Chemotherapy is a cancer treatment that is widely used. It refers to drug treatments that prevent cancer from metastasis or division and growth. It achieves this by killing cells. There is a wide range of drugs for attaining these goals. The effectiveness and impact depend on the stage of cancer for which treatment is being sought. Adverse effects are severe and the patient needs to discuss with physicians as to what to expect. The benefit of chemotherapy outweighs the adverse impact.
Chemotherapy is used for treating cancer. It prevents disease progression or brings about remission by destroying the cells post their division. There are serious side effects, and patients need to check regarding these with their medical healthcare practitioners. Based on the stage of cancer and the individual, chemotherapy brings on the elimination of cancer cells or long-term remission of the cancerous symptoms.
Chemotherapy is when cancer-killing drugs are used to treat cancer. As part of the body’s natural process, cells are replaced growing and division. When cancer takes place, cells reproduce in a manner that is uncontrolled. Many cells are produced and they occupy an increasing amount of space until space previously inhabited by useful cells are occupied.
Chemotherapy drugs come in the way of the cancer cell’s capacity to divide and reproduce. A combination of drugs or a single drug is used. These can be delivered through the bloodstream to attack cancer cells throughout the human body or they can be targeted to certain cancer sites.
Chemotherapy drugs impair cell division or mitosis in the case of cytotoxic drugs. These medicines also target the food source of the cancer cells, comprising the enzymes and hormones one needs to grow. This triggers the suicide of cancer cells, known as apoptosis. Stop the growth of new blood vessels using chemotherapy and starve a tumor instead of nourishing it.
The impact of stopping blood flow and oxygen as well as nutrients to the tumor results in destroying it. While some researchers hold that starving a cancerous growth could cause it to expand, the current scientific view is that it should impact by preventing cancer cells from the resistance of treatment by targeting the proteins deployed by cancer to raise resistance and drive metastasis.
What To Expect
Table of Contents
Chemotherapy is an invasive treatment that can have serious and adverse effects. This is as these drugs target cancerous as well as healthy cells. Adverse side effects can be the result, but these must be born to treat the disease.
Patients need to know what to expect before commencing treatment.
For the best results, patients need regular chemotherapy over a period specified by an oncologist or cancer specialist. A plan can be formulated regarding the treatment sessions that will take place and the length of time for which they take place.
The course of treatment ranges from a single dose on a single day to a few weeks, depending on the stage and type of cancer. Patients requiring more than one course of treatment have a rest period that permits their body to recover. Treatment can occur on a single day, followed by a week’s rest. Then there may be another day treatment followed by a 3-week rest period and more. This is repeated across time.
A counselor or therapist enables the patient to deal with mental and emotional issues and the ordeal of facing chemotherapy.
Blood Tests
Both before and after chemotherapy, blood tests are needed to assess the health of the patient and ensure their body can cope with possible side effects and issues. If a blood test detects liver problems, further treatment is not possible until the liver recovers. Chemotherapy chemicals and drugs are broken down or metabolized within the liver. In case the liver is overwhelmed, there can be a lot of secondary effects. When blood tests prior to treatment show a low count of leukocytes or erythrocytes or even platelets in the blood, treatment can take longer.
To ensure blood and liver functioning are maintained as far as can be, regular blood tests need to be carried out; these also track the progress of treatment.
How is the Dose Administered?
Photo by: Rhoda Baer/National Cancer Institute/ CC BYDepending on the type of cancer, patients can orally take chemotherapy or intravenously injected into the veins or elsewhere. If the patient is strong enough, orally administered chemotherapy may be the way out. Tablets can sometimes be taken while the patient is at home. The patient is, however, required to make regular hospital visits to check the health and respond to treatment. Drugs are in capsule or liquid form. The dose may be taken exactly when specified. In case the patient forgets to take a tablet at the specified time, the medical team should be immediately approached.
Chemotherapy may also be injected intravenously through an infusion or direct injection into the vein.
