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London Cancer is a partnership of NHS, academic, charity and cancer specialists dedicated to providing  expert, compassionate care for every patient, every time.

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Chemotherapy and biological therapies

"I need the cancer to be completely cured or at least under control."

Chemotherapy and biological therapies are the standard first-line treatment for many blood cancers.  They are used to control the disease or kill cancer cells anywhere in the body.

Chemotherapy

Chemotherapy is typically a combination of drugs, administered in tablet form or straight into the blood through a drip or as an injection under the skin.  It works by targeting and destroying cells which are multiplying quickly - like blood and lymph node cancer cells. 

Unfortunately, the drugs used in chemotherapy are not very good at distinguishing between cancer and your healthy cells which multiply quickly.  This is why chemotherapy causes side effects.  Your haematologist will tell you what to expect and prescribe drugs that either eliminate or reduce many of the side effects.The fact that chemotherapy kills healthy blood cells that are vital to your health means that during treatment you will be particularly vulnerable to infection. Again, your haematologist will discuss how you can reduce the risk of infection.

Depending on your particular cancer, chemotherapy may be given to you as a hospital inpatient (while you are staying in hospital) or as an outpatient in a hospital chemotherapy day unit.

Biological therapies

The latest advances in medical science mean that we're increasingly able to target cancer cells to interfere with the way cancer cells grow. This new generation of drugs, called 'biological' or 'targeted' therapies, exploits the differences between normal and cancer cells by targeting the cancer where it is relatively vulnerable. 

They work in a number of ways:

  • They can enter the cell and disrupt the cancer from inside
  • They can send signals to the immune system to destroy the cancer cells
  • They can attach themselves to receptors on the surface of the cancer cell and send signals for the cancer cell to die.

The accuracy of the targeting means that in contrast to chemotherapy, the cancer can be targeted with less collateral damage to healthy cells, though there may be some side effects, including vulnerability to infection.

Find out more about chemotherapy and biological therapies for:

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What questions can I ask my haematologist or CNS before my chemotherapy and/or biological therapies?

You are free to ask whatever questions you feel are important to you. The following questions may be useful. Feel free to print this list and take it with you when you meet your haematologist or clinical nurse specialist. Click here to print.

  • What are the side effects of chemotherapy and biological therapy?
  • What are the long-term effects?
  • Will chemotherapy affect my fertility?
  • How is this going to affect my everyday life?
  • What is the best drug/regime for me?
  • How long will the treatment last for?
  • Are there any other options?
  • Where can I have the treatment?
  • How successful will it be in treating my cancer?
  • How will I know if it has been successful?
  • Will I need other treatments in addition to chemotherapy?
  • Are there any clinical trials for chemotherapy I could take part in?
What are the general side effects of chemotherapy?

The side effects depend on the chemotherapy drugs you are receiving and how you react to them as an individual (people can react very differently to the same drug).

Your oncologist will give you information about the drugs you're receiving and the side effects they may cause. Many of these - including feeling or being sick - are prevented very effectively these days by other drugs, given to you with your chemotherapy as an inpatient, in your chemotherapy day clinic, or to take at home. 

Other common side effects are hair loss, a sore mouth and problems with the lining of the digestive system, and a reduced ability to make new red and white blood cells. The latter is called 'bone marrow suppression', and it means that you may feel increasingly tired and be at greater risk of infection. For this reason, you may receive your chemotherapy in hospital as an inpatient. If you are being treated as an outpatient (meaning you come into a clinic for your treatment) and you develop a temperature of over 38 degrees centigrade at home, your clinical team will advise you to contact them immediately or go straight to your nearest A&E. This is because your body has weakened defences, and you will need a course of intravenous antibiotics in hospital to fight off the infection.

If you are a woman and haven't been through the menopause, your oncologist will also talk to you about the potential impact of chemotherapy on your fertility and what can be done to reduce this.  Many chemotherapy drugs cause the ovaries to shut down and periods to stop, at least during treatment. Depending on your age and the chemotherapy drug you've received, your ovaries may resume their production of the hormone, oestrogen, after treatment, in which case your periods should return.  But this doesn't always happen, and the closer you are to menopausal age, the more likely you are to enter early menopause as a result of chemotherapy, even if your periods return after treatment.

Common to all of these side effects is that that the cells involved are fast dividing - just like cancer cells.  But while healthy tissue damaged by chemotherapy tends to revive quickly, cancer cells do not.

Will chemotherapy affect my fertility?

