Children’s Chemotherapy

What is chemotherapy?

Chemotherapy is a treatment that uses powerful medicines to destroy cancer cells. Because there are many different types of chemotherapy drugs available, the specific ones your child receives will depend entirely on the type of cancer being treated. To give the treatment the best possible chance of success, the specialist caring for your child will often recommend using a combination of several different drugs.

Depending on your child’s specific diagnosis, their medical team will use chemotherapy to achieve different goals:

• Neoadjuvant chemotherapy: This is given to reduce the size of solid tumours before a child undergoes surgery, making the operation safer and more effective.
• Adjuvant chemotherapy: This is used after primary treatments (like surgery) to destroy any remaining, hidden cancer cells and significantly reduce the chance of the cancer returning.
• Palliative chemotherapy: If a child’s cancer cannot be cured, their healthcare team may use gentler doses to alleviate symptoms, manage pain, and protect their quality of life.

Every step of this journey will be carefully planned and monitored by your child’s oncology team, who will always prioritise your child’s comfort and well-being.

How does chemotherapy work?

Cancer is a disease where cells in the body multiply out of control. To achieve this, each cancer cell splits to form two new cells. Chemotherapy works by interfering with this process, which is known as cell division.

Each type of chemotherapy drug works in a different way to block cell division, but they all result in the cells being unable to divide normally. This causes the cells to become damaged and die.
Combinations of drugs are often given together because by stopping cancer cells from dividing in different ways, there is a better chance of killing them.

Chemotherapy that is injected into the blood or swallowed can travel through the bloodstream, allowing it to reach cancer cells in most parts of the body. However, many of the normal therapeutic drugs cannot pass the blood brain barrier, which makes brain tumours harder to treat.

How effective is chemotherapy?

The effectiveness of chemotherapy depends on a variety of factors, such as the type of cancer being treated or whether it has spread to other parts of the body.

While some types of cancer are often cured by chemotherapy, for other types it is unlikely to be effective on its own. In these cases, it may be given alongside other treatments to improve their overall success.

It is difficult to predict exactly how a child’s cancer will respond to chemotherapy or what the future holds after treatment. Your child’s oncologist can provide more specific information about the potential effectiveness of this treatment based on your child’s unique situation.

Chemotherapy is often used alongside other treatments, your child’s medical team may also recommend radiotherapy or surgery as part of their care plan.

Chemotherapy side effects

Chemotherapy usually causes unwanted side effects because the drugs affect normal, healthy cells in addition to cancer cells. In particular, chemotherapy drugs impact parts of the body where cells naturally multiply at a fast rate.

These areas include the lining of the mouth and gut, the bone marrow where blood is produced, and hair follicles. There are many possible side effects, some of which are more likely to occur than others. The specific symptoms your child may experience depend on the combination of drugs they receive. If your child is prescribed high doses of chemotherapy, they may also experience more complex side effects.

Your child’s healthcare team can provide more specific information about the side effects your child might experience during their treatment.

How is chemotherapy given?

The most common way for chemotherapy to be given is into the blood through a vein (intravenous). This can be done either by injection with a syringe, or by infusion, using a device known as a drip.

To make it easier to give chemotherapy into the blood, your child may have a surgical procedure to put in a device known as a ‘central line’. This is a narrow tube which is inserted into a major blood vessel in the chest. Chemotherapy drugs can then be delivered through ports connected to the tube. The central line is removed after the full course is finished.

If your child is having chemotherapy delivered into the bloodstream, this will usually be done in hospital. The time needed to give the chemotherapy will depend on the type of drug used, but it can be anything up to a few hours. A child may only need to visit for the day, or they may need to stay in hospital for longer if their doctors need to monitor them.

Chemotherapy is often split up into multiple doses, with a rest period between each dose to allow the body to recover. The number of doses your child needs will vary depending on the type of drug used and the type of cancer they have. Your child’s oncologist will be able to explain more about the exact schedule for the chemotherapy that your child will receive.

Other ways to give chemotherapy

Chemotherapy may also be taken orally, as tablets or a liquid that is swallowed. These can often be taken at home.

There are other, less common methods for delivering chemotherapy drugs. These include injecting into a muscle (intramuscular), under the skin (subcutaneous), or into the fluid around the spine and brain (intrathecal).

Chemotherapy can feel overwhelming, but understanding how it works and what to expect can make the journey a little easier for both you and your child. Every child’s treatment is different, and your medical team will be with you every step of the way to guide you through it.

If you’re looking for more information on childhood cancer, including other treatments, types of cancer, and support available to your family, visit our childhood cancer information hub. You don’t have to face this alone, we’re here to help

Frequently asked questions about Chemotherapy