Chemotherapy

Chemotherapy Overview

Chemotherapy is a chemical drug treatment that uses powerful chemicals to kill and destroy rapid growing cells in the body. Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body.

Many different chemotherapy drugs are available. Chemotherapy drugs can be used alone or in combination to treat a wide variety of cancers. Though chemotherapy is an effective way to treat many types of cancer, chemotherapy treatment also carries a risk of side effects. Some chemotherapy side effects are mild and treatable, while others can cause serious complications.

Chemotherapy is often used in combination with other therapies, such as surgery, radiation, or hormone therapy. The use of combination therapy depends on:

The stage and type of cancer
Overall health
Earlier cancer treatments you’ve had
Location of the cancer cells
Personal treatment preferences

Chemotherapy is considered a systemic treatment, which means it affects the entire body. Chemotherapy has been proven to effectively attack cancer cells, but it can cause serious side effects that can severely impact your quality of life. You should weigh these side effects against the risk of going untreated when deciding if chemotherapy is right for you.

Uses of Chemotherapy

Chemotherapy is used to kill cancer cells in patients with cancer. Chemotherapy is primarily used to:

Lower the total number of cancer cells in your body
Reduce the likelihood of cancer spreading
Shrink tumor size
Reduce current symptoms

If you’ve undergone surgery to remove a cancerous tumor, such as a lumpectomy for breast cancer, your oncologist may recommend chemotherapy to ensure that any lingering cancer cells are killed, as well.

Chemotherapy is also used to prepare you for other treatments. It could be used to shrink a tumor so it can be surgically removed, or to prepare you for radiation therapy. In the case of late-stage cancer, chemotherapy may help relieve pain. Besides treatment for cancer, chemotherapy may be used to prepare people with bone marrow diseases for a bone marrow stem cell treatment, and it may be used for immune system disorders. Doses much lower than those used to treat cancer can be used to help disorders in which the body’s immune system attacks healthy cells, like lupus erythematosus or rheumatoid arthritis.

Chemotherapy for conditions other than cancer

Some chemotherapy drugs have proved useful in treating other conditions, such as:

Bone marrow diseases: Diseases that affect the bone marrow and blood cells may be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is often used to prepare for a bone marrow transplant.
Immune system disorders. Lower doses of chemotherapy drugs can help control an overactive immune system in certain diseases, such as lupus erythematosus or rheumatoid arthritis.

Risks of Chemotherapy

Side effects of chemotherapy drugs can be significant. Each drug has different side effects, and not every drug causes every side effect. Chemotherapy is designed to kill cells that divide quickly. While cancer cells are the kind that divide quickly, other cells in your body do this, as well. Following are the common side effects that occur during chemotherapy treatment:

Anemia
Bleeding
Constipation
Dry mouth
Easy bruising
Fatigue
Fever
Concentration problems
Fertility problems
Diarrhea
Hair loss
Insomnia
Infections
Lymphedema
Loss of appetite
Memory problems
Mouth sores
Nausea
Neuropathy
Nail changes
Pain
Sexual changes
Skin changes
Vomiting
Weight loss

Many of these side effects can be prevented or treated. Most side effects subside after treatment ends.

Long Term Side Effects of Chemotherapy

Chemotherapy drugs can also cause side effects that don’t become evident until months or years after treatment. Late side effects vary depending on the chemotherapy drug but can include:

Damage to lung tissue
Heart problems
Infertility
Kidney problems
Nerve damage (peripheral neuropathy)
Risk of a second cancer

There’s also the possibility of developing a second cancer as a result of chemotherapy.

