• Chemotherapy

    Dana-Farber/Brigham and Women's Cancer Care

    When you think about cancer treatment, chemotherapy may be the first method that comes to mind. Chemotherapy involves using medication to help eliminate cancer cells and keep them from multiplying in your body.

    The most common ways to receive chemotherapy are through infusion or through pills you can take at home (oral chemotherapy).

    Infusion

    clinician with a patient receiving infusion  

    If you have chemotherapy by infusion, the medication is delivered by an infusion "pump," entering your bloodstream through a needle in your vein, a port, or catheter.

    You'll receive your treatment in a comfortable reclining chair or a bed. At Dana-Farber, we offer lunch, complimentary snacks, and beverages to our patients during chemotherapy.

    Because your pump is on wheels, you may be able to walk around while receiving your treatment. Your sessions last between one and several hours, and are generally scheduled at one- to three-week intervals.

    You might receive additional medications and treatments (such as hydration) through infusion.

    Your infusion appointment

    The length of chemotherapy infusions can vary. Your nurse or doctor will let you know how long your treatment may take. If possible, try to make your appointment before 10 a.m. or after 2 p.m., as the middle of the day can be busy.

    Juices, fruit, sandwiches, pastries, coffee, and tea are available throughout the day. Our friendly volunteers serve drinks, refreshments, and lunch. You can also bring your own snacks from home, or purchase some in our cafeteria.

    You may bring one family member or friend to your infusion appointment. Children are welcome in the adult infusion areas if they are accompanied by another adult.

    It's a good idea to bring books, magazines, puzzles, a laptop computer, or portable music (with earphones) to help pass the time. Our infusion areas have wireless internet access. We also offer iPads for patients to use during treatment visits.

    Chemotherapy phone numbers

    Emergencies: call 617-632-3352 and ask for the adult oncology fellow on call.
    Clinical Research Center 617-632-5952 

    Hours

    Monday – Friday: All infusion areas are open from 7:00 a.m. – 8:30 p.m.
    Saturday and Sunday: All patients are seen on Yawkey 8 from 7:30 a.m. – 3:30 p.m.
    Holidays: All patients are seen on Yawkey 8 from 7:30 a.m. – 3:30 p.m.

    Infusion locations

    Yawkey 7 Infusion – Gastrointestinal Oncology, Multiple Myeloma and Non-Malignant Hematology
    Phone number 857-215-0700 

    Yawkey 8 Infusion – Hematologic Malignancies, Bone Marrow Transplant and Neuro-Oncology
    Phone number 857-215-0800 

    Yawkey 9 Infusion – Breast Oncology Center, Sarcoma and Genitourinary Oncology
    Phone number 857-215-0900 

    Yawkey 10 Infusion – Gynecologic Oncology, Thoracic Oncology and Head and Neck Oncology
    Phone number 857-215-1000 

    Side effects

    Some patients experience side effects from chemotherapy, such as hair loss, nausea, or fatigue.

    Side effects are usually caused by the activity of anti-cancer drugs in your normal cells, especially cells that multiply rapidly, such as those in your bone marrow, mouth, stomach, intestines, hair follicles, and reproductive cells (sperm and egg).

    Most side effects can be managed, so it's important to listen to your body during treatment and talk with your doctor or nurse about any changes you notice.

    Protect yourself from germs and complications

    When you're receiving chemotherapy, you may be more likely to catch colds, flu, and other contagious diseases. You can protect yourself and help us protect other patients while you're at Dana-Farber.

    • Friends or family members who are sick should not accompany you to infusion appointments.
    • Friends or family members who have been exposed to a contagious illness such as flu should wait three weeks before coming with you to your infusion.
    Please notify your physician if you have:
    • Fever above 100.5 F
    • Unusual bruising or bleeding
    • Unusual dizziness, lightheadedness, shortness of breath, and/or excessive fatigue
    • Persistent nausea, vomiting, diarrhea, or constipation lasting more than 48 hours after chemotherapy
    • Persistent mouth sores or painful swallowing

    Patient safety

    Patient safety is a priority for Dana-Farber, especially when your care involves chemotherapy. We have many systems in place to enhance the safety of our patients, including a computerized ordering system and bar-coded medications that help us make sure you are getting the right one. We encourage you to help make your experience safer by speaking up if something doesn't seem right.

    Clinical research

    Sometimes chemotherapy is given as part of a clinical trial, in which researchers are studying the safety or effectiveness of the medication. If you are participating in a clinical trial, your infusion might take place in Dana-Farber's Clinical Research Center instead of on one of the main infusion floors.

    Oral Chemotherapy

    doctor and patient at Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Medical Center  

    What is oral chemotherapy?

    Oral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form. It is prescribed by your doctor, nurse practitioner, or physician's assistant, and has the same benefits and risks as chemotherapy given by infusion.

    Today, many cancer patients receive oral chemotherapy as a treatment. This method is sometimes easier than getting chemotherapy by infusion at the hospital or clinic, because the medicine can be taken at home. It's important to understand that these pills can be just as strong as the intravenous form of chemotherapy.

    Oral chemotherapy is not just any pill.

    Dana-Farber — a leader in patient safety and an innovator in the safe administration of chemotherapy by infusion — is committed to educating patients and their families about the benefits and risks of oral chemotherapy. We apply the same safeguards to oral chemotherapy that we do for infusions. Patient education is central to this mission.

