Chemotherapy

Whenever we hear about cancer, the first thought that strikes us is “Chemotherapy”. Chemotherapy is often the most common term associated with cancer. It is considered one of the effective way to treat cancer among other cancer treatments. Here is a detailed article which helps you to understand the key points about chemotherapy.

Article Context:

Chemotherapy:

Chemotherapy is the treatment with anti-cancer medicines to destroy or control cancer cells. It is a widespread and effective way to treat cancerous tissues in the body. The term chemotherapy refers to the medications that prevent the cancer cells from dividing and growing further by destroying the dividing cells.

Why is Chemotherapy done?

As part of its natural process, the body replaces the cells with constant division and growth. But, when cancer occurs, the cells are reproduced in an uncontrolled manner. As the reproduction of new cells takes place and increase in number, they start to occupy the amount of space which was previously inhibited by the useful and healthy cells.

So, in order to prevent the further reproduction of cancer cells, chemotherapy is done. The medications used in the chemotherapy interfere with the ability of cancer cells to divide and reproduce. This helps to prevent the spread of cancer in the body by stopping the reproduction of its cells.

How does Chemotherapy work?

Chemotherapy is considered a systemic therapy to treat cancer. It circulates throughout the body in the bloodstream and helps to treat cancer cells formed almost anywhere in the body. Chemotherapy destroys the cells that are produced by splitting of existing cells. As cancer cells split and multiply rapidly than the normal cells, chemotherapy is much more likely kills the rapidly growing cells.

What does Chemotherapy do?

As mentioned earlier, the main objective of chemotherapy is to either stop or slow down the growth of rapidly multiplying cancer cells in the body. Chemotherapy uses either a single medication or combination of medications. These medications are mainly used:

  • As a primary treatment either to prevent cell division or to destroy cancer cells
  • To shrink a tumor prior to other treatments
  • To destroy any remaining cancer cells after other treatments
  • To relieve symptoms of cancer at advanced stages

The type of medications used for chemotherapy is based on the type and stage of cancer. These medications can:

  • Prevent cell division, which is the main cause of reproduction of cancer cells
  • Target the food source of cancer cells through which they get the required enzymes and hormones to grow
  • Trigger the destruction of existing cancer cells
  • Stop the growth of new blood vessels to cease the blood supply to the cancer tumors in order to starve them and prevent their growth.

How is Chemotherapy given?

The chemotherapy medications can be given in different ways. Each method of delivering chemotherapy is referred based on how the medications are administered into the body. Also, the chemotherapy delivery methods are chosen depending on the type, stage, and location of cancer. Here are the different type of chemotherapy delivery methods:

  • Injection
  • Intravenous (IV)
  • Intra-arterial (IA)
  • Topical
  • Oral

Injection: The chemotherapy medications are delivered with a needle, just as we would receive a shot. With this method, the medicine is administered directly into the muscle in the arm or in the fatty part of the arm, stomach, thigh, hip or leg just under the skin.

Intravenous (IV): The medication is most often given directly into the vein by inserting a tube with a needle. With this, the cancer cells are targeted through blood supply of the vein.

Intra-arterial (IA): With this method, the chemotherapy medicine is delivered directly into the artery that feeds the cancer cells, through a needle and a catheter. This helps to cease the growth of the tumors.

Topical: In the case of certain types of skin cancer, cream or gel-based chemotherapy medications are prescribed which can be applied on to the skin.

Oral: Some chemotherapy drugs are available in the form of pills, capsules or liquids which can be taken orally.

Besides these methods, in some cases, the chemotherapy drugs are given directly to one area of the body to treat cancer that has developed in a particular region. Based on the region where the drug has been administered, the chemotherapy is referred with various names. For instance, if the chemotherapy drug is given into the abdomen, it is referred to “Intraperitoneal chemotherapy”. Similarly, chemotherapy given into the chest cavity is “Intrapleural chemotherapy”, the central nervous system is “Intrathecal chemotherapy” and urethra into the bladder is “Intravesical chemotherapy”.

Preparing for Chemotherapy:

As cancer is a serious condition, so does its treatment is. Planning ahead prior to beginning the therapy helps with the potential problems associated with the treatment.

To start the therapy, the patient will be asked to undergo a series of health investigations to determine if he/she is healthy enough for chemotherapy. These investigations can include examinations of heart, liver and other blood tests. Based on the results of these investigations, the doctor decides which type of chemotherapy has to be used for the treatment.

Also, the patient needs to consult a dentist before beginning the treatment; as chemotherapy may affect the body’s ability to heal any infection in the teeth or gums, which can spread throughout the body. And, if the chemotherapy is given intravenously, a port is implanted into the patient’s body, mostly in the chest cavity near to the shoulder. A port is a device which helps for an easier access to the veins. During each session of intravenous chemotherapy, the IV will be inserted into the port.

Some tips to prepare for chemotherapy:
  • In most cases, people can work while getting chemotherapy. But it is important to be on a lighter workload until one gets to know about the possible side effects. So, make arrangements for work.
  • After the first session of chemotherapy, one may feel exhausted and unable to handle other works efficiently. So, it is better to arrange for anyone such as family members or caretakers to get some help with daily activities or to take care of pets or kids.
  • Discussing with the doctor about potential side effects from chemotherapy helps to plan accordingly. If infertility could be a possible side effect and one wishes to conceive a child, then they should store and freeze the sperm, eggs or fertilized embryos.

