Colorectal Cancer: In Treatment: Chemotherapy

Chemotherapy is administered in several different  forms.

Intravenous Therapy

Intravenous therapy includes the use of a  temporary or semi-permanent IV line into the forearm or by any one of a number of venous access devices(VADs). 

• The most common VAD’s are a chemoport which is surgically implanted in your chest under general anesthesia, or a PICC line which is usually in your arm. 
• These devices allow chemotherapy and fluids to be delivered without harming your veins with the sometimes caustic chemotherapy.  
• Ports also decrease the number of needle sticks needed and eliminate the need for temporary IV lines.  

While the drug is administered, you may feel a warm rush or begin sweating. If you do, check with the medical staff to be sure this is appropriate for your particular drug regimen.

Notify the medical staff if you feel burning, pain, redness or swelling near the injection site.

Portable Ambulatory Pumps 

A portable wearable pump delivers a continuous flow of chemotherapy  into the body.

With a portable pump, a drug or combination of drugs is administered through the day or at preset times. Settings can be for hours, days or weeks.

The pump is a small battery powered pump about the size of a small paperback book. It is connected via a tube to a needle which is either inserted in your Chemoport or PICC line..

The pump can be carried in a satchel that you wear around your waist or carry over your shoulder.

There are a variety of treatment schedules and pump types. Do not be concerned if you hear about people with other types of pumps  and schedules.

Advantages of the pump include continuous delivery of the chemotherapy and when the pump needs to be changed a nurse comes to you and changes it for you. Disadvantages include the inconvenience of having to carry and adjust to being  attached to a pump all day and night.

Intraperitoneal chemotherapy

For some types of colorectal cancer that spread along the lining of the abdomen, there may be an injection of chemotherapy directly into the abdominal cavity (the peritoneal cavity).

To get to the peritoneum, doctors either:

• Insert a catheter each time the treatment is given, or
• Implant several tubes and drains during the surgery to remove the tumor or during a later surgery.

As a general matter, this chemotherapy is given in cycles of five days a month for several months. The drugs are infused, left in lace for almost 24 hours, then drained.

Imaging studies such as CT scans may be administered during or after infusion to be sure that all areas of the peritoneum receive adequate amounts of medication.

Hepatic artery infusion (HAI)

Hepatic artery infusion is the delivery of chemotherapy directly into the liver.

HAI can be during surgery in the doctor’s office or at home through a portable infusion pump.

Administration in the doctor’s office is similar to delivery during Intravenous Therapy (see above).

Administration at home is by portable infusion pump. See above. 

Oral Therapy

Oral therapy is taking a drug by mouth.

Chemotherapy may include an oral medication together with or instead of intravenous injections.

You may also be given oral medications to prevent or treat side effects, such as nausea.

If you have difficulty taking pills, we have tips available by clicking here. It may also help to look at our information about tips to help keep you compliant (taking drugs over time when you are supposed to.)  For information, click here 

Subcutaneous injections 

An injection under the skin. (The traditional needle stick you get at the doctor's office).

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