Intra-arterial chemotherapy for retinoblastoma: Caring for your child at home after the procedure

Your child has had a treatment of intra-arterial chemotherapy for retinoblastoma (IAC). This procedure uses a small catheter inserted into the femoral artery (groin) to deliver chemotherapy medications to a tumour in the eye. The information on this page explains how to care for your child at home after the procedure, and when to call for help.

Discharge from the hospital

In most cases, children go home the same day as the procedure. This usually occurs about six hours after the procedure. Your child’s nurse will let you know when they are well enough to go home.

Dressing care

If your child has a dressing or bandage on, you can remove it after 24 hours. There is no need to replace the bandage if it is accidentally removed before 24 hours.

Bathing

Your child may have a bath or shower the day after the IAC. By this time, the dressing may be taken off, and the catheter entry site may be gently washed with soap and water.

Meals

If your child is feeling well enough after the anaesthetic, they can return to eating what they normally eat. It is also important to encourage your child to drink plenty of fluids for 48 hours after the procedure.

Pain relief

If needed, give your child acetaminophen for pain. Do not give your child any medicines that will thin the blood, such as acetylsalicylic acid (ASA) or ibuprofen, without checking with your child's health-care provider first.

Activity

After the IAC, your child will need to stay relaxed and comfortable. Your child may go back to school 48 hours after the procedure. They can return to normal activities on the day after the procedure but should avoid strenuous physical activities (jumping, dancing, riding a bike, etc.) for seven to ten days after the procedure. If you require a note excusing your child from any school or sport activity, your child's doctor can provide one for you.

Radiation

• Your child's procedure required the use of X-rays.
• Radiation side-effects are extremely unlikely but can occur.
• Please check your child's skin in the area of the exam for signs of redness or rash two to four weeks from the date of the procedure. Please speak to a nurse in the interventional radiology department if these signs occur.

Follow-up appointments

You will be called regarding your child’s next IAC treatment date and will be followed up by your child’s oncologist and ophthalmologist.

When to see a doctor

Call your child's doctor or go to the nearest Emergency Department right away if your child has any of the following symptoms:

• Fever greater than 38°C (100.4°F)
• Severe headache or throwing up (vomiting) that does not stop
• Severe pain where the catheter was inserted
• Bleeding or swelling at the groin
• A growing bruise at the groin
• Change in the colour or temperature of the foot on the side of the body where the catheter was inserted; for example, if the foot turns a pale blue or is cool to touch
• Severe swelling and redness around the affected eye

At SickKids

If you have any concerns in the first 48 hours, call the Image Guided Therapy (IGT) clinic at (416) 813- 7654 ext. 201804. Speak to the IGT clinic nurse during working hours or leave a non-urgent message.

If you have concerns and it is after working hours, see your primary care provider or go to the nearest Emergency Department. You can also call the Hospital for Sick Children switchboard at (416) 813-7500 and ask them to page a member of your child’s health-care team or the interventional radiology fellow on call.