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There are different ways that your chemotherapy can be delivered or administered. The main ones are bolus, continuous infusion, and pill form. Some chemotherapies can be administered by all methods and some are only available in one or two forms.
The method of delivery can effect efficacy and it can affect how bad the side effects are as well. Some studies suggest that delivery alone can improve effectiveness by over 10%. Primarily these studies have to do with 5FU - it has a half life in the body of 1/2 hr. That means after 1 hour only 1/4 of what youhave received is still there. After two hours, only 1/16.
Intravenous injection - Click on this link and read this excellent discussion of the options of getting chemotherapy by intravenous methods. Primarily methods for receiving chemotherapy are intravenous or oral. There are two options for receiving it intravenously - continuous infusion and bolus.
CancerCare Ontario has an excellent listing of administration guidelines for the different chemotherapies (not just for colorectal cancer). Note: Differences may exist between delivery guidelines from one country to the next.
Bolus
Also known as: bolus infusion
A bolus is a large dose of a drug given (intravenously by direct infusion injection or gravity drip) to raise blood-level concentrations to a therapeutic level.
The term is sometimes used for any large quantity of matter making its way through the digestive tract. In some situations it is used to describe the solid results of a bowel movement.
Bolus Definition
National Cancer Inst Dictionary
Dictionary.com
WrongDiagnosis.com
Continuous Infusion
Also known as: continuous rate infusion; CI; CADD (Continuous Ambulatory Drug Delivery) pump
'The rationale for CI chemotherapy is based on the physiology of the cell cycle and pharmacokinetics of chemotherapy agents. Because only a fraction of cancer cells are cycling actively at a given point in time, prolonged infusion of chemotherapy increases the amount of exposure of the cancer cells to the chemotherapy. Also, because many chemotherapy agents have short plasma half-lives, CIs provide a longer duration of drug exposure.' (Lokich & Anderson, 1997; Wilkes, Ingwersen, & Barton-Burke, 2002)
National and international safety standards exist for infusion pumps.
These pumps are also used with morphine in the treatment of intractable pain caused by cancer.
To understand this procedure or delivery method read the Policy and Procedures Guidelines from Regional Health in Ohio.
Read this excellent discussion of continuous infusion on the Oncology Nursing website: Transporting Patients Receiving Continuous Infusion Chemotherapy
Oral Chemotherapy
Also known as: pills, tablets
Oral chemotherapy is a cancer treatment that is taken as a tablet or capsule.
Oral Chemotherapy website sponsored by Roche for non-United States residents.
Issues
Insurance Coverage:
As with anything else, one consideration is whether your health insurance covers a pumps.
Read Aetna's Policy on Covering Pumps
Read BC/BS of North Carolina's Policy
Delivery Methods:
Further Discussion and Weblinks
Manufacturer Links
Hepatic/Infusion Pumps
Sorenson Medical
TIP: If you will be using one of the Sorenson ambIT® pumps they have user manuals you can download off of their website to assist you in comfortably adjusting to the pump.
Pharma Force Intl
I-FLOW Corporation
Distributors
InfuSystem, Inc
Ports
Port-O-Cath
Research Links
Continuous Infustion:
New Portable Infusion Pumps: Infusion Rate Accuracy and Consistency
Other Research Studies:
Brown, K.A., Esper, P., Kelleher, L.O., O'Neill, J.E.B., Polovich, M., & White, J.M. (Eds.). (2001). Chemotherapy and biotherapy guidelines and recommendations for practice. Pittsburgh, PA: Oncology Nursing Society.
Lokich, J., & Anderson, N. (1997). Dose intensity for bolus versus infusion chemotherapy administration: Review of the literature for 27 anti-neoplastic agents. Annals of Oncology, 8, 15-25.
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