The procedure of Chemotherapy:

As mentioned earlier, before beginning chemotherapy, the patient will undergo a set of investigations to determine the type of delivery method by which the chemotherapy drugs should be administered. Based on the delivery method, where the treatment is carried out will be decided.

For instance, if the chemotherapy drugs are given in the forms of either pills or liquids or creams, one can be treated at home. And if chemotherapy is given by other delivery methods, then they have to be performed either at a hospital or a cancer treatment center.

The schedule of chemotherapy is customized according to the patient’s condition. How often one should receive the treatment depends on the stage of cancer. The modifications in the treatment will be done based on how well the cancer cells are reacting to the chemotherapy.

After Chemotherapy:

After a session of chemotherapy, the patient will be regularly monitored and will be prescribed to undergo some investigations which include blood tests, imaging techniques and more. By evaluating the reports of these tests, the doctor knows how effective the treatment is.

As patients who get chemotherapy treatment for cancer are at higher risk for infection, bleeding and skin problems, they should be very careful and maintain personal hygiene. Also, patients should inform the doctor about the side effects they are experiencing after chemotherapy. This helps to make the required changes in the treatment to ease the symptoms of side effects.

Chemotherapy side effects:

Chemotherapy drugs destroy the cells that split and grow rapidly. Since other healthy cells in the body also divide quickly and grow in number as cancer cells do, chemotherapy affects even the healthy cells. Due to this, patients can experience side effects from chemotherapy.

Each chemotherapy drug has different side effects and the potential side effects depend on the type of drug the patient receives. Based on the individual factors and the type, extent of the treatment; the side effects can range from mild to severe. However, these side effects can be managed or relieved by other medications.

Some of the common side effects from chemotherapy may include:

  • Nausea and vomiting
  • Hair loss
  • Fatigue
  • Loss of appetite
  • Anemia
  • Infections
  • Weight loss
  • Constipation
  • Insomnia
  • Memory issues
  • Fertility changes
  • Dry mouth
  • Mouth sores
  • Easy bruising and excessive bleeding
  • Diarrhea
  • Pain from nerve damage

FAQ’s

  1. How often should I take chemotherapy?
  2. Will I lose my hair with chemotherapy sessions?
  3. Why is chemotherapy given over multiple courses?
  4. Can I take my usual medications during chemotherapy?
  5. Can I still work while receiving the treatment?
  6. How does the doctor decide which chemotherapy drug to use?
  7. How will I know whether the chemotherapy is working or not?

Q. How often should I take chemotherapy?

A. The schedule of chemotherapy depends on the medications that are being used for the treatment. The treatment schedule may incorporate one day or consecutive days per week or a month, with each set repeating for a number of courses.

Q. Will I lose my hair with chemotherapy sessions?

A. Some drugs used for chemotherapy may cause hair loss as one of the side effects, but not all drugs cause it. In general, the hair will grow back after treatment. However, your doctor knows which treatments can cause hair loss and you will be informed at the time of consultation while discussing the treatment plan. If the chemotherapy drugs which will be given for you are likely to cause hair loss, you will be intimated at first to avoid panic attacks later.

Q. Why is chemotherapy given over multiple courses?

A. Chemotherapy is a systematic treatment in which both cancer and healthy tissues are exposed to the drug. So, it takes some time for the healthy tissues to recover and regain their strength. However, every patient will receive an initial course of treatment before starting the chemotherapy. This helps the doctor to know whether the drug is effective against cancer or not. After the initial treatment, based on the overall health and side effects, the chemotherapy drug may be changed or additional courses may be planned.

Q. Can I take my usual medications during chemotherapy?

A. Before planning the initial course of treatment, the doctor will be provided with the details of the patient’s current medication. So, one can continue with their usual medications during their treatment sessions. However, it is safe to inform your doctor prior to the treatment of any changes in the dose or drugs. If needed, the doctor may ask you not to take a specific medication on the day of treatment which may have possible interactions with the chemotherapy drug being used.

Q. Can I still work while receiving the treatment?

A. Most people can work during their chemotherapy as long as they can match their treatment schedule. But, whether to work or not depends on what kind of work they do, the workload they are taking and the individual situations. As fatigue is one of the common side effects of chemotherapy, one may not be able to work as efficiently as earlier. So, it is better to make work arrangements before starting the treatment. For instance, you can ask your employer to allow you to work either part-time or work from home on the days you don’t feel well.

Q. How does the doctor decide which chemotherapy drug to use?

A. The medication or combination of medications for chemotherapy to be used is decided based on the type of cancer, and how advanced it is along with considering the other health issues, such as diabetes, heart disease etc. When the chemotherapy drug is decided, the potential side effects are mentioned to avoid panic attacks.

Q. How will I know whether the chemotherapy is working or not?

A. After the initial course of treatment, the effectiveness of chemotherapy is evaluated by performing some investigations which include blood tests and imaging techniques. Based on the results, the progress can be assessed. If the cancer cells are reacting well to the treatment with a minimal range of side effects, the same chemotherapy drug is continued for the treatment. Otherwise, the doctor may change either the dose or drugs for chemotherapy.

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