Chemotherapy

Chemotherapy is a term used to describe the treatment of cancer with medications or drugs.

Most chemotherapy drugs have a cytotoxic effect, that is they act by destroying cancer cells. They can also affect healthy tissue leading to side effects, but they have a more lethal effect on cancer cells which multiply faster.

Newer drugs that specifically target the cancer and have fewer side effects are also available and are effective against certain cancers, but traditional chemotherapy is still considered the best way to treat most cancers.

Your treatment is supervised by a specialist called a medical oncologist who plans your chemotherapy regimen based on various factors. You may receive a single drug or a combination of drugs to best treat your cancer.

Chemotherapy may also be combined with other treatments such as surgery or radiation. Unlike these treatments which treat or target cancerous tissue in a specific area, chemotherapy has a systemic effect, acting on cancer cells wherever they have spread in the body.

Indications

Your doctor may recommend chemotherapy if the type of cancer you have responds well to this mode of treatment.

Chemotherapy may be used as:

• The main or primary treatment
• As Adjuvant therapy where it is administered following surgery or radiation to help kill cancer cells that may be left behind.
• As Neoadjuvant therapy where it is administered before other treatments such as surgery or radiation therapy, to shrink the size of a tumor.

The treatment plan is influenced by various factors such as the size and location of the tumor, your general health, whether the cancer has spread or metastasized to other parts of the body and whether it is recurrent or has come back after being treated before. The goal of chemotherapy may be to eradicate the cancer completely or, if that is not possible, to slow the progress of cancer and prolong life which is referred to as palliative treatment.

Preparing for Chemotherapy

To ensure you are healthy enough to undergo chemotherapy your doctor will perform a medical examination including certain tests to check your kidney, liver and heart function. You should be free of any infections before your treatment begins.

Your doctor will discuss the side effects of the medication. You may also receive counseling to prepare you mentally. Special arrangements for side effects such as hair loss or infertility may be discussed. You may also need help with your regular activities during the treatment.

How is Chemotherapy Administered

You may receive chemotherapy in a hospital, a specialized clinic, your doctor’s office, or in some cases, at home. It is usually administered through a vein (intravenously) but can also be given orally as tablets, as a cream for topical application, through an artery that supplies the tumor area, or directly into a body cavity.

If you are receiving chemotherapy through a vein or artery, a catheter or pump will be inserted into the vessel so that the drugs can be administered.

The drugs chosen for your treatment depend on the type and stage of your cancer, your general health, and the goals of treatment.

Intravenous administration of the drugs may take a few minutes or hours. Certain drugs are administered continuously over days or weeks with the help of a pump.

The treatment is administered in cycles. Each cycle consists of the day or days you receive the medication and a period of rest so that you can recover from the side effects such as anemia and lowered immunity before your next cycle starts.

Oral chemotherapy may be in the form of a liquid or tablets. You may be able to take these medications at home daily, with rest intervals in between.

You will receive chemotherapy for a specific period, such as 6 to 12 months depending on the goals of treatment and your response. During this time, you will undergo periodic scans and tests to see how well you are responding to treatment. Your doctor will also assess the severity of your side effects and your ability to cope. The treatment can be adjusted accordingly.

Side effects of Chemotherapy

The side effects of chemotherapy depend on the individual drugs you are receiving, the type and location of the cancer and your general health. Some side effects can be quite significant, and some people react more severely than others. Your doctor will discuss what you are likely to experience and ways you can cope. Some common side effects include:

• Nausea
• Vomiting
• Loss of appetite
• Hair loss
• Fatigue
• Anemia
• Lowered resistance to infections
• Mouth sores
• Diarrhea
• Constipation
• Bleeding
• Fever

These side effects are usually easily treated and resolve after your chemotherapy ends. Most people can carry out their basic daily functions during chemotherapy despite the side effects.

Chemotherapy may sometimes also have delayed, long-term adverse effects including

• Infertility
• Kidney problems
• Heart and Lung problems
• Nerve damage

You will be advised regarding arrangements you can make prior to chemotherapy such as preserving eggs or sperm for future conception or planning a wig or head cover for hair loss.

Summary

Chemotherapy is a treatment for cancer which involves the use of drugs to kill cancer cells. It helps treat a wide range of cancers but can have serious side effects. Knowing what to expect can help you better prepare and have less anxiety. Newer treatments with fewer side effects may be helpful in certain cases. Your doctor will discuss your options.