Injections and infusions are a common way to receive chemotherapy. Both methods deliver cancer-treating medications directly into the bloodstream.
Chemotherapy is a common cancer treatment that uses specific medications to kill cancer cells. It’s typically considered a systemic treatment, meaning that it acts throughout your body instead of at just one location.
Many forms of chemotherapy are given as injections or infusions into your bloodstream.
This article explores the different types of chemotherapy injections and infusions, including what they entail, and their benefits and side effects.
Chemotherapy is often given intravenously, meaning that the chemotherapy drugs are able to enter your bloodstream directly. While this sounds straightforward, there are
- IV push: In this method, chemotherapy is given directly into an IV or catheter over a period of just a few minutes using a syringe.
- IV infusion: Chemotherapy is given via an IV bag drip over a period of minutes to hours.
- Continuous infusion: Chemotherapy is given over a span of hours or days using an electronic pump.
Intravenous chemotherapy can also be delivered through a number of other methods, as described below.
IVs for chemotherapy
Sometimes, chemotherapy will simply be injected into an IV that’s placed into a vein in your hand or arm. However, these types of IVs can only be used on a short-term basis, meaning they have to be removed after a few days.
That means that when you come back for your next chemotherapy treatment, an IV will have to be placed back into your hand or arm. Not only are the needle sticks uncomfortable, but frequent needle insertions can also damage veins over time.
However, other solutions are available. These are collectively referred to as central venous catheters (CVCs).
Central venous catheters for chemotherapy
CVCs involve placing a soft, flexible tube called a catheter into a large vein, typically in your chest. The other end of the catheter is outside of your body and can be used to inject chemotherapy drugs and other medications as well as to draw blood.
A minor surgical procedure is needed to place a CVC. It will typically stay in place until your treatment has concluded.
There are several types of CVC. They are:
- Central lines: A central line is a catheter that’s placed into a vein in your chest. The end of the catheter tube sticks out of the skin in your upper chest.
- PICC lines: A PICC line is a catheter that’s inserted into a vein in your arm and then threaded up to a vein in your chest. The end of the catheter tube sticks out of the skin in your arm.
- Ports: A port is a small disc that’s placed under your skin. A catheter on one end of the port goes into a large vein in your chest. A needle can be inserted into the outward-facing part of the port to inject medications or to draw blood. With a port, there’s no catheter tube that sticks out of your skin.
Other injection methods
Additional ways to inject chemotherapy include:
- Intrathecal injection: Intrathecal chemotherapy is injected directly into the cerebrospinal fluid (CSF) that surrounds your brain and spinal cord and is used to treat cancers affecting these areas.
- Intracavity chemotherapy: Intracavity chemotherapy is injected directly into a body cavity. An example of this is intravesical therapy for bladder cancer.
- Injection into muscle or skin: This delivery method involves the injection of chemotherapy medications directly into a muscle or under the skin (subcutaneously).
One of the main benefits of a chemotherapy infusion or injection is that it allows the treatment to quickly access the cancer site. For example, chemotherapy drugs can use your circulatory system to readily reach the tumor site when given intravenously.
Similarly, an intrathecal injection into CSF allows chemotherapy medications to access your brain and spinal cord, bypassing the protective blood-brain barrier. Or, intravesical therapy into the bladder allows medications to directly contact bladder cancer cells.
Additionally, CVCs for infusions provide the following benefits:
- allowing for easier, long-term access to your bloodstream in order to deliver chemotherapy and other medications as well as to draw blood
- dealing with fewer needlesticks when you go in for treatment
- having less risk of damage to veins or of having a catheter become displaced
- being able to receive several treatments at once if your catheter has multiple lines
Receiving chemotherapy by infusion or injection comes with its own set of side effects and risks. These may include:
- pain or a topical reaction at the injection site after an injection is given
- infection at the site of an injection or around a CVC
- blockage of an IV or CVC
- blood clots in the veins around an IV or CVC
- dislodgement of an IV or CVC, which can lead to tissue damage
- extravasation, which is when chemo leaks out from a vein into surrounding tissues
- an allergic reaction to the chemo drug(s) being infused or injected
The type of chemotherapy medications you receive and how it’s administered will depend on the type of cancer you have. Your doctor or oncologist will let you know what your treatment involves and what medications will be used.
