Chemotherapy (adults)

If you are a diagnosed with a brain tumour, one of the treatments your medical team may offer is chemotherapy. This is the use of drugs to destroy tumour cells by disturbing their growth. Chemotherapy can be used on its own as a treatment, or alongside radiotherapy.

Chemotherapy may also be used before surgery or radiotherapy to shrink the tumour or after surgery or radiotherapy, to prevent the tumour from returning.

What is chemotherapy?

Chemotherapy is the use of cytotoxic (anti-cancer) drugs that affect the growth of tumour cells by interfering with the way they divide and create copies of themselves.

Chemotherapy acts on all dividing cells, including healthy cells, but healthy cells are able to repair themselves better than tumour cells, so fewer of them die after treatment.

Your health team will carefully consider the best course of treatment for you. This will depend on:

  • the type of tumour you have and whether it has spread
  • your general health and fitness
  • your age

Chemotherapy may be given:

  • before surgery to shrink a tumour to make it easier to operate on
  • during or after surgery to kill small amounts of cells that haven't been removed, in order to reduce the chance of the tumour returning
  • to treat a tumour that has returned
  • to shrink a tumour that cannot be operated on
  • to prevent further growth of a tumour
  • prior to radiotherapy

How is treatment given?

Chemotherapy will be given to you in a series of treatments separated by rest periods. One treatment session and rest period is called a 'cycle' and a number of cycles make up the 'course' of treatment. There are various ways that chemotherapy can be given.

Tablets

Some chemotherapy drugs can be taken in tablet or capsule form like any other tablet. They are absorbed and carried around your body in the bloodstream to reach the tumour cells. You will be able to take the tablets at home, but will need to take care to touch them as little as possible and should wash your hands straight afterwards. There can be an after-taste to these drugs - chewing flavoured gum afterwards can help to disguise this taste.

Injection or drip

Chemotherapy drugs can be injected into a vein ('intravenously') or into the spinal fluid ('intrathecally'). They can also be given via a drip to the veins over a time period of half an hour to a few hours. As with tablets, the drugs are absorbed and carried around your body in the bloodstream to reach the tumour cells.

Wafers

Chemotherapy drugs are sometimes put inside a polymer wafer and inserted into the brain during surgery. The polymer wafers are made from a biodegradable material (i.e. one that breaks down in the body). Wafers are used to target cells which couldn't be removed by surgery. You may also hear these implants referred to as Gliadel ® wafers.

Ommaya reservoir / Ventricular access device (VAD)

This is a dome-shaped device that sits underneath the scalp and delivers chemotherapy directly into the cerebrospinal fluid (CSF), the clear fluid within the brain and spinal cord. By doing this, chemotherapy is delivered directly to the brain, which increases its effectiveness.

How long will chemotherapy last?

Typically a course of treatment may last 3-6 months, consisting of 4-8 cycles. You may have chemotherapy for a few days every few weeks.

Individual treatment plans vary, however – yours will be designed specifically for you.

Do I need to stay in hospital during the chemotherapy?

Chemotherapy is generally given as an outpatient treatment, which means that you don't have to stay in hospital overnight, although in certain circumstances you will need to. A member of your health team will talk to you about this before you start your treatment.

What side-effects can I expect?

Side-effects vary from person to person and according to the drugs you have been given. As chemotherapy (temporarily) acts on healthy cells as well as tumour cells though, it may cause some unpleasant short-term side-effects, which commonly include:

  • Lowered immunity (increased risk of infection)
  • Increased risk of bleeding/bruising
  • Tiredness
  • Anaemia
  • Nausea
  • Hair loss
  • Sore mouth ('oral mucositis')
  • Changes in taste, appetite and digestion
  • Effects on skin and nails, including sensitivity to sunlight and chlorine
  • Numbness or tingling hands or feet
  • Reaction with alcohol

Side-effects tend to gradually disappear over time once the treatment is complete, but if you are concerned about any of your side-effects, please remember to speak to your health team.

If you experience shortness of breath or an irregular heartbeat, tell your health team as soon as possible.

How will this affect my work?

While you will not need to stay in hospital to receive treatment, if you work, you will need to arrange time off for hospital appointments. Side-effects, such as tiredness and nausea, may mean you need a longer period of time off work.

Our Employment resources provide help and information on how to approach your employer about your diagnosis and how they can support you through this time.

How will I know if chemotherapy has worked?

You will be monitored for any changes to the tumour, sometimes during and sometimes following treatment. This can be through the use of scans ('MRI' and 'CT' scans) to see whether the tumour is shrinking.

What happens after treatment has finished?

You will have check-up appointments following treatment, which will sometimes include scans. These appointments may continue for a number of years after your chemotherapy has finished.


Page last reviewed: 05/2014
Next review due: Currently under review

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