What is intrathecal (IT) chemotherapy?
Intrathecal chemotherapy is when chemotherapy is given directly into the cerebral spinal fluid (CSF), which is the fluid that surrounds your brain and spinal column. It is administered into what is called the intrathecal space.
How is intrathecal chemotherapy given?
Intrathecal chemotherapy is given using a procedure called a lumbar puncture (LP). During a lumbar puncture a needle is inserted between the bones in your lower back into the intrathecal space. Some chemotherapy drugs can then be slowly injected through this needle.
Why is chemotherapy given into the cerebrospinal fluid?
In some forms of cancer, tumour cells can occasionally be found in the CSF, or may have a high risk of spreading there. Chemotherapy is given in this way as most forms of chemotherapy drugs, given by tablet or intravenous drip, are not able to pass through the bloodstream to the brain, spinal cord or the CSF.
Some types of cancer treatments will require regular intrathecal chemotherapy as part of the treatment plan. Your treating doctor will discuss with you how often, and for how long, you will need intrathecal treatment.
What does the procedure for having intrathecal chemotherapy involve?
Intrathecal chemotherapy is given by a doctor who has been trained to do this procedure. This procedure may be done in the x-ray department under the guidance of a CT scanner, on the ward or in the clinic. The procedure can take about 30 minutes.
- Before the procedure, you will have your blood pressure, temperature and pulse rate checked.
- While the lumbar puncture is being done, you will need to either lie on one side with your knees drawn up towards your chest, or to sit, bent over a table supported by pillows.
- This allows your back to curve as much as possible so that the bones of the spine are widely separated.
- The area is cleaned with an antiseptic lotion.
- Local anaesthetic is injected to numb the area.
- A very fine needle is inserted and a small amount of cerebrospinal fluid is removed. It is important to keep as still as possible during this time.
- Chemotherapy is injected slowly.
- The needle is then removed and a band aid is placed over the site which can be removed the next day.
What happens after the procedure?
- You may be instructed to rest in bed or lie flat for a period of time depending on the instructions from your doctor.
- Your nurse will assess your blood pressure, pulse, temperature and make sure that you do not have any complications after the procedure such as headache, neck stiffness, fever, blurred vision or vomiting.
Will there be any side effects after this procedure?
The most common side effect caused by a lumbar puncture is a headache. This usually goes away after a few hours.
Other problems are uncommon, however if you suffer any of the following:
- tenderness, redness, or drainage from the site
- neck stiffness
- headache with or without vomiting
- blurred vision
It is important to tell you doctor or nurse as soon as possible before you leave the hospital.
IMMEDIATELY go to your nearest hospital Emergency Department and let them know you have had intrathecal chemotherapy, or contact your doctor or nurse if you have any of the following at any time:
Emergency contact details
Ask your doctor or nurse from your treating team who to contact if you have a problem
- a headache that is not helped by mild pain killers
- fever or chills
- blurred vision or
- neck stiffness
|If you have any other questions about this treatment/procedure please ask your doctor or nurse.