How I will receive treatment (thanks to Veronica Lavanga for this info)

How treatment is given

Your chemotherapy treatment can be given to you as a day patient or during a short stay in hospital. The treatment is then continued at home. Before you start treatment you will need to have a blood test on the same day, or a few days beforehand. You will also be seen by a doctor, specialist nurse or pharmacist. If the results of your blood test are normal, the pharmacy will prepare your chemotherapy drugs. All of this may take a couple of hours.

Most people who have ECF will have their chemotherapy given through a thin plastic tube which is inserted under the skin into a vein near the collarbone (central line), or passed through a vein in the arm (PICC line). Your doctor or nurse will explain more about this to you.

You will be given an anti-sickness (anti-emetic) drug, either as tablets or by injection through your central line or PICC line. The chemotherapy drugs are then given separately:

• epirubicin (a red fluid) is given as an injection along with a drip of salt water (saline) into the line. It may sometimes be given as a drip
• after this you will be given cisplatin (a colourless fluid) which is given as a drip (infusion).

Before and after treatment with cisplatin, you will be given plenty of fluid through your drip to keep your kidneys working normally. This may mean that you will need to stay in hospital overnight.

Once your drip is finished you will start treatment with 5FU, which is usually given through a small portable pump. The pump is used to give a controlled amount of the drug into your bloodstream over a set period of time. There are several different sorts of pump, though all are small enough to be carried in a belt or holster so that you can continue doing the things you normally do.

Once the pump is connected to your line, you can go home with it. Before you go you should be given instructions on how to look after the pump. Your nurse should explain how to care for it and what to do if something goes wrong.

When the infusion is finished there may be some fluid left in the pump. This may be normal as some types of pump need to be overfilled to get the correct dose. You can check with your nurse or pharmacist whether you have this type of pump.

The 5FU treatment is given continuously over the whole time that you have your chemotherapy. You will need to have the drug reservoir or the entire pump replaced as it empties, usually on a weekly basis. This may be done at the hospital or you may be taught to change the pump yourself. Otherwise, arrangements may be made for a district nurse to come to your home to change the pump.

When you go home you will be given a supply of anti-sickness tablets to take with you. You should take these regularly if you have been told to do so, even if you are not feeling sick. This is because some medicines are much more effective at preventing sickness than stopping it once it has started. However, the 5FU in the pump is very unlikely to make you feel sick and it is unlikely that you will need anti-sickness medicines for more than a few days after your visit to the hospital.

If you do not have a central line or PICC line, 5FU can be given to you as a drip into your arm (through a small tube known as a cannula which is inserted into a vein in your arm). This is given over a shorter period, often for four days every three weeks. You will need to stay in hospital for the four days of treatment.