The drug can also be administered as an injection into the muscle in the thigh, arm or elsewhere.
Intrathecally, the chemotherapeutic drug can also be injected into the space between tissue layers that cover the spinal cord and the brain.
It may also be given in the form of an intraperitoneal injection, delivered into the body part where the intestines, liver, and stomach are located.
The chemotherapeutic drug may also be injected into the artery leading to the cancerous growth.
The drug may be administered via a pump or drip to ensure constant delivery rate. In case the patient needs a continuous infusion, ambulant infusion, protracted venous infusion, pumps may have to be worn for several months or weeks. They can walk about while receiving the medicine. Devices used to deliver the solution include the central line, catheter, and portacath.
A portacath refers to a port that can be implanted. It is like a thin, soft and flexible tube made of plastic that goes into a vein. It has a port or opening just under the skin of the arm or chest. The port has a thin rubber disc, where special needles can pass medicines into or take the blood from. It could also be topically applied as an ointment or a cream for application on to the skin.
Chemotherapy may be combined with radiation therapy.
Chemo drugs are very strong and kill cells that grow fast. This is even if it is not a cancer cell. Normal, healthy cells that grow fast can be harmed. This leads to side effects. Ask the cancer care team regarding side effects impacting patients post chemo. If bad side effects take place, blood tests may be needed to unearth a lower dose of chemo. If you need longer breaks between doses, it can also be managed. Even if the chemo has a side effect, the good may outweigh the bad.
For most individuals, side effects go away once the treatments end. How long this takes depends on each person. Some side effects take longer to disappear than others. Some of these side effects may never go away. Talk to your team about how to cope with these.
Common Chemotherapy Side Effects
Photo by: Sersa et al/CC BYCertain chemotherapeutic drugs lead to nausea where you can feel sick to the stomach and even throw up. These symptoms commence a few hours after the treatment and last for a short time. In some cases, it can last for a few days. Check with your cancer treatment team regarding your chemotherapeutic side effects and what you can do about it.
Even if a drug brings on nausea and vomiting, it is important to take it. Call your doctor if you are given to vomits beyond more than a day or if you cannot keep liquids down.
Some chemotherapy can make hair fall out from different parts of your body such as your head, arms, groin, face, and armpits. You may even lose hair slowly or overnight – it all depends on how your body reacts. Not all chemo drugs have an effect. While some only cause hair to thin out, others can impact you in a bigger way. As a precaution, you should check with your health care provider regarding what to expect from chemo drugs you are getting. Hair also grows back after chemo. Ask the team for tips on taking care of the scalp and the hair at the time of the chemo. Some individuals may even wear head covers such as scarves, caps or hairpieces.
Impact on the Bone Marrow
The bone marrow is a liquid part of the bones. It is the inner part and the point where all your blood cells are made. This includes WBCs, RBCs, and platelets. It is also impacted by chemo which causes blood cell counts to fall.
Red Blood Cells
RBCs or erythrocytes carry oxygen from the lungs to different parts of the human body. During a chemotherapy session, the bone marrow may not be able to make enough RBCs. Lack of red blood cells is known as anemia. This can cause shortness of breath, fatigue, and tiredness. It can also make the gums, skin or mouth look pale.
WBCs or leukocytes fend off infection. Chemotherapy lowers the number of WBCs which makes one less able to stave off infections. The cancer care team can suggest ways to stay safe from infections.
Platelets or thrombocytes form blood clots that prevent cuts or bruises from bleeding. If the bone marrow does not make enough platelets, you can bleed too much. This is more so, even from small cuts. If your platelet count falls low, you need to take care. Even brushing the teeth too hard can cause the bleeding to begin. Check with the team about how to floss safely.
These side effects on the bone marrow do not last long. Blood tests need to be done when the bone marrow produces new blood cells again. There are treatments that need to be used if blood cell counts fall lower.
