Chemotherapy uses anticancer or cytotoxic drugs to destroy cancer cells. They usually work by disrupting the growth of cancer cells. As they circulate in the blood they can reach cancer cells wherever they are located in your body. Most chemotherapy drugs are given directly into the blood stream either as an injection into a vein or into a bag of fluid through a drip. Some drugs can be taken by mouth such as temozolomide, procarbazine, and lomustime. A few chemotherapy drugs such as methotrexate can be introduced into the spinal fluid with an injection into the spinal canal in the lumbar region. This is known as intrathecal chemotherapy. The chemotherapy agent mixes with the spinal fluid and circulates throughout the brain.
Intrathecal chemotherapy is often used to treat or prevent neoplastic disease to the subarachnoid space. Injection is done under fluoroscopic guidance. There are strict national guidelines for the safe administration of intrathecal chemotherapy.
Intrathecal therapy is done in conjunction with the medical oncologist who has the primary responsibility for the patient's cancer treatment.
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