In Part 1 of this series we explained that this series of articles is not meant to be medical advice, but a guide that may help you as a parent of a newly diagnosed child with cancer cope just a bit better. Information is knowledge, and never more so than when you are dealing with childhood cancer!
These articles are meant to help you be the key part of your child’s treatment that you will need to be.
Take what works for you according to your situation and your child’s temperament, personality, fears, strengths, and how they deal with adversity, and leave what does not pertain to your situation.
Part 5 will deal with Different Types of Treatment and Possible Side-Effects of that treatment. As this is quite a long section, I will split it into 5(i) Surgery 5(ii) Chemotherapy 5(iii) Radiation Therapy 5(iv) Immunotherapy and Bone Marrow and Peripheral Blood Stem Cell Transplants.
Complementary and Alternative Medicine treatment (CAM) is very involved and will contain a lot of information, so that will be dealt with separately in Part 6 of this series of articles.
Chemotherapy involves the use of anti-cancer drugs to fight the cancer your child has. Chemotherapy is what is referred to as “systematic therapy” which means that the drugs are introduced into the bloodstream so that it can flow throughout the whole body, seeking out and killing cancer cells wherever they may be.
Some anti-cancer drugs work better in conjunction with others, so chemotherapy sometimes consists of a combination of drugs; this is known as combination chemotherapy.
Depending on which type of cancer your child has and which drugs the oncologist decides would be best, chemotherapy may be given in one or more of the following ways:
- By Mouth (oral medication) – The drugs are swallowed in liquid or pill form. If your child has problems swallowing pills, the pills can be broken into smaller pieces or crushed and mixed with applesauce, jam, pudding, or any other food that your child likes;
- Intramuscular Injection (IM) – The drugs are injected by needle into the muscle. Your child will know it as a “shot”;
- Intrathecal Injection (IT) – The drugs are injected by needle into the spinal fluid
- Intravenously (IV) – The drugs are injected by needle into a vein or into an IV line;
- Subcutaneous Injection (SC) – The drugs are injected by needle just below the skin. Your child will also know this as a “shot”;
Although it may be possible for your child to receive chemotherapy treatments at home, he or she will probably need to go to the hospital or doctor’s office to receive IV drugs or injections. Depending on the medicine, your child may need to stay in the hospital, perhaps overnight or longer.
When possible, involve your child in this type of treatment. A good way to do this may be to keep a special calendar to help them track when medicine should be taken.
Older children, particularly teenagers, may want to be responsible for taking and keeping track of their medication themselves. This might be a way for them to feel less helpless and like they are a bit more in control of their own body. You will still need to make sure that the medicine is being taken as ordered by the oncologist.
Notify the doctor immediately if your child misses any doses of medication or if he or she vomits them up.
Intravenous Chemotherapy is when the drug is administered via a thin needle into the vein, usually in the hand or arm. In babies and very small children, the needle may be placed in a vein in the scalp.
Getting chemotherapy does not usually hurt, but it may be painful when the IV needle is put in, and the drugs may cause a burning feeling. If the drug leaks from the vein, it could burn the skin, so great care must be taken to make sure the IV line is firmly in place.
IV chemotherapy can also be given through a catheter. In this instance, the catheter will remain in place during the course of treatment so that the chemotherapy drugs can be given as per schedule without having to place a needle into the vein over and over again.
Generally, central venous catheters are used for this type of treatment. The catheter is usually put into a large vein in the chest by making a small incision (cut) near the collarbone, while the child is under either general or local anaesthesia.
Two types of central venous catheters are commonly used:
- External Venous Catheter: In this type of catheter, the plastic tube extends outside the body;
- Port-a-Cath Catheter: This is a type of catheter that is placed under the skin; a needle is placed into it each time the drugs are administered. This type of catheter is usually more appealing to teenagers and is best suited to families who cannot take care of a catheter that needs special daily care.
In addition to the chemotherapy drugs, pain medicine and blood transfusions can be given through the catheter, and blood can also be drawn through the catheter.
Side Effects of Chemotherapy
Side effects can occur when the anticancer drugs affect not only the cancer cells but the healthy cells as well. Different chemotherapy drugs produce different side-effects.
Ask your doctor or nurse what side effects your child is most likely to have, and when they are likely to occur.
Side effects are either acute (they happen right away) or delayed (they happen days, weeks, or years after chemotherapy).
The most common side effects of chemotherapy are listed in the following table.
Remember, if you are not sure of anything, speak to a professional on your child’s oncology treatment team; they will be only too glad to help give you information or allay any fears you or your child may have regarding the treatment.
You are not alone in this; there are many individuals out there able and willing to lend a hand, some support, or even just listen – do not be afraid to reach out for help!
Do some research on the internet, reach out to an organisation like Little Fighters Cancer Trust for a bit of support and information and/or access to resources that will help you find out more and make an informed decision regarding your child’s treatment.
Part V (iii) of this series will deal with “Radiation Therapy”