Skin and Mouth Changes
Photo by: Corrado Bellini/ CC BYSome chemo drugs can even trigger sores in the throat as well as the mouth. Good mouth care is an essential part of treatment. Chemo recipients need to brush their gums and teeth after each meal. Check with a dentist before commencing chemo. A dentist can show the best way to take care of gums and teeth during treatment. Certain people are allergic to chemotherapy. This leads to skin welts and hives, itching or difficulty in breathing. Chemotherapy is given when a nurse can watch a patient for any type of problem. Problems need to be treated right away.
Asking cancer care tips for dealing with mouth and skin conditions is advisable during chemotherapy.
Birth Defects
Most chemotherapy can lead to birth defects if a woman gets pregnant at the time of treatment. Chemo can also induce sperm problems in males impacted by the disease, which can trigger birth defects. Ask the doctor about the birth control one should use and how long it is required to be used.
Fertility Issues
Some chemotherapeutic treatment can leave individuals unable to have children. The effect could also be permanent and not end when treatment comes to a close. If you want to have a child, be sure to consult the doctor for options before starting chemotherapy.
Memory Changes
Cancer treatment can impact memory and thinking patterns. This is known as chemo fog/chemo brain. In rare cases, it can last for a longer period of time post-treatment. This often occurs in therapies where a large dose of chemo drugs are administered.
Emotional Issues
Chemotherapy and cancer can affect the emotions of an individual too. Chemo presents a major challenge. There may be major challenges so consult with your cancer care team before and be sure to seek counseling for emotional hurdles and conflicts you may feel.
Side Effects: Why Does Chemo Cause It?
Chemotherapy treats a lot of the different kinds of cancers in an effective way. But like any other treatment, it comes with its own share of side effects. Chemotherapy side effects differ for each person. They are based on the kind of cancer, the location of the growth, drugs, dose and general health.
Chemotherapy leads to a lot of side effects. It works on active cells because of which these side effects come about. Active cells are those cells which grow and divide into more of the same cell type. Cancer cells are active, but then, so are healthier cells. These are the cells found in the bloodstream, the digestive system, mouth and hair follicles. Side effects happen when chemo damages healthier cells.
Your healthcare team can help you to prevent or even cure side effects, as many medications are available for side effects than in the past. Preventing and treatment of side effects known as supportive or palliative care is a critical part of cancer treatment.
Doctors and scientists have worked in tandem to develop drugs, drug combinations and ways of treatment that elicit fewer side effects. Many types of chemo are easier to tolerate as opposed to others.
Different drugs come with different types of side effects. Certain kinds of chemotherapy have specific side effects. Each person’s experience differs.
Different drugs cause different side effects. Certain types of chemotherapy often have specific side effects. But, each person’s experience is different. Check with your doctor about side effects noticed. For many types of chemo, side effects do not necessarily show how well treatment is functioning. It can, however, indicate the impact of specific targeted therapies.
Side Effects of Traditional Chemotherapy
Photo By: Cancer Research UK/ CC BY#1 Fatigue
The first and foremost side effect is fatigue. Feeling tired or exhausted almost all of the time is something you need to avoid. Be clear about how to cope with fatigue.
#2 Pain
Chemo sometimes leads to pain. This includes headaches, muscular pain, stomach linked pain, pain due to nerve damage, such as burning, numbness, or shooting pain in the toes and fingers.
Many types of pain pertaining to chemotherapy can get better or disappear between the treatments. Nerve damage worsens with every dose. When this takes place, the drug linked to nerve damage has to be stopped. It takes months or years for nerve damage from chemotherapy to go away or improve. In some cases, it does not disappear in entirety.
Pain treatment differs depending on what causes it. It is important to confer with the expert cancer care team regarding pain management while opting for chemotherapy. There can be causes for pain besides chemotherapy, such as cancer. If the pain is pertaining to chemotherapy, such as cancer. If the pain is associated with chemotherapy, doctors can treat it through pain-relieving medicines.
Blockage of pain signals can also take place from the nerves to the brain with nerve blocks or spinal treatments. Chemotherapy doses need to be adjusted too. Learn about cancer pain and how it can be managed.
