Chemotherapy

• Cure cancer - when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body and they will not grow back.
• Control cancer - when chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
• Ease cancer symptoms (also called palliative care) - when chemotherapy shrinks tumors that are causing pain or pressure.

• Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
• Destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy.
• Help radiation therapy and biological therapy work better.
• Destroy cancer cells that have come back ( recurrent cancer) or spread to other parts of your body ( metastatic cancer).

• The type of cancer you have. Some types of chemotherapy drugs are used for many types of cancer. Other drugs are used for just one or two types of cancer.
• Whether you have had chemotherapy before
• Whether you have other health problems, such as diabetes or heart disease

• Your type of cancer and how advanced it is
• The goals of treatment (whether chemotherapy is used to cure your cancer, control its growth, or ease the symptoms)
• The type of chemotherapy
• How your body reacts to chemotherapy

• Injection. The chemotherapy is given by a shot in a muscle in your arm, thigh, or hip or right under the skin in the fatty part of your arm, leg, or belly.
• Intra-arterial (IA). The chemotherapy goes directly into the artery that is feeding the cancer.
• Intraperitoneal (IP). The chemotherapy goes directly into the peritoneal cavity (the area that contains organs such as your intestines, stomach, liver, and ovaries).
• Intravenous (IV). The chemotherapy goes directly into a vein.
• Topically. The chemotherapy comes in a cream that you rub onto your skin.
• Orally. The chemotherapy comes in pills, capsules, or liquids that you swallow.

Chemotherapy is often given through a thin needle that is placed in a vein on your hand or lower arm. Your nurse will put the needle in at the start of each treatment and remove it when treatment is over. Let your doctor or nurse know right away if you feel pain or burning while you are getting IV chemotherapy.

IV chemotherapy is often given through catheters or ports, sometimes with the help of a pump.

• Catheters. A catheter is a soft, thin tube. A surgeon places one end of the catheter in a large vein, often in your chest area. The other end of the catheter stays outside your body. Most catheters stay in place until all your chemotherapy treatments are done. Catheters can also be used for drugs other than chemotherapy and to draw blood. Be sure to watch for signs of infection around your catheter. For more information on infection, see Infection.
• Ports. A port is a small, round disc made of plastic or metal that is placed under your skin. A catheter connects the port to a large vein, most often in your chest. Your nurse can insert a needle into your port to give you chemotherapy or draw blood. This needle can be left in place for chemotherapy treatments that are given for more than 1 day. Be sure to watch for signs of infection around your port. For more information on infection, see Infection.
• Pumps. Pumps are often attached to catheters or ports. They control how much and how fast chemotherapy goes into a catheter or port. Pumps can be internal or external. External pumps remain outside your body. Most people can carry these pumps with them. Internal pumps are placed under your skin during surgery.

• Asking someone to drive you to and from chemotherapy
• Planning time to rest on the day of and day after chemotherapy
• Getting help with meals and childcare the day of and at least 1 day after chemotherapy

• The name of each drug
• The reason you take it
• How much you take
• How often you take it

• The types and doses of chemotherapy used
• How long and how often chemotherapy is given
• Whether you get chemotherapy at home, in a clinic or office, or during a hospital stay
• The part of the country where you live

• What will my insurance pay for?
• Do I or does the doctor's office need to call my insurance company before each treatment for it to be paid for?
• What do I have to pay for?
• Can I see any doctor I want or do I need to choose from a list of preferred providers?
• Do I need a written referral to see a specialist?
• Is there a co-pay (money I have to pay) each time I have an appointment?
• Is there a deductible (certain amount I need to pay) before my insurance pays?
• Where should I get my prescription drugs?
• Does my insurance pay for all my tests and treatments, whether I am an inpatient or outpatient?

• Read your insurance policy before treatment starts to find out what your plan will and will not pay for.
• Keep records of all your treatment costs and insurance claims.
• Send your insurance company all the paperwork it asks for. This may include receipts from doctors' visits, prescriptions, and lab work. Be sure to also keep copies for your own records.
• As needed, ask for help with the insurance paperwork. You can ask a friend, family member, social worker, or local group such as a senior center.
• If your insurance does not pay for something you think it should, find out why the plan refused to pay. Then talk with your doctor or nurse about what to do next. He or she may suggest ways to appeal the decision or other actions to take.

• Benefits. All clinical trials offer quality cancer care. Ask how this clinical trial could help you or others. For instance, you may be one of the first people to get a new treatment or drug.
• Risks. New treatments are not always better or even as good as standard treatments. And even if this new treatment is good, it may not work well for you.
• Payment. Your insurance company may or may not pay for treatment that is part of a clinical trial. Before you agree to be in a trial, check with your insurance company to make sure it will pay for this treatment.