Chemotherapy and targeted therapies are the most prescribed treatments in the field of medical oncology. In the information which follows, chemotherapy refers to the administration of intravenous chemotherapy and/or targeted therapies.
At Genesis CancerCare, chemotherapy is only available as a private service at Shenton House in Joondalup.
Step 1: Initial Consultation
Your medical oncologist will meet with you to learn more about you, discuss your treatment options, and provide treatment recommendations in order to create a treatment management plan specific to your cancer.
If you have already had surgery or are being referred by another specialist, he will review any existing scans or surgery you may have had and perform a physical examination. He will have already had a discussion with your surgeon and reviewed his/her notes and possibly talked to his radiation oncology colleagues about you and your condition (if radiation therapy is indicated) in order to create the best treatment plan for you.
If you are being referred directly from your GP, your medical oncologist will probably order more tests so that he can get a better picture of your cancer and your general health. These may include a CT, MRI or PET scan, and blood or other tests.
Based on the type of cancer you have, your medical oncologist will explain the treatment options available to you, discuss his recommended treatment plan, and answer any questions you may have. Your medical oncologist will also discuss any potential short or long term side-effects. It can be useful to write down any questions you have and to bring them along to your first consultation. Family members or friends are also welcome.
An appointment will then be made for you either to start treatment or to discuss your condition further when the results of your additional tests come back (if required).
Step 2: Nurse Consultation and Education
Your medical oncologist will introduce you to one of our specialist cancer nurses who will set up a time with you to explain the treatment process in more detail. This will take about an hour and you are encouraged to bring a friend or family member with you. The nurse will also discuss other support services available as well as the benefits of participating in a world-renowned on-site cancer exercise program run in partnership with Edith Cowan University’s Health and Wellness Institute. The decision to participate is completely up to you, but we highly recommend it given the scientifically proven health and psychological benefits.
The nursing team is also available to provide you and your family with any additional support or information you may need. The nurse is responsible for administering treatments and, in close consultation with your doctor, will also monitor your overall health and well-being throughout the treatment phase and beyond.
Step 3: Treatment
The day before your treatment is due to commence you will need to have a blood test so that your number of red and white blood cells can be recorded (called a "blood count"), along with your liver and kidney function. This is because chemotherapy often reduces the number of blood cells in your body and can affect how well your liver and kidneys work.
On the day you receive chemotherapy, you'll typically go through a number of steps:
- You’ll be shown into the ‘Grace Unit’ where your nurse will take care of you throughout the duration of treatment. She will take your blood pressure, pulse, temperature and respiration rate, as well as your weight. She will also ask you a series of questions about your general health and well-being.
- The nurse will put in an IV (intravenous) line into an appropriate vein if you don’t have a port or catheter in place. Ports or catheters (also called PICC lines) are used in people with veins that are difficult to access or when the duration of treatment is expected to be long. Some people also need a continuous dose of chemotherapy over an extended period. If this is the case, you may be given a small portable pump that you can take home with you.
- Most chemotherapy treatments require ‘premedication’. This is additional medicine given prior to the start of each cycle of treatment to help prevent possible side-effects.
- Before treatment starts, your nurse will double-check your details, the name of your medicine and the dosage.
- The nurse will then start the infusion, which may be as short as 15 minutes or take up to several hours. You will be monitored carefully by your nurse throughout treatment, but particularly during the first 15 minutes. A friend or family member is welcome to stay with you throughout this time and your own TV screen or music is at your disposal.
- The pharmacist will introduce herself and is available to answer any specific questions you may have about the drug(s) you receive and provide you with further education about your medicine(s). She is also interested in knowing about any other medications you may be taking. It can help if you bring with you a list of current medications and their doses (available from your GP, or simply bring your medication with you).
- When your treatment has been completed, your nurse will take out the IV line.
- Before leaving, your nurse will again go over any side-effects you might expect, explain how to best manage them, and ensure that you know the number to contact should you experience any situations that require immediate medical attention. This is on the ‘purple card’ located in your information pack.
Step 4: Next Treatment
Some treatments are given weekly, some every 3 weeks, and others at different time intervals. It is important that you come for each consecutive treatment on the scheduled day as the timing of treatments is designed to have the best impact on killing cancerous cells.
Blood tests may be required in between treatment sessions and there may be occasions where treatment is delayed due to your blood count being lower than expected at the time your next infusion is due. Your doctor will evaluate this and reschedule treatment, if necessary.
If you are having chemotherapy prior to surgery (neo-adjuvant chemotherapy) you will probably have a scan after a few treatments to check on how your cancer is responding.
Step 5: Follow-up Consultation
While you will be closely monitored during the treatment phase, your doctor will see you at the end of your treatments to assess your progress and discuss any next steps, if required.