#3 Throat and Mouth Sores
Chemo damages the cells inside the throat and the mouth. This leads to painful sores in the areas through a condition called mucositis. Mouth sores usually take place 5-14 days post a treatment. Sores can get infected. Eating a healthy diet and keeping the teeth and mouth clean lowers the chance of mouth sores. Mouth sores end when treatment comes to a close.
#4 Diarrhea
Certain types of chemo cause watery bowel movements. It prevents or treats diarrhea and keeps you from getting dehydrated and losing body fluid. It also wards off health problems.
#5 Nausea
Nausea and vomiting are other side effects of chemo. These side effects depend on a specific dose and drugs. The right medication before and after each chemotherapy can prevent vomiting and nausea.
#6 Constipation
Chemo can also lead to constipation. This means not having bowel movements or difficult bowel movements. Other medications like pain medicines can also lead to constipation. Drinking enough water and fluids, consuming balanced meals and getting adequate exercise lowers the risk of constipation.
#7 Blood Disorders
Bone marrow refers to the spongy tissue within the bones. It makes new blood cells. Chemo impacts this process, so one may have side effects due to too fewer blood cells. Generally, the number of blood cells return to normal once chemo completes. During treatment, a low number of blood cells can cause issues and be closely monitored.
Tests for Blood Disorders
To check for blood disorders, the following tests will be used:
- Complete Blood Count
- A CBC or complete blood count shows the levels of RBC and WBC in the blood.
- Platelet Count
This test measures the number of platelets in the blood. Platelets are cells that stop bleeding; this is caused by plugging damaged blood vessels and helping the blood to form clots. Not enough RBCs cause a condition such as anemia. Symptoms include dizziness, fatigue, and shallow breathing
#8 Nervous System Impact
Certain drugs cause nervous system damage. This leads to nerve or muscle symptoms. One may experience a lot of sensations like burning, tingling, weakness or numbness in the hand or feet, weak or sore muscles, lack of balance, trembling or shaking. There may even be stiffness of the neck, or problems in seeing, hearing or walking normally.
Physical clumsiness is another side effect of chemo that can manifest itself.
The symptoms may get better with a lower chemo dose or post the treatment. But sometimes, the damage is permanent.
#9 Problems in Thinking and Memory
There are also changes in memory and thinking. Some people have a problem thinking and focusing well post the chemotherapy sessions. This is known as chemo brain by cancer survivors. Doctors call these cognitive changes or cognitive dysfunction.
#10 Fertility and Reproductive Issues
Chemo can also impact fertility and reproductive issues. Women may be unable to conceive or carry a child. For men, fertility loss is also noted. Women may also need a Pap test before commencing chemotherapy. This is on account of the fact that chemo can cause misleading test results.
Chemo can also harm the fetus. This is more so during the first trimester. This is when the organs start to develop. If one gets pregnant during treatment, it is important to use birth control.
#11 Appetite Loss
Chemo can also make a person feel less than hungry or even nauseous or full after eating a certain amount. If this lasts through the treatment, one loses weight and does not get the nutrition required. Muscle mass and strength are also lost, and these impact your ability to recover from chemotherapy.
#12 Hair Loss
Certain chemo causes hair loss all over the body. It can come out sometime or in large clumps. Hair loss commences after the first few weeks of chemo. It tends to rise within a couple of months into treatment. Doctors predict the risk of hair loss based on the drug and the doses received.
#13 Impact on Heart
Certain types of chemo can also impact the heart. It is essential to also check the heart before treatment. Doctors can then diagnose if the treatment causes later issues. One way out is the echocardiogram or ECHO test. This test uses ultrasound waves to create a moving picture of the heart.
Long-term side effects often disappear after treatment. Some continue, develop or come back later.