For women - If you haven't been through the menopause, your oncologist will talk to you about the potential impact of chemotherapy on your fertility and what can be done to reduce this.  Many chemotherapy drugs cause the ovaries to shut down and periods to stop, at least during treatment.  Depending on your age and the chemotherapy drug you've received, your ovaries may resume their production of the hormone, oestrogen, after treatment, in which case your periods should return.  But this doesn't always happen, and the closer you are to menopausal age, the more likely you are to enter early menopause as a result of chemotherapy, even if your periods return after treatment.

For men - Some chemotherapy drugs will have no effect on fertility, but others may reduce the number of sperm produced or affect their ability to reach and fertilise a woman's egg during sex. If you want to have children after your treatment you may be able to bank some of your sperm for later use, before you start chemotherapy. If this is possible in your case, you will be asked to produce several sperm samples over one or two weeks. These will then be frozen and stored so that they can be used later.

If you are interested in trying to preserve your fertility, you should discuss your options with your consultant or clinical nurse specialist before you have your chemotherapy.

Macmillan Cancer Support has further information about how chemotherapy can affect fertility.

Can I have fertility treatment on the NHS if I've had cancer?

If you do not already have children and you are under the age of 40, you will be entitled to fertility treatment on the NHS if your fertility is likely to be affected by your cancer treatment. Please discuss this with your consultant or clinical nurse specialist and they will put you in touch with a fertility specialist before your treatment starts.

Will I lose my hair and what specialist advice is available if this happens?

This depends on the type of chemotherapy drug or drugs you're receiving. Scalp cooling with a cold cap, which is used when some other cancers are treated, prevents or reduces hair loss by cutting off the blood supply to your hair follicles during treatment.  Unfortunately, this is not offered to patients with blood cancers as we want the chemotherapy to get everywhere, including the scalp, as the cancerous blood cells can potentially get everywhere within the body.

Your clinical team will also refer you for specialist advice on wigs, headscarves and other headgear you can wear until your hair grows back (and it always does).  Wig technology has come a long way, and it is often possible to replace your hair witha wig of the same colour and style.

Can I get my wig free on the NHS?

Your CNS or chemotherapy nurse will be able to advise you on this.

Further information on specialist wig stylists is available online. 

 

Are there any chemotherapy clinical trials suitable for me?

Hospitals within London Cancer actively participate in national and international oncology trials, the majority of which are co-ordinated by the National Cancer Research Network.  Providing you are suitable clinically, you will be offered access to one or more of these trials.

Participating in a clinical trial can produce better results by giving you access to the very latest thinking from the clinical profession.  It is an important personal decision, and your oncologist will want to talk through the potential risks and benefits with you. We encourage suitable patients to participate in clinical trials; it's one of the ways you can help to improve care for patients in the future - in the same way as patients in the past have done this for you. 

Clinical trials often have strict entry criteria so please remember that you may not be eligible to take part.

Find out about the clinical trials that are available here.

Who can I talk to for more information and advice about chemotherapy and biological therapy for blood cancers?

Macmillan Support Line 0808 808 0000. This is a free phone number (when calling from landlines) and is available Mon-Fri 9am-8pm. Website: www.macmillan.org.uk

Lymphoma Association helpline 0800 808 5555. This is a free phone number and is available Mon-Thurs 9am-6pm and Fridays 9am-5pm. Website: www.lymphomas.org.uk/

Myeloma UK infoline 0800 980 3332. This is a free phone number and is available Mon-Fri 9am-5pm. Website: www.myeloma.org.uk/

Leukaemia Care care line 08088 010 444. This is a dedicated free phone service that is available 24-hours a day, for people affected by blood cancers. Website: www.leukaemiacare.org.uk

Where can I have chemotherapy?

The following hospitals across London Cancer have a chemotherapy day unit:

  • Barts Hospital
  • Whipps Cross University Hospital
  • Barnet Hospital
  • Chase Farm Hospital
  • North Middlesex University Hospital
  • The Royal Free Hospital
  • University College London Hospital
  • The Whittington Hospital

The following hospitals across London Cancer have dedicated beds on a ward (inpatient facility) for patients receiving chemotherapy:

  • Barts Hospital
  • Newham University Hospital
  • Whipps Cross University Hospital
  • Barnet Hospital
  • Chase Farm Hospital
  • Queen's Hospital
  • King George Hospital
  • Homerton University Hospital
  • North Middlesex University Hospital
  • Princess Alexandra Hospital
  • The Royal Free Hospital
  • University College London Hospital
  • The Whittington Hospital

Visit our contact page to find out location and contact details for our hospitals.

 

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