Intrathecal chemotherapy is a type of chemotherapy that is administered into the fluid that surrounds your spinal cord and brain, or cerebrospinal fluid (CSF).
Why Do I Need Intrathecal Chemotherapy?
There are types of leukemia and lymphoma that spread to the CSF and nervous system. Unfortunately, most chemotherapy drugs are unable to reach into this area from the bloodstream. Doctors may give intrathecal chemotherapy to treat this kind of disease, or prevent spread from occurring.
What Should I Expect?
If you have a type of leukemia or lymphoma that has a tendency to spread to the nervous system, it is likely that you received a lumbar puncture, or spinal tap as part of your diagnosis. This is very similar to what you will experience while getting intrathecal chemotherapy.
Your oncologist or hematologist will perform a lumbar puncture, and inject the chemotherapy directly into your CSF to kill any cancer cells.
If you require a number of these types of treatments, your doctor may decide to place an “Ommaya reservoir” into your scalp. This reservoir has a small catheter that reaches into the fluid around your brain. Chemotherapy drugs can be given through the Ommaya reservoir, and you will no longer need the lumbar punctures. Ommaya reservoirs are left in place throughout your treatment and are safe to go home with.
When Should You Call the Doctor?
If you have received this treatment as an outpatient, you should contact your healthcare provider if you develop:
- A fever with a temp of greater than 100F or 38C
- Dizziness or a headache that will not go away
- Pain in your spine
- Numbness, tingling, or a change in sensation in your arms or legs
- Difficulty walking
The Bottom Line
Types of leukemia and lymphoma that spread the nervous system can be difficult to treat. Cancer cells can live and multiply, possibly undetected in the CSF where traditional chemotherapy can not reach them. In order to treat and prevent this from occurring, doctors will administer intrathecal chemotherapy to kill any cancer cells.
Goodman, M. Chemotherapy: Principles of Administration. In Yarbro, C., Frogge, M., Goodman, M., Groenwald, S. eds(2000) Cancer Nursing: Principles and Practice 5th ed Jones and Bartlett: Sudbury, MA.