There are many different kinds of chemotherapy drugs, and many of them can be administered as an infusion. Examples of
- alkylating agents like cisplatin and cyclophosphamide
- anthracyclines like daunorubicin and doxorubicin
- antimetabolites like cytarabine and gemcitabine
- taxanes like docetaxel and
paclitaxel - vinca alkaloids like vincristine
Some chemotherapy drugs can be given in multiple ways. For example, 5-fluorouracil can be given as an infusion for several types of cancer. It also comes in the form of a topical cream that can be used to treat certain skin cancers.
Other types of cancer treatments besides chemotherapy are also given by infusion. Two examples include targeted therapy and immunotherapy.
In addition, certain cancer treatments need to be administered through a central venous catheter (CVC) because the medications used would be damaging to your veins.
There are many places where you may have a chemotherapy infusion. This can depend on factors like the specific medications you’re receiving, their dose, and your doctor’s recommendation.
You may receive a chemotherapy infusion at:
- the hospital as an inpatient or an outpatient
- a clinic
- your doctor’s office
- your home
Depending on your treatment plan, your infusion could take up to a few hours. Here are several things you can do to prepare:
- Aim to get good sleep the night before your infusion.
- Wear comfortable, loose-fitting clothes.
- Make sure you’re well-hydrated.
- Try to eat a light meal or snack beforehand.
- Bring a book, music, or a tablet to keep yourself busy during your infusion.
- Ask if it’s possible to bring a friend or family member along for support.
Before your infusion procedure, a healthcare professional will make sure you’re settled and comfortable.
Blood tests will be done to check things like blood cell counts and the function of your liver and kidneys in order to ensure that you’re healthy enough to receive chemotherapy.
If you don’t have a CVC in place, a healthcare professional will place an IV in your hand or arm. If you do have a CVC, it will be flushed prior to being used.
Your infusion will be given directly into your IV or your CVC. If you have a port, a special needle called a port needle will be used to access your port through your skin. You’ll receive some numbing cream beforehand, so this won’t hurt.
Any additional IV treatments you may need, such as anti-nausea medications, may also be given through the CVC.
Healthcare staff at the infusion center will monitor you during your infusion. They’ll check in with you to ensure that you’re still comfortable and aren’t having an adverse reaction to your infusion.
If you don’t have a CVC, the IV will be removed from your hand or arm after your infusion. If you do have a CVC, it will be flushed after your infusion is over.
A chemotherapy infusion can take as little as a few minutes to as long as several hours. Your doctor will let you know what to expect beforehand so that you can prepare accordingly.
You may have side effects after your infusion. The type and severity of side effects can depend on the drug(s) used and on the dosage.
Side-effects usually appear the day after treatment or a few days after with the most intense symptoms happening the week after treatment and then improving over time or until the next treatment.
Some of the most common chemotherapy side effects are:
Your doctor will give you tips on how to manage side effects. In the meantime, try to take care of yourself by resting up, staying hydrated, and eating a nutritious diet.
Chemotherapy is typically given in cycles. One cycle consists of a treatment period followed by a period of rest so that your body can recover from the effects of chemo.
Cycle lengths often range from 14 to 28 days. For example, if you’re on a 28-day cycle, you’ll receive your infusion once every four weeks. The number of cycles needed depends on things like:
- the type of cancer you have
- the stage of the cancer
- how aggressive your cancer is
- how your cancer responds to the chemotherapy
Chemotherapy is often given by an injection or infusion directly into your bloodstream. Options include injection with a syringe, in an IV drip, or as a continuous infusion using a pump.
Chemotherapy medications may be delivered into your bloodstream through an IV placed into your hand or arm, or through a CVC. This can be a central line, PICC line, or port.
The types of chemotherapy drugs you’ll receive, how long your infusion will take, and how many chemotherapy cycles you’ll need all depend on you and the type and stage of your cancer. Your doctor or oncologist will give you a better idea of what to expect.