Chemotherapy

Overview

Chemotherapy, a potent drug-based treatment, is employed to combat fast-growing cells in the body, with its primary application being in cancer treatment. The rationale behind its effectiveness lies in the fact that cancer cells exhibit rapid growth and multiplication compared to most other cells in the body. There is a diverse array of chemotherapy drugs available, which can be administered either individually or in combination to address a wide spectrum of cancer types.

In addition to chemotherapy, various other drug therapies are deployed in the fight against cancer:

• Hormone therapy: This category of drugs is designed to impede certain cancers from accessing the hormones essential for their growth.
• Immunotherapy: Immunotherapeutic drugs are instrumental in enhancing the body’s immune system to better combat cancer.
• Targeted therapy: Targeted therapy medications are engineered to modify the behavior and multiplication of cancer cells.

While chemotherapy remains a potent tool in cancer treatment, it is crucial to acknowledge that it does come with the potential for side effects. These side effects can range from mild and manageable to severe and possibly life-threatening. In some cases, chemotherapy is used in conjunction with other treatment modalities like surgery or radiation therapy to comprehensively address cancer.

Reasons for undergoing the procedure

Chemotherapy is a treatment used to eliminate cancer cells in individuals diagnosed with cancer. It serves various purposes in the management of cancer:

• Curative treatment: Chemotherapy can be employed as the primary or sole method to completely cure cancer.
• Adjuvant therapy: Following other treatments like surgery, chemotherapy may be administered to eradicate any residual cancer cells that could remain within the body.
• Neoadjuvant therapy: In some cases, chemotherapy is used to shrink tumors before other treatments like radiation or surgery, making these interventions more effective.
• Palliative care: Chemotherapy is also utilized to alleviate the signs and symptoms of cancer, improving the patient’s quality of life by targeting and reducing cancer cells. This is referred to as palliative chemotherapy.

In addition to its use in cancer treatment, certain chemotherapy drugs have demonstrated effectiveness in addressing other medical conditions:

• Bone marrow diseases: Conditions impacting the bone marrow and blood cells can be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is frequently employed as a preparatory measure for this procedure.
• Immune system disorders: In specific diseases such as lupus and rheumatoid arthritis, lower doses of chemotherapy drugs can help regulate an overactive immune system.

This versatile medical approach is crucial in combating cancer and managing other serious health conditions.

Risks

Chemotherapy drugs are designed to target rapidly dividing cells, which includes cancer cells. While they effectively destroy cancer cells, they can also harm healthy cells in the process, leading to potential side effects. Some examples of rapidly dividing cells in the body include those found in the blood, skin, hair follicles, and digestive tract. As a result, common side effects of chemotherapy may manifest in these areas and include:

• Hair loss.
• Increased susceptibility to infections.
• Constipation.
• Anemia.
• Bleeding problems.
• Nausea.
• Loss of appetite.
• Fatigue.
• Diarrhea.

Chemotherapy can lead to delayed side effects that may not manifest until months or years after treatment. These late effects can vary depending on the specific chemotherapy drug used and may include:

• Lung tissue damage
• Heart issues
• Infertility
• Kidney problems
• Peripheral neuropathy (nerve damage)
• Increased risk of developing a second cancer

To assess your risk of experiencing these late side effects, consult your doctor and inquire about the potential signs and symptoms to watch out for that might indicate a problem.

