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Chemotherapy, or the use of chemicals to destroy cancer cells, can be employed in a variety of treatment approaches. Three common types of chemotherapy include intravenous (IV) chemotherapy, oral chemotherapy and subcutaneous or intramuscular injections. Single course or multiple course chemotherapy might be administered alone or in combination with other treatments, depending on the cancer type and how far it has progressed. Cancer treatment strategies might involve the sole use of chemotherapy agents, the use of radiation or surgery combined with chemotherapy or the use of chemotherapy before or after surgery to aid in tumor reduction.
Among the most common types of chemotherapy is IV chemotherapy, which is administered through a catheter device. The intravenous line might be removed immediately after each treatment, or a long-term port or catheter might be installed for a longer duration of treatment. The type of catheter used might vary according to several factors, including the location of the cancerous tumor and the intended length of treatment. A peripherally inserted central catheter line, which is installed in a large vein in the arm through an outpatient procedure, might remain in place for several weeks or months. A portable pump might be used to provide continuous infusion of chemotherapy drugs over several days or weeks.
Another one of the common types of chemotherapy is administered orally, or by mouth. The chemotherapy agent might take the form of a pill, capsule, tablet or liquid. In some cases, oral chemotherapy is applied sublingually, or under the tongue, rather than being swallowed. One advantage of a sublingual chemotherapy agent is that the medication is not lost if vomiting occurs.
Among the other types of chemotherapy is the needle injection of chemotherapy agents. Subcutaneous or "sub-q" injection is done under the skin, and intramuscular injection delivers the chemotherapy agent into the muscle tissue. Alternatively, the chemotherapy agent might be injected directly into a cancerous lesion. Other injection-based chemotherapy processes include delivery of the drug directly into the abdominal cavity, called intraperitoneal injection; into the bladder, or intravesicular injection; into the lung area, or intrapleural injection; or into the artery supplying blood to the tumor, or intra-arterial injection.
In some cases, such as when the chemotherapy drug needs to reach the cerebrospinal fluid in the spinal cord or brain, the drug might be administered via intraventricular or intrathecal injection. Intraventricular injection uses an ommaya reservoir under the skin of the scalp, with a catheter delivering the chemotherapy agent directly into the outer ventricle of the brain. Intrathecal injection is done through a lumbar puncture procedure, commonly known as a spinal tap.
Implantable and topical chemotherapy are used sometimes. After the surgical removal of a brain tumor, the surgeon might implant several dissolvable chemotherapy wafers in the brain cavity for gradual absorption. Topical chemotherapy delivers the chemotherapy drug by direct application to the skin.