Although each and every blog ‘published’ here is being composed and addressed to you the reader, you will appreciate that it is not possible for me to know in what capacity (e.g. as patient, loved one, friend or other interested party) you are currently reading them.  Sometimes therefore, as in what follows, I may be required to make an assumption, namely that you, as reader, are also the patient and that consequently I should address the following to you in person, which is what I now intend to do.

As we have already seen, cancerous cells may be carried through the lymphatic system to local lymph nodes and to the periphery and other organs via the bloodstream.  Wherever such spread is considered to be likely, the need for systemic treatment is indicated; that is, treatment that can and will reach even outlying sites where cancer cells may be lurking. This is where (as we shall see shortly) chemotherapy comes into its own and can be used alone or in combination with radiotherapy.

A simple but ready example of what systemic (as opposed to local) in this context means, may be given by referring to a house plant, which is affected by some form of leaf disorder. It can either be treated locally, i.e. by painting affected leaves with an appropriate chemical agent or preparation. Alternatively it can be treated systemically, i.e. by applying an appropriate inhibitor substance (or whatever one happens to be applying) with spray or brush, from where it will enter and affect the plant’s entire system.

Prior to any treatment being given, it is usual and normal to carry out blood tests and take x-rays. Sometimes other scans etc., (already referred to) are also employed in the assessment of treatment effect. The route chosen to administer the drug(s) will depend on what they are, as well as on the type of cancer being treated. Chemotherapy may be given as one or more than one drug and where the latter applies, treatment is referred to as “combination chemotherapy”.

Delivery may be by mouth, i.e. in tablet or capsule form. However, it is more commonly delivered by injection via a syringe into a vein or by means of a ‘drip’ or infusion pump. Where chemotherapy is given as an infusion, the purpose-designed electrical or battery-operated pump is also able to carefully time and regulate delivery. Less often, the drug is injected into a muscle or under the skin and, depending on its mode of administration, patients may receive their treatment as a hospital in-patient over two or three days.  More commonly, it will be delivered in a day ward with no requirement for overnight stay. This brief account, although covering the most common ways in which chemotherapy is administered, is by no means exhaustive of all delivery methods available. However, any further description of or discussion about these are (in the writer’s submission) best left to appropriate members of medical or nursing staff ‘on the ground’ at the time.

Following each course or “pulse” of chemotherapy, the body needs time to fully absorb and recover from the effects of treatment. On the other hand, it is simply not possible at the outset of chemotherapy to predict the actual length of these “between treatment” rest periods. This is heavily dependant on how quickly the body recovers from any unwanted effects of the drug. Regular blood tests will continue to be carried out in order to determine what you may hear referred to as the “white cell count”.  (white blood cells· are the body’s most important form of defence against infection from bacteria). Time off treatment allows the number of white cells to recover to around normal levels.  However, should you at any time feel especially unwell or develop a chill or fever, it is always a wise precaution simply to contact your GP or oncology doctor/nurse without delay. He/she will then decide what additional help you may need; e.g. antibiotic treatment.