm. Your caregiver will make sure that the IV works and medicine can be given through it. Your caregiver will then give the chemotherapy medicine through the IV. Your caregiver may place a new IV into your vein before each dose of chemotherapy. The IV may then be removed after you get your chemotherapy. Your caregiver may decide to leave the IV in your vein for a few days. Chemotherapy may be given quickly through the IV, or it may take a few hours for you to get the medicine.

What is chemotherapy? Chemotherapy is also called "chemo". It is a special medicine used to fight cancer. Chemo can cure some cancers. Chemo may also help you live longer if you have cancer. Chemo cannot cure all kinds of cancer. There are many different kinds of chemo. Sometimes chemo can make you feel sick. Your caregiver will decide what kind of chemo you will get and how you will get it. How often and how long you get chemo depends on the type of cancer you have. It also depends on the chemo medicines that are used and how your body handles the chemo.

How does chemotherapy work?

• In your body, you have healthy cells that divide and grow to make more healthy cells. Cancer cells do not divide and grow normally. Cancer cells multiply much more quickly than normal cells. This is how they take over normal cells. Your body cannot fight off these cancer cells because they grow so quickly.
  
  
• Chemotherapy prevents cancer cells from growing and dividing. Chemo may also help prevent the spread of cancer to other parts of your body. Chemo directly attacks these rapidly dividing cells. Chemo also harms healthy cells. Some healthy cells that may be harmed by chemo are hair and reproductive (ree-proh-DUK-tiv) cells. Reproductive cells are cells in your ovaries (OH-var-ees) or testicles (TES-tih-kls). These cells will usually repair themselves when you are done with chemo.

How long will I need to use peripheral IV chemotherapy?

• Your caregiver will decide how long you need to receive peripheral IV chemo. The kind of cancer you have will affect how long you get chemo. Different chemo medicines may be used together. For some people, combining chemo medicines may decrease the amount of time the medicine is needed.
  
  
• You may need chemo for a few hours every day, every week, or once or twice a month. You may need to get chemo for several months or longer. Chemo is often given in cycles. This means that you will use chemo for a period of time, and then will have a break from it. This allows your body to grow new, healthy cells.

Where will I be treated? You and your caregiver will decide where you need to go to be treated with IV chemo. Chemo can be given in a hospital, a special clinic, or at home. The type of chemo you get will affect where you are treated. The very first time you get chemo, you may be in the hospital. Your caregivers can watch you closely to see how you feel during and after treatment. Your caregivers can then decide if any changes in the chemo need to be made. If you get your chemo at home, a caregiver specially trained in giving chemo will give it to you.

How will I feel after getting peripheral IV chemotherapy? You may be tired for a few days or longer after you get your chemo. You may be too tired to go to work or do any other activities. You may also feel nauseous (sick to your stomach) or may vomit (throw up). Follow your caregiver's instructions about rest and activity after chemo treatments.

What are side effects of chemotherapy? Chemo can have many different side effects. You may have one or more of these side effects, or you may have none of them. Most chemo side effects are short-term, and will go away after the treatments are done. One possible bad side effect from a few peripheral IV chemotherapy drugs is extravasation (eks-trav-ah-ZAY-shun). Extravasation is when the chemo medicine leaks out of your vein, causing burning and blistering. This can cause long-term damage to your skin. Caregivers will teach you what to look for and what to do if there are signs of extravasation. Most chemo does not cause extravasation. Ask your caregivers for more information about your chemo drugs. Other possible side effects from chemo include:

• Blood problems: Chemo may change the amount of certain blood cells in your body. These cells are called white blood cells, red blood cells, and platelets. Your blood may not have enough red blood cells because of your chemo treatments. This is called anemia (ah-NEE-mee-uh). Your blood may not clot as well once you start chemo. Clotting is how fast you stop bleeding. You may also bruise easier than normal. Blood cell changes can cause serious health problems. Your caregiver will do blood tests to check these blood cells and find any problems early.
  
  
• Diarrhea (deye-ah-REE-ah) or constipation (kon-sti-PAY-shun): Chemo can affect your intestines (bowel). You may have diarrhea (loose stools) or constipation (having hard BMs, less often than usual). Let your caregiver know if you have diarrhea for more than 24 hours. Let your caregiver know if you have pain and cramping with your diarrhea. Also let your caregiver know if you do not have a BM for several days.
  
  
• Fatigue: You may feel fatigued (very tired) after you get chemo. This may happen suddenly or over time. It is often not relieved with rest or naps. Fatigue can last for days, weeks, or months.
  
