Chemotherapy involves administration of medications that affect all cells which divide at a fast rate, therefore targeting cancer cells. Most of these medications are given into the bloodstream through veins, less commonly by mouth or injected under the skin. In order to avoid frequent painful venous puncture a permanent catheter is placed (under anaesthesia by surgeons) connected to the veins which can be buried under the skin (port-a-cath) or externally, outside the chest (Hickman catheter). These catheters are removed after the end of therapy.

Side effects

The side effects of chemotherapy can be variable and are due to the fact that these medicines affect not only cancer cells but also other cells in the body which normally divide at a frequent rate. Very commonly children feel nausea and vomit but several medicines are used that can prevent or control these symptoms.

Hair loss is also a very common but transient side effect and hair re-grows within a few weeks after the treatment is over. Loss of appetite, diarrhoea or constipation, mouth sores, and loss of weight are also common. A lot of children require nutritional support during treatment using feeding tubes (which are not painful) and several medicines are used to control constipation, diarrhoea and mouth sores.

Fever, need for transfusions and infections are also relatively common side effects. Basic hygiene, hand washing, avoidance of prolonged exposure to sick contacts and balanced diet are some ways to prevent infections but unfortunately most of the time they cannot be avoided.

Depending on the chemotherapy medicines used hearing loss, jaw pain and "pins and needles" sensation can also occur. Very rarely some of the medicines can cause heart, kidney, nerve, liver or lung damage.

Long term side effects are in general rare but depending on the medicines used can include infertility or second cancers such as leukaemia.

Details of the side effects, method of administration and potential long term risks are always discussed prior to treatment for each individual medicine and are monitored very closely with blood tests or other investigations during and following the end of therapy.