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The end of chemo? One magic pill may hold answer

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Intrapleural chemotherapy:

Chemotherapy is given through a chest tube inserted into the space between the lung and the lining of the lung.

Intramuscular injections:

The chemo injection is given through the skin into the muscle layer. Most chemotherapy cannot be given this way because of the harshness of the chemical.

Subcutaneous injection:

The chemo injection goes into the space between the skin and the muscle. Especially useful if the patient's platelet count is low, because subcutaneous injections are less likely to cause bleeding.

Intraperitoneal chemotherapy:

A catheter is placed through the abdominal wall with the catheter draining into the abdominal cavity. Chemotherapy is then infused directly into this cavity.

Intra-arterial chemotherapy:

Drugs are given directly to the artery that is supplying blood to the tumour. This gives the affected area a high dose of radiation without the associated toxicity to the rest of the body.

Intravesicular chemotherapy:

Medication is injected through a catheter directly into the bladder.

Implantable chemotherapy:

As many as eight dime-sized wafers diffused with appropriate chemo drugs are left inside the skull after surgery on a brain tumour. The wafers slowly release cancer-killing radiation as they dissolve over a period of weeks.

Intraventricular and intrathecal chemotherapy:

Used when drugs need to reach the cerebrospinal fluid ( CSF) in the brain and spinal cord. Access to the CSF is gained through the spine or by threading a catheter though the skull into the lateral ventricle of the brain. Used most commonly in acute leukemia patients.

Topical chemotherapy:

Some chemotherapy creams can be applied directly to the skin. The cream is absorbed directly into the cancerous lesion. The use of topical creams is very limited in cancer treatments.

Intravenous chemotherapy:

Nontunnelled catheter: Inserted at the bedside directly through the skin into the jugular vein. The catheter then travels through the vessel into the superior vena cava. Usually only used short term. An X-ray is required to make sure the catheter is in place.

Tunnelled catheter:

Surgical procedure in which the catheter is tunnelled between skin and muscle of the mid-chest, then inserted into the superior vena cava. An Xray is required to make sure the catheter is in place.

Peripherally inserted central catheter:

Inserted into one of the large veins of the arm near the bend of the elbow. It is then pushed through veins until the tip sits in a large vein just above the heart. An X-ray is required to make sure the catheter is in place.

Angiocatheter:

Placed in the vein in the arm or hand and removed after the chemo medication is given.

Common chemotherapy side effects

Flu symptoms: Tiredness, muscle aches or headaches and chills can begin as soon as an hour after treatment and last up to three days.

Hair: Hair loss can occur on all parts of the body. Patients may lose the hair on their head, including some or all eyelashes and eyebrows, and on their body, including pubic, chest, and underarm hair.

Skin: Minor skin irritations may develop, including: redness, rashes, itching, peeling, dryness and acne.

Oral: Mouth, throat and tonsils can become very dry, making talking, chewing and swallowing very difficult.

Mouth: Sores can develop on the tongue and lips.

Eyes: Eyes become very watery, red, sore or dry and temporary changes in vision are possible.

Appetite: Desire to eat fades and eating habits change, along with food dislikes changing day-to-day. Chemotherapy drugs also cause temporary changes in taste and smell, making food less appetizing.

Nausea and vomiting: The most common and most feared symptom of chemotherapy.

Diarrhea and constipation: Irregularity ranging from loose, frequent stools to great trouble moving bowels.

Infections: Many drugs used during chemotherapy affect the immune system, limiting the body's ability to fight infection.

Bleeding or bruising: Red spots under the skin, unusual bleeding from gums or nose, bleeding from the bladder or rectum, and vaginal bleeding happen because chemotherapy affects the body's ability to make platelets, which help with clotting.

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SOURCES: HEALTH CANADA, THE MAYO CLINIC, CLEVELAND CLINIC CANCER CENTER WRITING AND RESEARCH BY UNNATI GANDHI AND RICHARD JOHNSON

Series schedule

Nov. 20 Drugs and dollars:

The pressure of high costs on care

Nov. 21 So tired of waiting:

Treatment is still taking too long

Nov. 22 Canada's research chasm: A nation falls behind

Nov. 23 PET scan scandal: High tech sits idle

Nov. 24 Screen test: Beating the

colorectal killer

Nov. 25 in Focus English lessons: The quest for a national strategy

Nov. 25 in NewsThe science of stem cells: A new way of looking

at cancer

Today The end of chemo: There must be a better way

Thursday Can a shot of the flu cure cancer?

Saturday In his shoes:

Eight-year-old Spencer fights to live

Wednesday, Dec. 6 It's everywhere: Is the environment killing people?

Saturday, Dec. 9 "C-type" mentality: The psychology of survival

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