What is Chemotherapy?
Chemotherapy is an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body. It’s usually used to treat cancer, as cancer cells grow and divide faster than other cells. A doctor who specializes in cancer treatment is known as an oncologist. They’ll work with you to come up with your treatment plan.
Chemotherapy is often used in combination with other therapies, such as surgery, radiation, or hormone therapy. This depends on:
. The stage and type of cancer you have
. Your overall health
. Previous cancer treatments you’ve had
. The location of the cancer cells
. Your personal treatment preferences
It’s considered a systemic treatment, which means it affects the entire body.
While chemotherapy has been proven to effectively attack cancer cells, it can cause serious side effects that can severely impact your quality of life. You should weigh these side effects against the risk of not getting treatment when deciding if chemotherapy is right for you.
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Before Chemotherapy
Why it’s done
Chemotherapy is used to kill cancer cells in people with cancer.
There are a variety of settings in which chemotherapy may be used in people with cancer:
. To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer.
. After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy.
. To prepare you for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy.
. To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy.
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 and rheumatoid arthritis.
Risks and Side effects
Side effects of chemotherapy drugs can be significant. Each drug has different side effects, and not every drug causes every side effect. Ask your doctor about the side effects of the particular drugs you’ll receive.
Side effects that occur during chemotherapy treatment
Common side effects of chemotherapy drugs include:
. Nausea
. Vomiting
. Diarrhea
. Hair loss
. Loss of appetite
. Fatigue
. Fever
. Mouth sores
. Pain
. Constipation
. Easy bruising
. Bleeding
Many of these side effects can be prevented or treated. Most side effects subside after treatment ends.
Long-lasting and late-developing side effects
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
Ask your doctor if you have a risk of any late side effects. Ask what signs and symptoms you should be aware of that may signal a problem.
How you prepare
How you prepare for chemotherapy depends on which 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 your 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 friend or family member drive you to your first 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.
What you can expect
Determining which chemotherapy drugs you’ll receive
Your doctor chooses which chemotherapy drugs you’ll receive based on several factors, including:
. Type of cancer
. Stage of cancer
. Overall health
. Previous cancer treatments
. Your goals and preferences
Discuss your treatment options with your doctor. Together you can decide what’s right for you.
How long does chemotherapy last?
The doctor will make a plan with the individual that specifies when treatment sessions will occur and how many they will need.
A course of treatment can range from a single dose on one day to a few weeks, depending on the type and stage of cancer.
Those who need more than one course of treatment will have a rest period to allow their body to recover.
A person might have treatment on one day, followed by a week’s rest, then another one-day treatment followed by a three-week rest period, and so on. A person may repeat this several times.
Some people may find talking to a counselor about the mental and emotional aspects of cancer and chemotherapy helpful.
Blood tests
Blood tests assess the person’s health and ensure that they will be able to cope with possible side effects.
Liver health: The liver breaks down chemotherapy chemicals and other drugs. Overloading the liver could trigger other problems. If a blood test detects liver problems before treatment, the person may have to postpone treatment until it recovers.
Low count of red or white blood cells or platelets: If these blood counts are low before treatment, the person may need to wait until they reach healthy levels before starting chemotherapy.
It is important to have regular blood tests during the treatment period to ensure that blood and liver functions remain as healthy as possible and monitor the effectiveness of the treatment.
During Chemotherapy
Types of chemotherapy
Types of chemotherapy include:
. Alkylating agents: These affect the DNA and kill the cells at different stages of the cell life cycle.
. Antimetabolites: These mimic proteins that the cells need to survive. When the cells consume them, they offer no benefit, and the cells starve.
. Plant alkaloids: These stop the cells from growing and dividing.
. Antitumor antibiotics: These stop the cells from reproducing. They are different from the antibiotics people use for an infection.
The doctor will recommend a suitable option for the individual. They may recommend combining chemotherapy with other options, such as radiation therapy or surgery.
How Chemotherapy is performed
How chemotherapy drugs are given
Chemotherapy drugs can be given in different ways, including:
. Chemotherapy infusions. Chemotherapy is most often given as an infusion into a vein (intravenously). The drugs can be given by inserting a tube with a needle into a vein in your arm or into a device in a vein in your chest.
. Chemotherapy pills. Some chemotherapy drugs can be taken in pill or capsule form.
. Chemotherapy shots. Chemotherapy drugs can be injected with a needle, just as you would receive a shot.
. Chemotherapy creams. Creams or gels containing chemotherapy drugs can be applied to the skin to treat certain types of skin cancer.
. Chemotherapy drugs used to treat one area of the body. Chemotherapy drugs can be given directly to one area of the body. For instance, chemotherapy drugs can be given directly in the abdomen (intraperitoneal chemotherapy), chest cavity (intrapleural chemotherapy) or central nervous system (intrathecal chemotherapy). Chemotherapy can also be given through the urethra into the bladder (intravesical chemotherapy).
. Chemotherapy given directly to the cancer. Chemotherapy can be given directly to the cancer or, after surgery, where the cancer once was. As an example, thin disk-shaped wafers containing chemotherapy drugs can be placed near a tumor during surgery. The wafers break down over time, releasing chemotherapy drugs. Chemotherapy drugs may also be injected into a vein or artery that directly feeds a tumor.
How often you receive chemotherapy treatments
Your doctor determines how often you’ll receive chemotherapy treatments based on what drugs you’ll receive, the characteristics of your cancer and how well your body recovers after each treatment. Chemotherapy treatment schedules vary. Chemotherapy treatment can be continuous, or it may alternate between periods of treatment and periods of rest to let you recover.
After Chemotherapy
Results
Your doctor and cancer treatment team will regularly monitor the effectiveness of your treatments. These will include imaging techniques, blood tests, and possibly more. Your doctor can adjust your treatment at any time.
The more you share with your doctor about how chemotherapy is affecting you, the better your treatment experience will be. You’ll want to tell them about any side effects or treatment-related problems you’re having so that they can make adjustments to your treatment if necessary.
Factors affecting success and survival rates
There are a variety of factors that may affect how successful chemotherapy is and a person’s survival rate. These factors include:
. Cancer survival rates
Cancer survival rates are one way to show how effective various treatments, including chemotherapy, can be.
A survival rate refers to the percentage of people who live for a certain amount of time after a cancer diagnosis.
Survival rates can also help people gain an understanding of their outlook because they provide information about the likely outcomes of people with similar cancers.
However, it is essential to remember that a range of factors influences survival rates and chemotherapy success rates. Many of these factors vary from person to person.
. Cancer grade
Cancer grade is a measure of how abnormal the cancer cells appear under a microscope. More abnormal cells tend to grow and spread at a faster rate.
. Cancer stage
Cancer stage indicates how large a tumor is and how far its cells have spread. A doctor can use various systems to determine what stage a cancer has reached.
They may use the following 0–5 scaling system:
. Stage 0: Abnormal cells are present but have not spread to nearby cells.
. Stages 1, 2, and 3: Cancer is present. Higher stages indicate larger tumors and a more extensive spread into nearby tissues.
. Stage 4: The cancer has spread to other areas of the body.
Researchers who collect data to determine cancer statistics may use the following terms to describe the cancer stage:
. In situ: Abnormal cells are present but have not spread to nearby tissues.
. Localized: Cancer has not spread beyond the place where it first developed.
. Regional: Cancer has spread to nearby lymph nodes, tissues, or organs.
. Distant: Cancer has spread to distant parts of the body.
Other factors
Other factors that can affect the success of chemotherapy include:
. Age
. Overall health
. Any other medical conditions
Read more about: Chemotherapy drugs
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