Chemotherapy for childhood cancer

Chemotherapy for childhood cancer

Chemotherapy is the use of anti-cancer medicines, most of which are called cytotoxic because they have the ability to destroy cells. Cells go through cycles of resting, growing and dividing. Different types of cells spend different amounts of time doing these tasks. Cells that grow and divide quickly are susceptible to chemotherapy medicines.

What is chemotherapy?

Chemotherapy is the use of anti-cancer medicines, most of which are called cytotoxic because they have the ability to destroy cells.

How do chemotherapy medicines work?

The body is made up of cells and these cells go through cycles of resting, growing and dividing. Different types of cells spend different amounts of time doing these tasks. Cells that grow and divide quickly are susceptible to chemotherapy medicines. It is during the process of growing and dividing that cytotoxic medicines get into cells and change their make-up so they cannot continue to multiply. Some medicines act best during the cells' growing phase and others act best during the cells' dividing phase. This is the reason most children will receive combinations of different medicines.

How will I find out about the medicines that will be used during my child’s chemotherapy treatment?

Soon after the diagnosis of cancer has been made, your child's doctor will provide you with a treatment protocol. It will contain details of the planned treatment, the names of the medicines to be used and how and when they will be administered.

You will also be given medicine information sheets about the medicines to be given to your child and their possible side effects. The information sheet will also tell you if you need to protect yourselves and other family members from contact with these medicines which are present in urine, faeces and blood up to 48 hours after chemotherapy treatment finishes. See:

What are the side effects?

Chemotherapy medicines cannot tell the difference between normal cells and cancer cells and affect all cells that divide rapidly. The damage caused to normal cells may lead to side effects. Different chemotherapy medicines cause different side effects and also, since children respond to chemotherapy differently, some children will have fewer problems, others more. The side-effects are managed as they develop so that children are kept as comfortable as possible at all times. Because normal cells have the ability to repair themselves effectively, the side-effects are almost always temporary.

The normal cells most often affected include those in the:

  • bone marrow (where blood is produced), causing fewer blood cells than normal. This is known as a low blood count
  • digestive system (mouth, stomach, bowels or intestines, rectum), causing nausea, vomiting or mouth and gut ulcers
  • hair follicles, causing hair loss

See the following for detailed information about chemotherapy side effects, their treatment and management:

What can I do?

Tell your child's doctor or nurse if your child has other symptoms that you think may be medication side-effects.

Keep all your medicine information sheets for your child and file them together in a folder. They list the possible side-effects of your child's medicines.

Keep the treatment protocol for your child and file this together with your child's medicine information sheets and any other printouts about your child's treatments.

How is chemotherapy given?

The most common methods of giving chemotherapy medicines are intravenously (into the blood stream) and orally (by mouth). They can also be given intramuscularly (by injection into a muscle), subcutaneously (by injection under the skin) and intrathecally (by injection into the fluid surrounding the spinal cord).

Chemotherapy is administered according to the treatment protocol. Most chemotherapy is given in cycles where there is a course of treatment followed by a recovery period. The recovery period of two to three weeks allows the body to recover from the side effects of the medicines.

Will chemotherapy hurt?

Oral chemotherapy is just like taking any other medicine by mouth. It does not hurt but if your child does not like medicines the nurse or hospital play specialist will give you some hints to help make it easier them.

Intramuscular injections may sting as the needle goes into the skin and the medicine is injected.

Subcutaneous injections can be given after applying an anaesthetic cream to your child's skin beforehand, to make the area feel numb. Your child's nurse will put the cream on or show you how to do it.

Intrathecal injections are given under general anaesthetic so your child will be asleep and unable to feel anything.

Intravenous injections. If your child has an external catheter in place the medicine is put into the tubing and there is no skin prick for your child to feel. If your child has an internal catheter in place, the skin over the Port will be numbed by applying an anaesthetic cream before the injection is given. Your child's nurse will put the cream on or show you how to do it.

Will my child be admitted to hospital?

Not always.

If your child is having chemotherapy tablets or suspension they can be taken while your child is at home.

Some chemotherapy will be given in the outpatient clinic or day-stay unit of the hospital. The medication may be given as a quick injection from a syringe or it may be given in a bag of fluid over a period of several hours.

Some chemotherapy is complex and is best managed in hospital. If this is the case for your child it will be written in the treatment protocol.

Acknowledgements

All the fact sheets in the Childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the National Child Cancer Network Clinical Leader.

This page last reviewed 23 April 2013.
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