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 inhibit proliferation 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 or in combination with other drugs like immunotherapy or targeted 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.

Procedure

Chemotherapy is a common cancer treatment that uses powerful drugs to destroy cancer cells and stop them from multiplying. An oncologist, a doctor who specializes in cancer treatment, will oversee your care and determine the best approach for your specific situation.

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.

How Long Does Chemo Treatment Take?

The duration of chemo treatment can vary significantly from person to person. A single treatment session might last anywhere from a few minutes to several hours, depending on the specific drugs being used and how they are administered. A complete course of chemotherapy often involves multiple rounds of treatment, with each round consisting of a period of treatment followed by a break to allow your body to recover. This on-and-off pattern can be repeated over weeks or months, and the total length of your chemotherapy regimen depends on factors like the type and stage of cancer, your overall health, and how well the treatment is working.

Chemotherapy Side Effects

Chemotherapy side effects occur because the drugs can damage healthy cells that divide quickly, such as those in your hair follicles, digestive tract, and bone marrow. Common side effects include:

• Fatigue: Feeling unusually tired and weak is one of the most common side effects. This can be caused by the body working hard to repair itself, anemia, or other factors related to the treatment.
• Nausea and Vomiting: Chemotherapy drugs can irritate the lining of the stomach and intestines, leading to feelings of sickness. Your care team can provide anti-nausea medications to help prevent and manage this.
• Hair Loss: Since hair follicles are fast-growing cells, chemotherapy often causes hair to thin or fall out completely from your scalp and other parts of your body. Hair usually grows back after treatment ends.
• Mouth Sores: The drugs can cause painful sores or ulcers to develop in your mouth, making eating and swallowing difficult.
• Changes in Appetite: Many people experience a loss of appetite or changes in their taste, which can make it challenging to eat and maintain a healthy weight.

Self-Care After Chemotherapy

Taking proactive steps to manage your health and well-being is crucial for how to minimize chemotherapy side effects. Here are some helpful self-care strategies:

• Rest and Prioritize Sleep: Listen to your body and rest when you feel tired. Taking short naps and getting a full night’s sleep can help your body recover.
• Stay Hydrated and Eat Nutritious Meals: Drink plenty of fluids, and try to eat small, frequent meals throughout the day. Opt for bland, easy-to-digest foods if you’re experiencing nausea.
• Maintain Good Oral Hygiene: Gently brush your teeth with a soft-bristled toothbrush and rinse your mouth regularly to prevent and manage mouth sores.
• Engage in Gentle Exercise: Light activities like short walks can help boost your energy levels and improve your mood, but be sure to check with your doctor before starting any new exercise routine.

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 or other modalities as a treatment approach.