Chemotherapy and targeted therapies are the most prescribed treatments in medical oncology. In the information below, chemotherapy refers to the administration of intravenous chemotherapy and/or targeted therapies.
Step 1: Initial Consultation
Your medical oncologist will meet with you to learn more about you, your treatment options, and provide you with recommendations in order to create a plan specific to your cancer.
If you’ve already had surgery or are being referred by another specialist, the medical oncologist will review any previous scans or surgery and perform a physical examination. They will have already had a discussion with your surgeon and reviewed their notes and most likely spoken with their radiation oncology colleagues about you and your condition (if radiation therapy is indicated) in order to create the best treatment plan.
If you are being referred directly from your GP, your medical oncologist will probably order further tests so that they can get a clear picture of your cancer and general health. These may include a CT, MRI or PET scan, and blood or other tests.
Based on the type of cancer you have, your medical oncologist will explain treatment options available to you, discuss a recommended treatment plan, and answer any questions you may have. It can be useful to write down questions you may have and to bring them along to your first consultation. Family members or friends are also welcome.
Step 2: Nurse Consultation and Education
Your medical oncologist will introduce you to a specialist cancer nurse who will set up a time with you to explain the treatment process in more detail. This will take about an hour and you are encouraged to bring a friend or family member with you. The nurse will discuss other support services available, such as our onsite allied health providers.
The nursing team is available to provide you and your family with any additional support or information you may need. The nurse is responsible for administering treatments and, in close consultation with your doctor, will monitor your overall health and well-being throughout treatment and beyond.
Step 3: Treatment
The day before your treatment commences you will need to have a blood test so that your number of red and white blood cells can be recorded (called a "blood count"), along with your liver and kidney function. This is because chemotherapy often reduces the number of blood cells in your body and can affect how your liver and kidneys function.
On the day you receive chemotherapy, you'll normally go through a number of steps:
- You’ll be shown into the department where your nurse will take care of you throughout the duration of your treatment. The nurse will take your blood pressure, pulse, temperature and respiration rate, as well as your weight. They will also ask you a series of questions about your general health and well-being.
- The nurse will put in an IV (intravenous) line into an appropriate vein if you don’t have a port or catheter in place. Ports or catheters (also called PICC lines) are used in people with veins that are difficult to access or when the duration of treatment is expected to be long. Some people also need a continuous dose of chemotherapy over an extended period. If this is the case, you might be given a small portable pump that you can take home with you.
- Most chemotherapy treatments require ‘premedication’. This is additional medicine given prior to the start of each cycle of treatment to help prevent possible side-effects.
- Before treatment starts, your nurse will double-check your details, the name of your medicine and dosage.
- The nurse will then start the infusion, which may be as short as 15 minutes or take up to several hours. You will be monitored carefully by your nurse throughout treatment, but particularly during the first 15 minutes. A friend or family member is welcome to stay with you during this time and your own TV screen or music is available during treatment
- The pharmacist will introduce themselves and answer any specific questions you may have about the drug(s) you receive and provide you with further education about your medicine(s). They are interested in knowing about any other medications you may be taking. It helps if you bring with you a list of current medications and their doses (this is available from your GP, or simply bring your medication with you).
- When your treatment has been completed, your nurse will take out the IV line.
- Before leaving, your nurse will go over any side-effects you might expect, explain how to best manage them, and ensure that you know the number to contact should you experience any situations that require immediate medical attention.
Step 4: Next Treatment
Some treatments are given weekly, some every 3 weeks, and others at different time intervals. It is important that you come for each consecutive treatment on the scheduled day, as the timing of treatments is designed to have the best impact on killing the cancerous cells.
Blood tests may be required in between treatment sessions and there may be occasions where treatment is delayed due to your blood count being lower than expected at the time your next infusion is due. Your doctor will evaluate this and reschedule your treatment, if necessary.
If you are having chemotherapy prior to surgery (neo-adjuvant chemotherapy) you will probably have a scan after a few treatments to check how your cancer is responding.
Step 5: Follow-up Consultation
While you will be closely monitored during the treatment phase, your doctor will see you at the end of each treatment to assess your progress and discuss any next steps, if required.