Preparation for Chemotherapy

Preparation for chemotherapy depends on which chemotherapy drugs you’ll receive and how they’ll be administered. Your doctor will give you specific instructions to prepare for your chemotherapy treatments. You may need to:

Have a device surgically inserted before intravenous chemotherapy: If you’ll be receiving your chemotherapy intravenously into a vein, your doctor may recommend a device, such as a catheter, port or pump. The catheter or other device is surgically implanted into a large vein, usually in the chest. Chemotherapy drugs can be given through the device.
Undergo tests and procedures to make sure your body is ready to receive chemotherapy: Blood tests to check kidney and liver functions and heart tests to check for heart health can determine whether your body is ready to begin chemotherapy. If there’s a problem, your doctor may delay your treatment or select a different chemotherapy drug and dosage that’s safer for you.
See your dentist: Your doctor may recommend that a dentist check your teeth for signs of infection. Treating existing infections may reduce the risk of complications during chemotherapy treatment, since some chemotherapy may reduce your body’s ability to fight infections.
Plan ahead for side effects: Ask your doctor what side effects to expect during and after chemotherapy and make appropriate arrangements. For instance, if your chemotherapy treatment will cause infertility, you may wish to consider your options for preserving your sperm or eggs for future use. If your chemotherapy will cause hair loss, consider planning for a head covering.
Make arrangements for help at home and at work: Most chemotherapy treatments are given in an outpatient clinic, which means most people are able to continue working and doing their usual activities during chemotherapy. Your doctor can tell you in general how much the chemotherapy will affect your usual activities, but it’s difficult to predict exactly how you’ll feel.Ask your doctor if you’ll need time off work or help around your home after treatment. Ask your doctor for the details of your chemotherapy treatments so that you can make arrangements for work, children, pets or other commitments.
Prepare for your first treatment: Ask your doctor or chemotherapy nurses how to prepare for chemotherapy. It may be helpful to arrive for your first chemotherapy treatment well rested. You might wish to eat a light meal beforehand in case your chemotherapy medications cause nausea. Have a family member or a friend drive you to your first chemotherapy treatment. Most people can drive themselves to and from chemotherapy sessions. But the first time you may find that the medications make you sleepy or cause other side effects that make driving difficult.

Types of Chemotherapy Drugs

Your doctor chooses which chemotherapy drugs you’ll receive based on several factors, including the following:

Type of cancer
Stage of cancer
Overall health
Previous cancer treatments
Overall goals and preferences

C hemotherapy Delivery and Administration

Your doctor can work with you to consider all variables and determine the best course of your treatment suited for your disease. Chemotherapy is typically given in a pill form or directly into veins by an injection or an IV. In addition to these two forms, chemotherapy may also be administered in several other ways.

Chemotherapy delivery options include the following:

Chemotherapy can be delivered directly into the tumor, depending on the tumor’s location. If you undergo surgery to remove the tumor, your doctor can implant slow-dissolving discs that release medications over time.
Some skin cancers can be treated with chemotherapy creams.
Chemotherapy can be delivered to a specific part of the body through localized treatment, such as directly into the abdomen, chest, central nervous system, or into the bladder through the urethra.
Some types of chemotherapy can be taken by mouth through pills.
Liquid chemotherapy drugs can be delivered in single shots, or you can have a port installed where a needle is inserted for each treatment. The infusion method with a port only involves pain at the injection site during the first visit, but the port needle can loosen depending on your level of activity.

Where you receive treatment depends on your chosen delivery method. For instance, if you use creams or pills, you can give yourself treatments at home. Other procedures are usually performed at a hospital or a cancer treatment center. Your chemotherapy schedule, as in how often you receive treatment, will be customized for you. It can be changed if your body doesn’t handle the treatment well, or it can be increased or decreased depending on how well the cancer cells react to treatments.

Outlook after Chemotherapy

Your cancer doctor (oncologist) will regularly meet you during the chemotherapy treatment. Your oncologist will ask about any side effects you’re experiencing, since many can be controlled.

Depending on your situation, you may also undergo scans and other tests to monitor your cancer during chemotherapy treatment. These tests can give your doctor an idea of how your cancer is responding to treatment, and your treatment may be adjusted accordingly.

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