The type of chemotherapy you get depends on the type and extent of your tumor and how fast it is spreading. How often you get treatments depends on the type of drugs you receive.
You may take the chemotherapy drugs in pill form by mouth. But for primary bone tumors, you usually get chemotherapy drugs by an intravenous (IV) drip. This means you get the drugs through a needle attached to a tube so that they drip slowly into your veins. These treatments can last several hours each.
In most cases, you get chemotherapy through a small flexible tube placed in one of your large veins. This tube is called a vascular access device or central venous catheter, and it’s placed by a specially trained radiologist or surgeon.
There are various kinds of vascular access devices, but they all fall into one of two types:
A thin catheter inserted into a large vein with the end of the tubing outside the skin. Catheters of this type include Hickman catheters, Broviac catheters, peripherally-inserted central catheters, and midline catheters.
A port, which is a small diaphragm, inserted just under the skin, and attached to tubing inserted into a large vein. A special needle connected to IV tubing is used to stick through the skin into the diaphragm to deliver the chemotherapy. Port-a-Cath is a brand name for a port.
You may get chemotherapy as an outpatient. Or, you may need to be in the hospital for a few days. The dose of chemotherapy is high to maximize the effect on the cancer cells. Your doctor and chemotherapy team will need to protect your kidneys, liver, and other organs from the chemotherapy. They will give you plenty of fluid to flush the medication out of your body. This will minimize the drug’s effect on your normal cells.
You may have chemotherapy one time a day for many days in a row. This is called a session or cycle. After each session, you will not have chemotherapy for a few weeks. Occasionally, you may get a lower dose several weeks in a row, with a shorter but more frequent rest period. This rest period helps your body recover from any side effects of the treatment. It helps your blood counts return to a somewhat normal level before receiving the next session. Before every chemotherapy session, you must have blood drawn to check your blood counts. If the counts are too low, chemotherapy is postponed until the numbers improve. The number of chemotherapy sessions you have depends on the type of cancer you have and how well the drugs are working. Children have a set number of sessions. These are based on the results of research studies.
There are several chemotherapy drugs to choose from. Doctors who specialize in giving chemotherapy are called medical oncologists. Some of the most commonly used drugs to treat primary bone cancers are listed below. They are given in different combinations: