What is chemotherapy?
Chemotherapy uses medicines to kill cancer cells. It is often called “chemo” (pronounced KEE-mō).
Most chemo medicines attack all fast-growing cells. Newer chemo medicines target cancer cells more precisely, with less effect on other fast-growing cells.
Your child’s doctors may suggest chemotherapy:
- As your child’s main treatment.
- Before surgery or another treatment to help shrink a tumor.
- After surgery or other treatment to kill any cancer cells that remain. This lowers the risk that cancer may spread or come back.
What's special about chemotherapy at Seattle Children's?
- We are specially trained in caring for kids, not just in using chemotherapy to treat diseases. Our cancer doctors (oncologists) have all received special training in pediatrics and pediatric hematology-oncology.
- We are experts in providing the supportive care children and teens need to receive chemotherapy safely and to recover fully.
- Our team works to minimize both short-term and long-term side effects of chemotherapy.
- When possible, we give chemotherapy without having your child stay overnight in the hospital. Pediatric nurses in our Outpatient Infusion Unit monitor your child closely.
- We provide the most current chemotherapies, including promising new medicines offered only in clinical trials.
- Our cancer doctors help set national standards for care of children with cancer.
- Your child benefits from the work of physician-scientists at Fred Hutchinson Cancer Center and UW Medicine, as well as at Seattle Children’s. The National Cancer Institute has named our partnership a comprehensive cancer center.
For many children with cancer, treatment includes promising new chemotherapies offered only in research studies. These studies are called clinical or therapeutic trials.
As national leaders in pediatric cancer research, we can offer our patients phase 1 clinical trials that are not available at most centers. Often our doctors lead these early studies. They are especially important if your child’s tumor does not respond to their first treatment or comes back after treatment.
To see if there is a clinical trial for your child:
Our experts help set the worldwide agenda for pediatric cancer research. Seattle Children’s oncologist Dr. Doug Hawkins is leader of the Children's Oncology Group (COG). Learn about cancer research at Seattle Children's.
How does chemotherapy work?
Most chemo medicines attack all fast-growing cells, including cancer cells. Newer medicines (called targeted therapies) attack cancer cells more precisely. This means less harm to healthy fast-growing cells and fewer side effects for your child.
Chemotherapy is almost always delivered to a child’s whole body (called systemic). The medicines go into the bloodstream and throughout your child’s body to kill cancer cells. Sometimes chemotherapy is put directly into the blood vessel that feeds the tumor.
The way your child gets chemo depends on:
- The type of medicine (chemicals) used
- The type of cancer
- Where the tumor is
The mix of medicines and how long they are given depend on your child’s cancer. Doctors may give your child medicine:
- Through a thin plastic tube (IV catheter) placed under your child’s skin and into a blood vessel in their chest or arm. Leaving the IV line in place lets your child get chemotherapy with less need to poke a vein in their arm over and over. This method is used most often.
- Through a temporary IV line in your child’s hand or am.
- As a shot in the skin or muscle.
- By mouth. It may be a pill or liquid.
- As a shot into the spinal fluid. This is used to keep cancer from spreading to the brain and spinal cord. It also treats any cancer there.
- Into an artery near a tumor. This method (intra-arterial infusion) delivers more medicine directly to the tumor. Seattle Children’s was one of the first hospitals in the nation to offer this treatment. We have used it more than 100 times to treat children with retinoblastoma.
Children receive chemotherapy at our hospital campus in Seattle. Depending on the type of medicines your child needs, they may:
- Stay in our Cancer and Blood Disorders Center - Inpatient (as inpatients)
- Have daytime appointments in our Outpatient Infusion Unit
If you do not live in the Seattle area, your child may be able to receive care closer to home during some parts of their treatment. We work closely with providers in other states, such as at Community Medical Center in Missoula, Montana.
Most medicines used in chemotherapy affect fast-growing cells in the body. These include cells that grow to become blood, hair and the lining (mucous membranes) of the mouth and bowel. Damage to these cells may give your child side effects such as:
- Hair loss
- Mouth sores
- Loss of appetite, nausea or vomiting
- Diarrhea or constipation
- Increased risk of infection (from lack of white blood cells)
- Easy bleeding or bruising (from lack of platelets)
- Tiredness (from lack of red blood cells)
Rash is a common side effect of some targeted therapies.
Expert nurses and doctors will watch your child closely. Based on how your child is doing, we adjust their treatment. We provide many types of supportive care to ease your child’s symptoms and any side effects they might have. Your child’s team will talk to you about:
- Possible side effects of your child’s specific medicine
- Ways to help your child feel better
Many side effects go away after treatment. Some chemotherapy drugs cause other side effects that may be long-lasting.
Our Cancer Survivor Program provides long-term follow-up care to help young people stay healthy after being treated for cancer in childhood.
If you would like an appointment, ask your child’s primary care provider to refer you.
Providers, see how to refer a patient.