Chemotherapy

Chemotherapy is the use of drugs to kill disease, including cancer. Most chemotherapy drugs move around the body in the bloodstream so they can reach all cancer cells wherever they are in the body and damage them. The cells eventually die, and the cancer may then shrink, or go away completely.

Unfortunately chemotherapy drugs don’t only affect cancer cells. They can damage any cells that are actively growing and dividing, for example, cells in the mouth and hair roots. This can cause side-effects such as sore mouth or hair loss.

Normal cells recover quite quickly, so any damage to them is usually temporary. This is why most side-effects go away once chemotherapy is over.

There are many different chemotherapy drugs. Some are given on their own, but several drugs are often given together (combination therapy).

The chemotherapy given depends on many things, such as:

  • The type of cancer
  • What the cancer cells look like
  • Where the cancer started
  • Whether the cancer has spread to other parts of the body

Chemotherapy is delivered in the Cancer Centre and in the Bridgewater Suite on the Belfast City Hospital site. Some haematology patients may also receive chemotherapy in Ward 10 North of Belfast City Hospital.

To read more about chemotherapy treatment, please follow the links on the right.


  • Preparation

    This section is for oncology patients only.

    There are a number of things patients can do to prepare for undergoing chemotherapy:

    • Dental Health: Make sure dental check-ups are up to date and any dental work is done before the chemotherapy starts. If dental visits are needed while on chemotherapy, or in the six weeks after it finishes, the medical team should be contacted.
    • Flu Vaccine: It is recommended that patients get the flu vaccine if they will be having chemotherapy during the autumn and/or winter. Ideally this should be at least 7 – 10 days before chemotherapy starts. If vaccinations are needed while on chemotherapy, or in the six weeks after it finishes, the medical team should be contacted.
    • Other vaccines: Patients should not have any live vaccines while having chemotherapy and for 6 months afterwards.

      It’s best for patients to discuss the details of their treatment with their doctor, who will be familiar with their particular situation and type of cancer.

    Any questions about preparation for chemotherapy can be directed towards the Northern Ireland Cancer Centre.

    Haematology patients should seek advice from their consultant regarding any dental work or vaccination administration.

  • Structure of Treatment

    In reception

    The patient will be asked to attend Bridgewater Suite or Ward 3A of the Cancer Centre for their first appointment to prepare for chemotherapy.

    Patients should give their name and the time of their appointment to the receptionist. The receptionist will let the nursing/consultant staff know the patient has arrived. There is a waiting area where patients can wait until they are called by a member of staff. Tea, coffee and daily newspapers are provided.

    The reception staff will give the patient a pager which will light up and buzz when staff are ready to see the patient. This should be kept close to them at all times. The pager works within half a mile so patients may go anywhere in the hospital grounds, e.g. to the coffee shops, dining room or car park. Patients should inform reception staff if they are leaving the waiting area.

    The first visit is likely to take a few hours. Patients may want to bring something to keep them occupied while waiting.

    Consultation Room

    Before beginning chemotherapy treatment, patients will be brought into a consultation room for a medical assessment and blood tests. Such assessments and tests will determine fitness for treatment.

    At each appointment, patients will have a blood test. It can take at least an hour for results to be processed. Depending on the results, it may be safer if treatment is delayed for a few days. If so, another appointment will be given.

    Once the blood test results have been processed and it is safe for the patient to have chemotherapy, they will discuss the treatment with a consultant oncologist or nurse and will be asked to give their consent. There will be an opportunity to ask questions.

    Treatment

    Some patients may go home after seeing their doctor and return for their chemotherapy in the next few days. If a patient is having chemotherapy or treatment on the same day as their first appointment, they should plan to be there all day.

    Patients should be aware that when the pharmacy is preparing their chemotherapy these are specific to them and must be exactly right. They are checked several times so this can take up to a couple of hours.

    The patient will then receive their chemotherapy.

    If the treatment is a day treatment, the patient can then go home. The patient will be given new appointment dates to attend for chemotherapy. The patient should attend for treatment according to their schedule. If they are being treated as an outpatient, the treatment will take place in the Bridgewater Suite or the Cancer Centre, depending on the type of treatment being given.

    The patient should attend for treatment according to their schedule. If they are being treated as an outpatient, the treatment will take place in the Bridgewater Suite or the Cancer Centre, depending on the type of treatment being given.

    Please note: Haematology inpatients on Ward 10 North will be given their treatment on that ward.

    Next steps

    Once the chemotherapy is completed the patient will be booked for a number of outpatient review appointments to monitor their progress and to provide an opportunity for the patient to ask any questions.

    The patient will be given new appointment dates to attend for chemotherapy.

    Click here for information on how Bank Holidays may affect your treatment schedule

  • Side Effects

    Unfortunately there are a number of unpleasant side effects of having chemotherapy drugs as part of cancer treatment but many can be controlled with medicines.