Before the procedure

Your oncologist will assess your readiness for treatment through various tests. During this period, you can take several steps to prepare for chemotherapy:

• Gain knowledge about your treatment: It is crucial to educate yourself about your upcoming chemotherapy regimen. The more you understand, the better equipped you’ll be to cope with the challenges. Consult your oncologist to learn about the specific chemotherapy drugs you will receive, including their benefits and potential side effects. Explore available resources, both online and through organizations and support groups, to gather comprehensive information about your treatment.
• Prepare for potential side effects: Anticipate and manage potential side effects before your treatment commences. For instance, if you are aware that hair loss is a possibility, consider getting a wig that matches your current hairstyle or purchasing scarves and head wraps. If skin changes and sunlight sensitivity are expected side effects, invest in skincare products with gentle ingredients. There are numerous proactive measures you can take to prepare effectively.
• Schedule a dental check-up: Chemotherapy commonly leads to mouth sores and alterations in taste perception, making eating less enjoyable. It’s essential to address dental issues before starting treatment to avoid additional challenges. Ensure your teeth are in good health and your mouth is free from infections.
• Address financial concerns: While most insurance providers cover chemotherapy treatments, having a clear understanding of your financial resources can alleviate stress, allowing you to focus on your cancer treatment. Familiarize yourself with the resources provided by your insurance company and inquire about patient assistance programs. You can also explore the National Cancer Institute’s support services page for various resources, including financial assistance.
• Coordinate with your workplace: Chemotherapy may necessitate adjustments to your work schedule. Depending on your job, options such as remote work or taking time off may be available. Consult your oncologist to understand how treatments may affect your ability to perform your job effectively. Discuss these details with your employer and make necessary arrangements accordingly.
• Establish a treatment routine: Seek guidance from your oncologist regarding your treatment plan, including the treatment environment and duration. Use this information to create a structured routine for your treatments. For example, if the treatment sessions are lengthy, plan to bring a lunch or prepare for entertainment with books or music. Many individuals find it helpful to have a light snack about an hour before treatment to minimize side effects like nausea.

During the procedure

The experience of chemotherapy can vary depending on how your oncologist administers the treatment. Chemotherapy is typically a systemic approach, meaning the medication spreads throughout your entire body. There are several ways to receive systemic chemotherapy:

• Intravenous (IV) infusion: This is the most common method, where the chemotherapy drug is delivered directly into your bloodstream through a vein. Typically, an IV needle is used, often in your arm.
• Injections: Some chemotherapy drugs are given as shots or injections.
• Oral medications: Certain chemotherapy drugs are available in pill or liquid form that you can swallow.
• Topical application: In some cases, a chemotherapy cream is applied to the skin.

However, for certain types of cancers that do not respond well to systemic chemotherapy, a more targeted approach may be necessary. Examples include:

• Intra-arterial chemotherapy: This method involves delivering chemotherapy directly into an artery that supplies blood to a tumor.
• Intracavitary chemotherapy: Chemotherapy is administered directly into a body cavity, such as the bladder or abdomen. One specific technique is hyperthermic intraperitoneal chemotherapy (HIPEC), which involves heated chemotherapy in the abdomen after surgery.
• Intrathecal chemotherapy: This type of chemotherapy is delivered into the space between the brain and spinal cord.

The duration of your chemotherapy treatment depends on the specific chemotherapy drugs you are receiving. Treatment sessions can vary in duration, ranging from a few minutes to several hours. Some individuals require continuous infusion, which can last several days. Continuous infusion may begin at the hospital or an infusion center and continue at home.

In most cases, multiple rounds of chemotherapy are necessary. Typically, one round involves treatment for several days or weeks, followed by a break to allow your body to recover. Subsequently, you may undergo additional rounds of chemotherapy, following a similar pattern. The frequency of treatment can vary, with some individuals receiving it daily, weekly, or monthly, depending on their treatment plan.

After the procedure

After completing chemotherapy, some side effects may disappear, but others might emerge later on, known as chemotherapy late effects. These can include infertility, early menopause, cardiac problems due to cancer treatments, cognitive issues (often called “chemo brain”), and neuropathy (nerve damage symptoms). Cancer rehabilitation is a valuable resource for managing these treatment-related side effects.

Outcome

Cancer can potentially recur after chemotherapy or any cancer treatment. After treatment concludes, your healthcare team typically schedules follow-up appointments to monitor for any signs of disease recurrence. If your oncologist detects cancer returning, they may suggest additional rounds of chemotherapy as a treatment approach.