  
• Flu-like symptoms: You may feel like you have the flu after you get chemo. You may have chills, a fever, or muscle and joint aches. These may last for a few days.
  
  
• Hair loss: This can be a common side effect of chemo. Your hair may become thinner or fall out. Hair loss may happen anywhere on your body that you have hair. It can happen right after you begin chemo, or several weeks later. Your hair will usually grow back when you stop your chemo treatments.
  
  
• Infection (in-FEK-shun): Chemo harms healthy white blood cells. A decrease in healthy white blood cells puts you at risk for infection. Ask your caregiver about protecting yourself from infection.
  
  
• Kidney or bladder problems: Some types of chemo may cause bladder or kidney infections. They may also cause permanent damage to your kidneys or bladder.
  
  
• Mouth, gum, or throat problems: You may develop sores in your mouth or throat. You may also have white patches in your throat. Ask your caregiver about ways to prevent these problems.
  
  
• Nausea or vomiting: You may have nausea and vomiting with your chemo. There are special medicines that your caregiver can give you to help decrease these side effects.
  
  
• Nerve or muscle problems: Chemo can cause the nerves in your body to hurt, feel weak, burn, or tingle. These are usually not a sign of serious problems, but may be hard to live with. These symptoms usually go away after you are done with chemo. It may take a year or more for these symptoms to go away or get better.
  
  
• Pain: Chemo can cause many side effects that cause pain. Let your caregiver know if you have pain that does not go away or gets worse.
  
  
• Poor appetite: You may not feel like eating. Ask your caregiver about what you can do to have a balanced and healthy diet.
  
  
• Problems with memory or mood: Chemo may make you feel depressed (very sad) or confused. Talk to family, friends and your caregiver about your feelings. Caregivers may suggest ways to help you cope with your treatment, and feel better.
  
  
• Sexual problems: Chemo can affect your sexual organs. In women, their menstrual (MEN-stroo-al) cycle (monthly periods) may change or stop. There may be vaginal (VAJ-i-nal) dryness, which may cause pain or discomfort with sexual intercourse (sex). There may also be hot flashes. A hot flash is a sudden feeling of heat that spreads throughout your body. It may be dangerous for a woman to become pregnant. Men may not be able to have or keep an erection (ee-REK-shun). Both men and women may be unable to have a child. Ask your caregiver for more information about sexual function while using chemo.
  
  
• Skin problems: Chemo can cause dry skin. It can also cause other skin problems such as a rash, itching, redness, and sensitivity to the sun. Your nails may also peel, become yellow, or cracked.

What are the tests or treatments I may need during chemotherapy? You may need several different tests or treatments during your chemo. Tests will help your caregivers see how the chemo is working. It will also allow your caregiver to see how your body is handling the chemo. Your caregiver may order one or more of the following:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Blood culture: Your blood may be tested to see if there is infection in it. You may need to have your blood tested more than one time.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• CT scan: This is also called a "CAT" scan. A special x-ray machine uses a computer to take pictures of your cancer. Your caregivers look at these pictures. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps cancer areas show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish.
  
  
• Blood Transfusion: You may need a blood transfusion (trans-FU-zhun) if your chemo hurts your blood cells. You may ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation. Many people are worried about getting AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus. If you refuse a blood transfusion, your condition may get worse, and you may die.
  
  
• Special precautions: Chemo medicines are dangerous if you touch them. While you are being given a chemo treatment, your caregivers will wear special gloves and gowns. They will do this to help prevent getting the medicine on their skin or clothing. Special waste containers will be used for any leftover chemo and supplies.

Risks:

• There are risks with getting peripheral IV chemotherapy. The chemo could leak out of your vein and harm your skin permanently. If this happens, you may need to get chemo another way, such as through a larger vein in your body. You could have a bad reaction to the chemo. You may also develop infection in your mouth or other places in your body.
  
  
• Chemo may permanently damage many organs in your body. The chemo may not work well for you, and the cancer could spread to other places in your body. A new cancer could grow. You could die. If you choose not to get chemo, the cancer may spread more quickly. You could die sooner. Ask your caregiver if you have any questions or concerns about your cancer or treatments.

Support: You and your family may feel scared, confused, and anxious after being told you have cancer. Getting chemo is very frightening. These feelings are common. Talk about them with your caregiver or with someone close to you. For more information, you may call or write:

• American Cancer Society
  Phone: 1-800-227-2345
  Web Address: http://www.cancer.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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