Medical Oncology

The Canterbury Regional Cancer & Haematology Service (CRCHS) Medical Oncology Department is located at Christchurch Hospital on the ground floor of the Oncology building.

It is one of two tertiary centres delivering medical oncology and chemotherapy treatment in the South Island. There are a number of satellite centres around the CRCHS coverage area that also deliver chemotherapy. Medical oncologists visit these centres for patient clinics.

The Oncology Department at Christchurch Hospital has a dedicated oncology day ward which delivers chemotherapy treatment. The Medical Oncology service sees approximately 7000 patients per year and an average of 25 – 30 chemotherapy treatments are delivered Monday to Friday.

Chemotherapy is the treatment of cancer using drugs that kill rapidly growing cells. Read the Cancer Society booklet about Chemotherapy for more information.

How does chemotherapy work?

Chemotherapy works be entering the blood stream which means the drugs can reach most places in your body attack and kill cancer cells as they divide to form new cells.

How is chemotherapy given?

Chemotherapy is usually given on a regular basis as an outpatient although sometimes you may need to be admitted to the hospital as an inpatient. Depending on the chemotherapy treatment regimen required, treatment frequency may be weekly to four weekly. Most treatment may range from 4 to 6 months in duration.

Chemotherapy is usually given by injection or infusion but sometimes is given as tablets or capsules.

Sometimes chemotherapy and radiation therapy are given at the same time to make the treatment more effective.​​

Biological therapies try to attack particular parts of the cancer cell either indirectly by the immune system or by attacking the cancer cells directly.
Treatment may be given by injection, infusion or as tablets.

Biological therapies may be given on their own or in combination with chemotherapy or radiation therapy.

Monoclonal antibodies, angiogenesis inhibitors and cell growth inhibitors are all examples of biological therapies.

How do Biotherapy drugs work?

Instead of working systemically to effect cancer and healthy cells as traditional chemotherapy does, they work by targeting very particular parts of cancer cells or pathways involved in cancer growth. The drug binds to the cancer cell or pathway and prevents the process continuing.

This also means the side effects experienced can be different to chemotherapy as the traditional systemic effects such as lowering of the immune system do not occur because the drug has targeted a very specific area.​

Preparing for your appointments

View more information about preparing for your visit to the Canterbury Regional Cancer & Haematology Service.

You may attend a separate chemotherapy education session with a nurse before your treatment starts. At this session the nurse will cover the type of chemotherapy regimen you will receive, including the drugs and their potential side effects, how long it takes to deliver, how many cycles you will have and more.

You will have received a Patient Information Folder on your first clinic visit. The folder includes information about your treatment and is useful to bring along to each appointment. If you have not received a folder, ask the nurse for one at this appointment.

We are always happy to explain what the treatment involves and answer any questions you have at any stage of your treatment.
We can also refer you to a number of support services to help you throughout your treatment.

Arriving for treatment

It’s a good idea to allow plenty of time, especially if you have travelled by car, as parking near the hospital can be difficult. See our Location tab for further information about parking.

On your arrival please let the receptionist on the ground floor of the Oncology Department know that you are here. The receptionist will ask you to take a seat in the waiting area.

When the nursing team are ready to treat you a member of the team will locate you and escort you to the Oncology Day Ward where your treatment will begin.
It is normal to feel nervous or apprehensive about your first day of treatment but most people find the treatment a lot easier than they imagined. However if you do feel anxious the team will be more than willing to discuss any concerns you have.

Usually treatment is given Monday to Friday but some patients will be asked to attend on weekends or public holidays.

Before the treatment begins

The nurse will begin by introducing themselves and answering any questions you may have. If you are returning for treatment they will want to know what side effects you have had between your last treatment and the current one.
Your arm will be warmed with a heat bag or in a sink of water. This plumps up your veins for the cannula (small plastic tube) to be inserted. The cannula is used to deliver the drugs directly into your vein. A small number of people may have a central venous access device (CVAD) in place. This is a longer term option and stays in place 24 hours a day for the duration of your treatment period. It is a necessity for some of the chemotherapy drugs we administer.
Once your cannula is placed the nurse will check the patency of it by flushing intravenous fluids through it and checking for blood return from the cannula (or CVAD).

Two nurses will undertake a thorough check of all the drugs you are to receive and will then check your identity. Please don’t be upset if we check your identity repeatedly. It may be done several times on each visit by asking for your full name and birth date. This is necessary to maintain your safety and ensure you are receiving the drugs that are meant for you.

Who gives the treatment?

There are a number of nurses working in this team who have all received additional training to handle and administer chemotherapy drugs. You may have different nurses on each occasion you come for treatment.

Between each treatment visit

Between each cycle of chemotherapy you will receive an appointment to be seen in an outpatient clinic. In these clinics you will be reviewed for any side effects of the treatment by a member of your treatment team which may be either a doctor or nurse. Staff will let you know if a blood test is required before this appointment.