    The side effects include:

    • Increased chance of infection: Chemotherapy will reduce the number of white blood cells (this is known as neutropenia).White blood cells help fight infection. As a result of normal white blood cells being reduced, patients on chemotherapy can have an increased chance of infection. Patients should try to avoid people who have an infection such as the cold or flu. Patients should contact the Haematology helpline at once if they develop a temperature or feel unwell as treatment may be needed.
    • Bruising and Bleeding: Chemotherapy can reduce the number of platelets in the body. Platelets help clot blood and stop bleeding. Patients should contact the Haematology helpline at once if they have unexplained bruising or bleeding (this includes nose bleeds, bleeding gums, blood spots or rashes on the skin).
      Anaemia (Fewer red blood cells) : While having chemotherapy treatment or following chemotherapy treatment patients may become anaemic. This condition is caused by a reduction in the amount of iron in the body and cause patients to feel very tired and breathless. Patients should tell their hospital doctor if they feel they have symptoms of anaemia.
    • Nausea and Vomiting: Some drugs used during chemotherapy to treat cancer may cause nausea or vomiting. Patients may be offered anti-emetics (anti-sickness drugs) to prevent or reduce nausea and vomiting.
    • Hair Loss/Wig Fitting Services: A distressing side effect of some types of chemotherapy is hair loss. Most cancer patients are entitled to a free wig from the NHS. For more information on wig fitting services and support please contact the Macmillan Support and Information Centre at the Belfast City Hospital or speak to a nurse. Telephone: 028 9069 9201 / 028 9069 9202 or Email: belfast@macmillan.org.uk or cancerinfo@belfasttrust.hscni.net.
    • Numbness or tingling in hands or feet: Some chemotherapy drugs may cause side effects on the nerves leading to numbness or tingling in the hands or feet. This is known as peripheral neuropathy. Patients should tell their hospital doctor if they notice this.
      Sore mouth and loss of appetite: Some chemotherapy drugs can cause a sore mouth or small ulcers to develop. Patients should talk to their doctor or nurse for advice on how to manage these symptoms.

    Patients should contact the Haematology helpline at once if they feel unwell.

  • Locations

    Bridgewater Suite

    On arrival at the Bridgewater Suite patients should go to the reception desk and give their name and the time of their appointment to the receptionist. The receptionist will let the medical and nursing staff know that the patient has arrived.

    Patients will recieve a pager which will light up and buzz when their appointment is ready. This should be kept close at all times. The pager has a working radius of half a mile so patients may go anywhere in the hospital grounds, e.g. to the coffee shops, dinin room or car park.

    Bridgewater Suite has a waiting area where tea, coffee and daily newspapers are provided.

    Blood tests may taken before the patient sees a doctor.

    When the pager buzzes the patient will be taken into a consultation room for a medical assessment before treatment.

    Ward 3A

    On arrival at the Northern Ireland Cancer Centre patients should take the lift to the third floor of the Cancer Centre and go to the reception desk in front of the lifts. This is the reception desk of Ward 3A.

    Patients should give their name and the time of their appointment to the receptionist. The receptionist will let the nursing/consultant staff know the patient has arrived.

    Ward 3A has a waiting area where patients can wait until they are called by a member of the nursing staff. Tea, coffee and daily newspapers are provided.

    Patients will recieve a pager which will light up and buzz when their appointment is ready. This should be kept close at all times. The pager has a working radius of half a mile so patients may go anywhere in the hospital grounds, e.g. to the coffee shops, dining room or car park. Patients should inform Level 3 reception staff if they are leaving the level.

    Before beginning chemotherapy treatment, patients will be brought into a consultation room for a general medical assessment and blood tests. Such assessments and tests will determine fitness for treatment. The first visit to the Unit is likely to take a few hours.

    At each appointment, patients will have a blood test. It can take up to an hour for results to be processed. Depending on the results, it may be safer if treatment is delayed for a few days. If so, another appointment will be given.

    Once the blood test results have been processed the patient is cleared for chemotherapy, they will discuss the treatment with a consultant oncologist or nurse and will be asked to give their consent.

    During this time pharmacy is preparing the chemotherapy to be given to the patient. These are specific to each patient and they must be exactly right. They are checked several times so this can take up to a couple of hours.

    The patient will then receive their chemotherapy.

    If the treatment is a day treament, the patient can then go home.

    Ward 10 North (Haematology Ward), BCH

    Ward 10N is the inpatient unit for the treatment of Haematological Disorders. The ward is located on the tenth floor of the Belfast City Hospital Tower. There are 28 inpatient beds there and the area is staffed at all times by a group of nursing and medical staff. Treatments given there include chemotherapy and stem cell transplantation.

    Other treatments such as Factor V111, Haemate P and biological therapies are also delivered in the ward. Visiting hours are 1pm-9pm daily. Visitors are encouraged not to visit if they have any type of infection or are unwell. Children are not permitted to visit unless they are the child of an inpatient.

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