Medical oncology treatment
What happens before, during and after your treatment, and information about potential side effects and the people you may meet.
About medical oncology
Medical oncology includes:
- chemotherapy treatment
- immunotherapy treatment
- targeted therapy.
Chemotherapy treatment
Chemotherapy is the use of medicines to kill or reduce the spread of cancer cells. Chemotherapy is given as cycles and may be given:
- once a day
- once a week
- once a month.
This depends on the type of cancer and the best course as determined by research. Chemotherapy treats the entire body, unlike radiation, which treats only the part of the body exposed to the radiation. As a result, any cells that may have escaped from where the cancer originated are treated.
Immunotherapy treatment
Immunotherapy is a type of drug treatment that uses or stimulates your immune system to fight cancer. It helps your immune system recognise and work against the disease.
Targeted therapy
Targeted therapy is a type of drug treatment that targets specific mutations or proteins within the cancer cell. They do many things to the cancer cell, including turning off signals telling the cancer cell to grow or divide.
Before medical oncology treatment
We may need to test the function of other organs before starting treatments. Depending on the results of these tests, treatments may have to be adjusted to suit your specific body requirements.
Tests may include:
- CT scan — an x-ray machine with a computer produces pictures of the head or body, and shows the soft tissues and bones in more detail than an ordinary x-ray
- ultrasound — high frequency sound waves (unable to be heard by the human ear) and a computer produce a picture of most parts of the body except for the lung, bowel, or bone
- electrocardiogram (ECG) — a recording of your heart's electrical activity
- echocardiogram — an ultrasound of your heart
- magnetic resonance imaging (MRI) — a scanner that produces cross-sectional soft tissue images of any area of your body
- multi-gated assessment — a test of the heart designed to evaluate the function of the right and left ventricles of the heart and to indicate heart failure
- bone scan — a scan which uses a small amount of radioactive material to produce a map of your bones to show any changes to their structure or make-up
- glomerular filtration rate — a test to measure the function of your kidneys.
You may also have to visit a dentist before having treatment to check that your oral health is satisfactory.
A cancer nurse coordinator may contact you. They will help you navigate through some of these procedures.
If you have a cancer diagnosis, you will likely be visited by your community cancer nurse and given information about your treatment plan.
You may also be referred to other services, such as our social workers. They can help you with areas that may be impacted by your diagnosis and treatment.
What medical oncology treatment involves
Most chemotherapy, immunotherapy and targeted therapy drugs are given in one of the following ways:
- You might take a tablet or medicine orally (swallowed). This can sometimes be collected by your local pharmacy after having an appointment with your doctor.
- It may be given intravenously as an injection over a short period or as an infusion over a longer period. For these treatments, you come into hospital for part of the day.
You will see a doctor or nurse before having your treatment each time you come in. They will assess your symptoms and how you felt after your last treatment.
- In most cases, for intravenous treatments, you will have a small needle put into your hand or arm. It will be removed before you go home.
- In some cases, people require a type of line in their veins that remains there for the duration of their treatment. These are called central lines.
- Sometimes, several different drugs are given, one after the other, as a part of your treatment regimen.
You will be required to have regular blood tests throughout treatment to monitor that they are at a good level to proceed with your next treatment.
Some people may require supportive treatments alongside their cancer treatment, such as:
- blood transfusions
- bone strengthening treatment.
Some treatments, but not all, can make you feel sick. You will be given medication to stop this from happening.
Most people do not need to stay in hospital overnight to have their treatment, but some regimens do require this. Most people do not need to be admitted to hospital because they are unwell, but some people do. You will be taught what signs or symptoms you need to look out for and what symptoms may require you to come to hospital.
You will be given information about your treatment and contact numbers of who to call if you have questions or concerns throughout treatment.
People you may meet
These doctors specialise in haematology and prescribe your chemotherapy or other treatment. They are called haematologists.
Nurses administer your chemotherapy or other cancer treatment.
Clinical nurse specialists work closely with the doctors in your team and the nurses delivering your treatment. They are experts in your particular diagnosis and the treatments you may need. They can provide support and education to you and your whānau.
Cancer nurse coordinators assist with appointments and any needs you may have before treatment.
The vascular access team specialises in putting intravenous needles and lines in. If you need a special line in they will do this for you.
Palliative care can help you and your whānau if you have a life-limiting illness. This service can help you early on in your illness, when you are first diagnosed, or during treatments such as chemotherapy or radiotherapy.
The palliative care team can:
- offer advice on troublesome symptoms
- help with emotional support
- talk through difficult decisions and choices you may have to make with your whānau.
The team works with your oncologists and other support services involved in your care.
There are palliative care services in both the hospital and the community (hospice services).
A cancer diagnosis is not just a medical event. It brings changes to the way you and your whānau live.
Our oncology social workers can:
- talk to you about the changes that your diagnosis has had on your life
- support you in accessing services that can help you manage them.
They can also provide counselling and emotional support if you are feeling anxious, down or worried about:
- your health
- your whānau
- the future.
If you would like to speak to an oncology social worker, ask someone in your radiation treatment team to refer you.
Reception staff will check you in for your appointment and guide you to the part of the department you need to be in.
Reception staff can help with:
- booking appointments
- travel and accommodation arrangements
- updating your contact details
- refreshments.
If you are unsure about anything, ask our reception staff to help you find the right person to talk to.
Cancer Society volunteers come into the wards to help provide refreshments and meals to patients while they receive treatment.
After medical oncology treatment
After finishing your course of treatment, you will be booked for follow-up appointments with your team of doctors.
There are many services and groups available to support you after treatment, such as:
Side effects from medical oncology treatment
Some people have no side effects from their treatment.
But sometimes the chemotherapy or treatment will make you feel sick. Each type of treatment has different side effects. These will be discussed with you before starting any treatment, so you know what to expect.
Chemotherapy targets cells that are quickly dividing, whether it is a cancer cell or not. This means some non-cancer cells that divide quickly are also damaged. The following is a list of some normal cells that divide quickly in the body and may be affected by the effects of chemotherapy:
- cells in your hair — this can cause hair loss
- cells of the skin and mouth — this can cause sores in your mouth and dry skin
- cells in your stomach and intestines — this can cause you to feel sick, vomit or have diarrhoea
- cells in your bone marrow — this is where your red and white blood cells are made. White blood cells fight infections, so you are very prone to these temporarily, and they can become serious. Loss of red blood cells can make you anaemic and tired.
There are many medicines you can take to reduce or lessen the side effects of chemotherapy. Your care team will talk to you about these and what is appropriate for your situation.