When you have completed treatment

When chemotherapy has finished you will have an outpatient clinic visit to discuss your future follow up requirements. For some people follow up with the Oncology Department will continue but for others you may be discharged from our care back to your surgeon or GP for continued care. You should receive the sheet ‘Finishing your chemotherapy treatment’ at this clinic visit or from the nurse on your final chemotherapy visit.​

Experiencing side effects

The side effects you may experience from your chemotherapy treatment will depend on many factors, such as the drug or combination of drugs, the dose you have been given and how you as an individual tolerate the treatment.
It is important to remember that everyone is different so possible side effects, including their severity, will vary from person to person even though the treatment regimen may be the same.

Effects of chemotherapy on healthy cells

As chemotherapy is a systemic treatment side effects are not limited to the site of your cancer. Other healthy cells that are dividing can be damaged by chemotherapy. Most commonly the cells that divide more often (such as the cells in hair follicles that produce new hairs, or cells in the lining of your stomach) tend to be affected more than cells that divide less frequently. Healthy cells damaged by chemotherapy, however, are able to recover better than cancer cells so most side effects are for a short time afterward.

Side effects from Biotherapy

The side effects from biotherapy or targeted agents can be different to traditional chemotherapy as the drug targets a very particular part of a cell or pathway.

Concerns you may have

Your treatment team will provide you with written information on each drug you will receive and the potential side effects that may be experienced with each one.

If you are concerned about any of the side effects you are experiencing you should contact us (24 hours) on: 03 364 0020 and speak with a nurse.

The Cancer Society Website has information about possible side effects which may be of use to you.

Throughout your chemotherapy treatment you may meet many different health professionals and support staff. Some of these people are listed below along with how they can help and support you throughout your treatment.

Medical Oncologist

Your Medical Oncologist is the doctor in charge of your chemotherapy treatment. They have received specialist training in the use of chemotherapy and biotherapy drugs to help treat cancer. They will meet you before your treatment starts and during the course of the treatment to see how you are managing.

Registrar

These are qualified doctors who are in training. They work alongside the Medical Oncologist in charge of your care. You may see a Registrar in clinic before, during and after your treatment or if you become unwell.

Charge Nurse Managers

Charge Nurse Managers are responsible for the running of the Oncology Day Ward, outpatient clinics, Medical Day Unit and the Inpatient Ward . You may meet them if you are admitted either for or during your chemotherapy.

Clinical Nurse Specialist

The Clinical Nurse Specialist is a specialist nurse with experience and advanced knowledge of chemotherapy and cancer. They may also be directly involved in your care by seeing you in clinic, the ward or talking by telephone.

Clinical Nurse Specialists also provide leadership and mentorship to the nursing staff as well as being involved in education, quality and research activities.

Registered / Enrolled Nurses

Registered nurses staff the Inpatient Ward and the Oncology Day Ward, they will give you the chemotherapy as well as providing you with a chemotherapy education session to tell you all about the treatment and side effects. These nurses have received specialist training in the delivery of chemotherapy drugs.

Enrolled nurses will greet you when you come to clinic or may care for you on the ward.

Hospital Aides

Hospital Aides assist nurses in caring for patients and also help to keep the clinical areas tidy and well stocked.

Ward Clerk

The Ward Clerk deals with enquiries concerning patients as well as performing administrative and clerical tasks.

Cleaning staff

Our cleaners have a vital role because they look after the cleanliness of the service areas.​

Also view Allied Health for Allied Health staff information.

Frequently asked questions

You should not hesitate to call us if you feel unwell in any way while on chemotherapy. Our telephone is answered 24 hours a day, 7 days a week by the nursing team and they are happy to take your call. Dial (03) 364 0020 then follow the prompts.

There are a few things to keep in mind while you are receiving chemotherapy:

Lowered Immune System

Firstly your immune system may be lower than normal which increases the risk of getting unwell while you are on chemotherapy treatment. Be aware of being in close contact with people while they are unwell. Try to avoid being too close (within 1 metre) or ask to delay contact with family/friends until they have been free of symptoms for 48 hours.

Diet

You do not need to take any special dietary precautions, however you should follow good hand hygiene and food hygiene practices.

Body fluids/waste

Once the chemotherapy enters your system it circulates and will be eliminated through your urine, bowel motion, sweat and vomit. The chemotherapy drugs you are receiving have the potential to be hazardous to health. Exposure to other people of the drugs or your body waste should be kept to a minimum. Handling of body fluids is detailed on our Receiving Chemotherapy hand-out.

Sex

There is no clear indication on whether body fluids such as saliva, semen or vaginal fluid would contain any chemotherapy drugs in large enough quantity to be hazardous to another person. It is important while you are receiving chemotherapy to maintain your quality of life so we do not recommend that you stop participating in sexual intimacy. Some people may prefer to use barrier protection (condoms) while on treatment. You should discuss this with your treatment team if you have any questions or concerns.

Please read our hand-out Receiving Chemotherapy

In most cases, yes, you can work while having chemotherapy treatment. We would encourage you to maintain as normal a life style as possible while undergoing treatment. The main side effect which impacts on a person’s ability to maintain this life style is fatigue. It is variable how affected people are by treatment and side effects.