Some types of chemotherapy can permanently damage different parts of the body such as the lung, kidney, liver, and heart. Additionally, people have trouble thinking, concentrating or remembering after the treatment. Changes in the nervous system can occur after treatment. Children with chemotherapy may develop side effects that take place after years and these are known as late effects. Cancer survivors also face a chance of recurrence of the disease.
Can Side Effects be Prevented/Treated?
Photo By: Practical Cures/ CC BYThere are means of stopping chemo side effects or making them better. If you have side effects, be sure to talk to your cancer care team. As everyone gets different chemo drugs, the impact on the body can also be different. Overall, health and fitness depend on how the body responds to chemotherapy.
Some individuals can get through life without undergoing chemo every day. Others need to visit the hospital for treatment. Most people have to change work hours to get to the chemotherapy session. Ask if you will be required to take time off from work.
Chemo involves adverse side effects. But the recent advances in science and technology have made most of these manageable. Based on the extent and type of treatment and other individual factors, adverse side effects range from mild to severe as well. Some individuals have no side effects.
The impact of treatment depends on the extent of the symptoms.
How To Treat Side Effects
#1 Nausea and Vomiting
Nausea as well as vomiting impact over seventy percent of the patients. In such cases, anti-emetic drugs can help. When symptoms lessen, even then these can be taken. For best results pair with herbs and supplements like ginger.
#2 Alopecia
Chemo, as mentioned before, can trigger hair loss. Hair starts to fall out or become brittle and thin a few weeks after treatment with different types of chemotherapy. It may impact any part of the body. Hair loss can lead to distress. Doctors need to put patients in touch with counselors or offer advice about wigs or other suitable ways to cover the head.
Using a cold cap while the chemo dose is being administered can prevent hair loss and also promote prevention of the same while keeping the scalp cooler.
Patients who require the medication to reach the scalp, however, such as those with leukemia, cannot wear a cold cap. Once treatment is over, hair grows back normally. Nails become brittle and flaky. Skin reverts to dry, soreness and is oversensitive to the sunlight. Patients need to stay out of the sun during peak times, use sun blocks and clothes that offer maximum protection.
#3 Fatigue
Another common side effect is fatigue. It may be present most of the time or only during specific activities. Patients need to rest and avoid overtiring tasks. Severe tiredness is to be reported to the doctor, as there is a drop in RBC leading to anemia.
#4 Hearing Impairment
Chemo has a toxic effect which may necessitate hearing aid remedies as patients may experience permanent or temporary hearing loss.
#5 Low WBC Count and Susceptibility to Infections
As the leukocytes go down in number, immunity is weakened while receiving chemotherapeutic care. This is called neutropenia. WBCs form part of the immune system and fend off infection. This makes the patients susceptible to infections.
Antibiotics can reduce the chance of developing infections. Patients and carers also need to follow precautions.
Maintaining personal hygiene is important. Regular hand washing with warm water and soap is a must. So is bathing or taking a shower once a day, changing the bedclothes, clothing and bathroom towels on a regular basis. Following food hygiene is also important, and this includes keeping the veggies and the meat separately, thoroughly cooking animal produce, washing the veggies and keeping cutlery, crockery and surfaces spic and span.
Additionally, patients need to stay away from those with illnesses or infections. Skin wounds need to be carefully treated. You need to dress cuts and grazes, using sterile dressing to prevent the bacteria from coming into the skin.
Those undergoing chemo who develop an infection may require instant treatment. This includes hospitalization and receipt of intravenous antibiotics.
Chemotherapy patients who develop an infection need immediate treatment. This may mean being hospitalized and receiving intravenous antibiotics.
#6 Bleeding and Low Platelet Count Problems
Low platelet count, also known as thrombocytopenia leads to blood clotting issues. Platelets are a type of blood cells that help in clotting. A low platelet count triggers bruises and nosebleeds or even bleeding gums. The flow of blood from a small cut may also be hard to stop. When the platelet count falls exceptionally low, the person requires a blood transfusion.
To reduce the chances of bleeding, patients need to use an electric razor or avoid a shave.