    Oral chemotherapy is a serious treatment. When taking oral chemotherapy at home, patients must understand special instructions, precautions, and side effects. Following these instructions will help you receive the most benefit from the drug.

    What information should you gather before you begin oral chemotherapy?

    • Your doctor, nurse, or pharmacist will give you instructions for how and when to take your oral chemotherapy. Please follow instructions carefully, and keep them close by for future reference.
    • Be familiar with both the trade name and generic name of the drug.
    • Understand the dose and frequency of the drug. Always double- and triple-check the dose before taking. You may need to take several pills of different strengths to make the total dose.
    • Know the best time of day to take the drug.
    • Understand whether you should be taking the drug before or after a meal or snack.
    • Review all other medicines or supplements you take with a member of your oncology team. Some medications can interfere with how well the oral chemotherapy works.
    • Know what to do if you miss a dose, vomit, or take an extra dose by mistake.
    • If you are in a clinical trial, you might have special instructions.

    Communicate with your other health care providers. Be sure your primary care physician, dentist, and other caregivers are informed about the oral chemotherapy you are taking.

    Prepare for your start date:
    • Find out if your oral chemotherapy can be filled at your local pharmacy or ordered by mail.
    • Allow enough time for your prescription to be filled, and have it on hand before your intended start date.
    • Talk with your oncology team in advance if you have concerns.
    Oral chemotherapy can be costly, so:
    • Check with your insurance company regarding your coverage and co-payments for oral chemotherapy.
    • Learn more about treatment-related medication co-payments by calling Dana-Farber Patient Assistance and Community Resources at 617-632-3301. You may also visit NeedyMeds for help with the cost of medicine.

    How can I be sure to take my oral chemotherapy pills at the right time?

    woman taking pills from bottle  

    Remembering to take your medication at the right time of day is not as easy as it may sound, especially if you have an active life.

    Tips to keep in mind:
    • Try to take your pill at the same time and under the same circumstances every day.
    • Use the reminder features on your smart phone or home computer to prompt you to take the drug as prescribed.
    • If you travel, make sure you have enough pills on hand for unexpected delays.
    • Keep a diary (either on paper or an e-calendar) that records the time, date, and how you are feeling. A diary is a good tool to verify that you are taking the drug correctly; it will also help you recall exactly how you where feeling during the weeks or months between appointments.
    • Bring the diary to your next appointment at Dana-Farber.
    • Ask a family member or friend to call or visit you periodically to review your drug diary.
    • Leave your drug diary in a prominent place so you will see it and complete it every day.
    How do I manage symptoms and side effects of oral chemotherapy?
    • Be sure you understand what the drug is intended to do and how it acts in your body.
    • General side effects from oral chemotherapy include:
      • Fatigue
      • Skin changes (especially to palms of hands or soles of feet)
      • Nausea or vomiting
      • Flu-like symptoms
      • Mouth, hair, and nail changes
       
    • Become familiar with the most common side effects of your drug. Find the fact sheet for your specific drug on the Medications A-Z page of Dana-Farber's Health Library.
    • Keep information about side effects where you can refer to it often.
    • Record in your diary 3-4 times per week the side effects you are feeling. Use a few words, or check off side effects from a list provided by a member of your clinical team.
    • Be sure to share this information with your clinical team during your next Dana-Farber appointment.

    Don't wait to call your oncology team.

    Depending on the type of oral chemotherapy you are taking, you might experience some unique side effects. It's important to keep in close contact with your oncology team. Plan ahead: Keep contact numbers for your doctor or nurse, along with your drug information, in a prominent place.

    Oral chemotherapy is becoming more common to treat many types of cancers. Partnering with your oncology team and communicating any concerns is an important part of your treatment plan:

    • Contact a member of your clinical team immediately if side effects prevent you from taking your drug doses as prescribed.
    • Skin changes can be difficult to treat without direct observation. If you develop an unusual skin rash after taking the drug, call your nurse or doctor.

    How do I handle oral chemotherapy safely at home?

    Most oral chemotherapy medicine is stored at room temperature, away from heat or moisture. Your doctor or nurse will tell you if your medication needs special storage or handling.

    Storage
    • Keep your medicine in its original container.
    • Keep it away from other medications and beyond the reach of children or pets.
    • Do not store oral chemotherapy pills in a bathroom with a shower, or on your windowsill.
    Handling
    • Wash your hands thoroughly before and after you take the pills.
    • Do not crush, break, or chew your pills.
    • Caregivers should be extra cautious when administering the drug.
      • Avoid handling with bare hands.
      • Empty pill(s) into cap lid or small plastic cup for dispensing.
      • You may wear latex gloves, if contact is unavoidable.
      • The only person exposed to the drug should be the patient.
       
    Disposal
    • If you have oral chemotherapy pills left over, please return them to the pharmacy where the prescription was filled.
    • Do not flush them down the toilet, pour them in the sink, or throw them away in the trash.

    For more information about oral chemotherapy handling, storage and disposal, see Dana-Farber's oral chemotherapy fact sheet.

    Other resources

    Better Coverage for Oral Chemo: Why It Matters
    Chemotherapy Related Neuropathy: Managing This Nerve Wracking Problem
    Oral chemotherapy fact sheet 

     
     
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