Chemotherapy for Your Child's Solid Tumor: What to Expect

Chemotherapy or “chemo” is one of three major treatments for solid tumors. The others are surgery and radiation therapy.

Chemotherapy is treatment with medicines that kill cancer cells. Because these drugs travel through the bloodstream, chemo is called a systemic treatment. That means it affects the whole body, so chemo can kill cancer cells in the tumor as well as any cells that broke away from it and traveled through the blood or lymph to another area.

Chemo can cure some types of cancer in children. But there is more than one reason a pediatric oncologist may give chemo to a child with a tumor. 

Where chemo fits with overall treatment

You will have the chance to talk with your child’s medical oncologist, the doctor who specializes in using medicines to treat cancer. That person will explain how chemotherapy fits in with the rest of your child’s treatment plan. You will discuss the following: 

• Why your child needs chemo
• The details about any clinical trials for which your child may be eligible 
• Whether your child will get chemo before or after surgery
• Whether your child will need radiation in addition to chemo
• The number of drugs your child’s treatment team recommends and the exact names of the drugs 
• How your child will take each drug—by swallowing it, getting a shot or getting an IV
• Whether your child will get more than one drug at the same time or if one drug will have to be given before the other

How will my child get chemotherapy?

There’s a chance that your child will get chemo by swallowing a pill or liquid. Or, the nurse or doctor may inject the chemo drugs into your child’s muscle or under the skin. But the most common way to get chemo is by IV.

IV stands for intravenous. The word describes how the medicine gets into the body—through the veins.

Setting up an IV

To set up an IV, a small needle will be inserted in the forearm or hand. The needle is attached to a tiny tube. It’s very similar to how your child may have given blood for tests.

The chemo meds are inside a plastic bag, which is on a stand. It needs to be higher than your child so that the medicine will naturally flow down from the bag, through the IV tube and into the veins.

Preparation needed for chemo

You will work with the treatment team to make some decisions about your child’s care. Take the time you need to understand your choices before your consent for treatment to start. Here are a few things you’ll discuss with your child’s team: 

• Whether they think your child needs a catheter or port. These are small, hollow soft-plastic tubes that stay under the skin. They let your child get IV medicines without having to get injected by a needle for an IV day after day.
• The type of catheter they think will be best for your child. The difference between them is where they are placed, how they are used and how to keep them clean.
• What the process will be like when your child has the catheter inserted.
• Whether your child needs other tests or treatment before chemo starts.

Your child's chemo schedule

Your pediatric oncologist will set the schedule based on the type of cancer your child has, the chemo drugs he or she will get, and how the drugs affect the tumor and your child. The treatment team will explain:

• About how long each chemo treatment will take.
• How many days in a row your child will have chemo.
• How many “rest” days there will be between your child’s treatments.
• How many cycles your child will have (one cycle is the number of days in a row your child gets chemo added to the number of rest days between chemo treatments).

Treatment centers where your child can receive chemo

The place your child gets chemo depends on the way he or she receives it. These are the places you’ll talk about with your child’s team:

• At a cancer treatment center, like St. Jude 
• In a hospital or clinic as an outpatient
• In a doctor’s office
• At home
• Staying overnight in the hospital as an inpatient

If your child is participating in a clinical trial, it may be possible to get chemo closer to home while your St. Jude team continues to guide your child’s care. If you’re interested in this option, bring it up with your child’s treatment team. 

Learning about chemo side effects

Medicines can sometimes cause side effects—usually unpleasant reactions that the drug wasn’t prescribed for. Chemo drugs, for instance, don’t just kill cancer cells. They kill any cells that grow rapidly, even when that fast growth is normal, as it is in hair cells.

Different children may respond to medicine differently. The side effects your child has may not be the same as those of another child who is taking the same drugs. Even so, your child’s oncologist will tell you:

• The side effects that are most common
• When they might start after your child first has chemo
• What you can do to help your child feel better and if there is anything the doctor can prescribe to ease the side effects
• About how long side effects last
• Side effects that may not be common but that may be dangerous so you can recognize them if they occur
• Possible long-term effects of the medicine, if any

How to keep your child healthy during chemo

Having cancer makes your child more likely to get infections, and getting chemo does, too. Even something as common as a cold can become serious in your child. Do your best to follow the infection prevention steps your nurse gives you. Follow them while you’re at the hospital and at home.

If any of the guidelines don’t make sense to you or you don’t understand why you need to do something, ask anyone on your child’s treatment team.