Additionally, a soft toothbrush needs to be used. While using sharper objects such as kitchen utensils or tools for gardening. Additionally, gloves can prevent gardening injuries.
#7 Low RBC Count and Anemia
RBC or erythrocytes carry oxygen to different tissues in the human body. Low levels of RBC lead to anemia. Symptoms range across shortness of breath, tiredness, and palpitations of the heart. Those with severe anemia may require an urgent blood transfusion as well.
Medications like erythropoietin make the blood produce RBCs to a greater degree. Good iron sources include dark, leafy veggies, meat, beans, nuts, raisins, prunes, and apricots.
#8 Mucositis
This is an inflammation of the mucous membrane, which impacts different body parts such as the digestive system, including the stomach, intestines, esophagus, mouth and other body openings. Oral mucositis leads to symptoms in the mouth. These may start within a week or so of treatment. There could also be a pain in case the mouth has been burned. The tongue, lips and mouth experience ulceration. Eating, talking and drinking can also be painful. In case bleeding takes place, there’s also a chance of infection. The severity of symptoms is associated with the strength of the chemo dose. Caphosol is prescribed for treating this condition. Some medications can also reduce the risk of mucositis. The symptoms go away a few weeks after the treatment ends.
#9 Appetite Loss
Whether chemotherapeutic treatment or cancer impacts the metabolism of the human body, it leads to loss of weight and appetite till cancer goes into remission or the treatment comes to an end. Severity is associated with the cancer type and chemo treatment. Taking smaller, more regular meals can nourish the body to a greater degree. Drinking liquids through a straw further help in maintaining the intake of fluid. Those who cannot consume liquid or food may need to be hospitalized and fed through the nasogastric tube, which enters the stomach directly through the nose.
#10 Fertility and Pregnancy
Patients may lose the desire to engage in intercourse as libido is impacted during chemo treatment. Once treatment ends, the libido returns to normal. In association with the medication administered, chemo also reduces fertility in women and men. Fertility returns once treatment is over. Patients who desire children in the future can freeze the sperm or embryo for later use. Chemo drugs also lead to congenital disabilities. So avoiding pregnancy during chemotherapy is important. Using barrier methods of birth control is important at the time of treatment and for a year thereafter. Oral birth control systems can interfere with chemotherapy. For women cancer patients, it becomes essential to disclose the pregnancy to the medical healthcare practitioner.
#11 Bowel Problems
Diarrhea can take place when expulsion of damaged cells takes place from the body. There can also be a case where constipation takes place, apart from other GI problems. These symptoms commence once treatment starts. These bowel problems can be monitored and treated as they appear.
#12 Cognitive and Mental Health Issues
Close to 75% of the patients report issues with thinking, attention and short-term memory during chemotherapy. For close to 35 percent, this may take place for months or years post the treatment. This also impacts the ability to reason, multitask and organize. Mood swings and depression can also take place, whether related to treatment or issues for the future.
Types of Chemotherapy
There are many different types of chemo drugs and ways to receive these. The key categories range across the following. Agents that alkylate work directly on the DNA and destroy different stage cells during the life cycle. Examples range across chlorambucil, thiotepa, busulfan, and cyclophosphamide. Another class is the antimetabolite.
This replicates the proteins that cells require to survive. When cells consume these, no additional benefits are offered and cells undergo starvation. Examples range across purine antagonists, folate antagonists, and pyrimidine antagonists. Plant alkaloids possess the capability to block the metastasis of cells. Examples of these range across mitomycin, doxorubicin, and actinomycin D. Then, there are anti-tumor antibiotics which offer DNA binding and stop the RNA from synthesis so cells cannot reproduce. These differ from antibiotics used for infections. Examples range across mitoxantrone, doxorubicin and bleomycin. A suitable option depends on the cancer type the person has, how advanced it is and the type of chemo had as well as health issues like diabetes.