In most cases, yes, we would encourage you to maintain your lifestyle as much as possible. It is variable how affected people are by treatment and side effects.
Read the Cancer Society brochure on ‘Being active when you have cancer’.

Only a few of the drugs we use cause hair to thin or fall out completely. Your doctor or nurse will let you know if you are receiving any of these drugs and the chances of hair loss for you. We can arrange a subsidy for a wig for you and the Cancer Society can also help with turbans.

Some chemotherapy drugs cause more nausea and/or vomiting than others. We have a range of anti-nausea tablets associated with each chemotherapy regimen we give to help prevent this occurring. Anti-nausea tablets will be prescribed for you and you should take them as we instruct you to. We always aim to prevent any nausea or vomiting by taking the tablets before this occurs. If you are taking them as instructed but still have nausea and/or vomiting you should telephone us as we have other anti-nausea drug options we can try.

Some chemotherapy drugs are more likely to affect fertility than others. Your treatment team will discuss this with you before commencing any treatment. If your fertility will be affected the options to preserve fertility will be discussed with you before starting any treatment.
It is recommended that you do not attempt to conceive a child while you are on treatment. Please discuss the need for contraception to prevent this with your doctor or nurse. Your treatment team can also tell you how long you should wait after you have finished treatment before attempting to conceive a child.

The nurse administering the drugs will wear a gown and gloves for their protection. Chemotherapy drugs are known hazardous agents and we want to minimise exposure to other people.

The nurses will have already explained other precautions you may need to take with any contaminated clothing and your body fluids at home. You will receive the booklet Receiving Chemotherapy which will outline this information as well.

The drugs will be administered as on the prescription. The amount of time it takes varies from one regimen to another and the nurse will have explained your regimen in the chemotherapy education session. The infusion line is flushed between each different drug. When complete the cannula is removed and you may go home.

You should experience no adverse effects with the chemotherapy running. If you do start to feel unwell or experience pain at the infusion site you should get the attention of a nurse immediately.

The majority of people having chemotherapy receive it as an outpatient in the Oncology Day Ward and go home the same day. A few people may need to stay in hospital for their treatment. Your doctor will indicate if this is necessary before you commence any treatment. If you do have to stay in hospital you will be in the Oncology Ward.

On the first treatment we recommend you bring a family member or friend with you who can drive you home. In most circumstances you will be able to drive home after treatment. You can also discuss this with the nurses.

Between each cycle of chemotherapy you will see the doctor in clinic. Cycles can vary in length between 2-4 weeks. Your doctor or a nurse will explain what your particular cycle length is with you.

This visit is to discuss how you tolerated the last cycle of treatment. The doctor will want to know what side effects you experienced and will discuss how best to manage these.

This is also the time when the doctor can write a prescription for any medications you require to support you during chemotherapy treatment i.e. anti-nausea medications.

Any other medications you take that are related to other conditions should continue to be prescribed by your GP. We like to keep them fully involved and informed about your care.

You should have a blood test within 48 hours of each chemotherapy treatment to ensure your blood count has or is recovering sufficiently to go ahead with the next planned treatment.

Complementary treatment is a term which is used to refer to a wide range of health care practices and products which are used alongside (or complementary to) mainstream conventional treatments. On the other hand alternative treatment is a term which refers to health care practices and products which are used instead of (or as an alternative to) mainstream conventional medicine.
Such treatments will range from being entirely safe to very dangerous, from possibly helpful to definitely unhelpful. Most complementary treatments will fit into the category of safe but of unknown efficacy. Once it has been demonstrated that a therapy is effective and safe then it is no longer complementary therapy, it becomes mainstream treatment.

When making decisions about any of these types of therapies, it is important to be fully informed and to seek the advice of your doctor. Your doctor will have a good idea which of these treatments are safe and possibly helpful and will also know which of these treatments are ineffective or dangerous.

If you are already taking complementary medicines it is important to tell your medical team. This is because your immune response may be suppressed due to treatment making some complimentary medicines unsafe to take such as raw or powdered products or they may interfere with how your treatment works. Other examples of complementary therapies are relaxation therapy, yoga, meditation, aroma therapy, reiki, music therapy, tai chi and massage therapy. These can help deal with the emotional and physical impact of the disease and treatment side effects.

For further information please discuss with either the nurses or your medical team, read the information available from the Cancer Society or visit the Memorial Sloan-Kettering Cancer Centre

While your treatment is running you shouldn’t feel any different. It is not normal to have any discomfort in your arm with the drugs infusing so if you experience this you should alert the nursing staff immediately. In rare cases the drug can inadvertently go into the tissue which would cause discomfort, this is called extravasation and requires urgent action to prevent damage to the tissue. It is also rare for people to experience an allergic reaction to chemotherapy drugs however there are some drugs which are more likely to cause a reaction. Additional medication is given before the administration of these drugs and the medical and nursing staff will talk with you about the need for these before treatment begins.

Again if you feel anything abnormal while having treatment you should alert the nursing staff immediately. The drugs need to be stopped immediately for the reaction to settle.​

Page last updated: 22 October 2018

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