Efficiency of Chemotherapy
Despite its adverse effects, chemotherapy can be effective in treating cancer. It leads to complete remission sometimes. Effectiveness is associated with individual factors. These range across the type, stage and location of cancer, the overall health, age and prevailing medical conditions of the patient. Chemo, in some cases, can achieve complete remission with the patient being fully cured and cancer not returning. But in most cases, the symptoms have to be managed.
At times, chemotherapy combines with other treatments such as radiation therapy or surgery for results that are effective. Neo-adjuvant therapy can also be tried to shrink the tumor prior to the surgery. Following the remission or surgery, chemo is used to remove cancer cells that remain. Referred to as adjuvant therapy, this delays or prevents the remission too.
For patients in the advanced stages of the disease, chemotherapy can slow the progression and reduce symptoms of the disease, even when a cure is impossible. This is referred to as palliative chemotherapy.
Outlook and Prognosis
During and after chemotherapy, patients undergo blood tests and exams to assess the treatment progression. Side effects of chemo drugs will disappear when the treatment comes to a close. The quicker cancer is treated, the more possible it is to go into remission and get the disease cured.
Certain individuals function during chemotherapy but need to adjust their schedule.
Getting Support During Treatment
Whether you opt for a counselor or joining an online or local support may help. It is critical to keep in close contact with the doctor at any time of cancer treatment, as one can deal with adverse impacts. Patients should not make sudden changes to the lifestyle without a physician consultation. Chemo can also be costly, so it is important to talk to the doctor to uncover options and discuss with the health insurance provider regarding services covered.
Certain people can work during chemo, but others may need sick leave.
Chemotherapy and Other Treatments
Chemotherapy is an aggressive chemical drug therapy meant to destroy the fast-growing cells in the human body. It is also used to treat cancer, as the cancer-ridden cells divide and grow faster than any other cell. Doctors who specialize in cancer treatment are known as oncologists. They work to come up with a treatment plan.
Chemotherapy is used along with other therapies such as radiation or hormone therapy and surgery. This is linked to the type and stage of cancer one has one’s overall health, previous cancer treatments, locations of the cancer cell and individual treatment preferences.
It is considered a methodical and structured treatment which affects the complete body. When a chemo drug attacks cancer cells, it can cause serious side effects that can severely impact the quality of life. Side effects need to be weighed against the risk of not getting treatment when assessing if chemo is right for an individual.
Why Chemotherapy is Used
Chemotherapy is primarily used to lower the total cancer cells in the body and reduce the chance of cancer from spreading. It also shrinks the tumor size and prevents current symptoms.
If surgery has been carried out to remove a cancerous tumor, such as lumpectomy for breast cancer, oncologists can recommend that chemo is essential to ensure lingering cancer cells are also destroyed. Chemotherapy can also be used for other treatments. It can be used for shrinking a tumor for surgical removal or preparation for radiation therapy. Chemotherapy can also relieve pain in the event of late-stage cancer.
Apart from treatment for cancer, chemo is also used to manage bone marrow and immune system disorders.
Doses of chemo of a lower magnitude than cancer can help disorders where the body’s immune system attacks cells which are healthy such as RA or lupus.
How to Prepare for Chemo
As chemo is a serious treatment for chronic conditions like cancer, it is important to plan ahead before starting with therapy. Additionally, the doctor and hospital staff help in dealing with problems linked to treatment.
Before therapy begins, a series of tests are essential to determine if one is healthy enough for chemotherapy. This includes exams of the heart and blood tests to determine the liver’s health. The tests can be used to guide doctors on the type of chemo used in treatment.
Doctors also need to recommend that the dentist is visited before the treatment. This is because chemo impacts the ability of the body to heal, so teeth or gum infections could be possible.
For those getting chemotherapy through an IV line, a port may be installed. The port is a device implanted in the body, near the shoulder in the chest. This allows easier access to veins and less pain. IV is inserted into the port at the time of each treatment.
Preparation Tips and Guidelines
Preparation tips for chemotherapy include making arrangements for work. Most people function in work settings quite effectively even during chemotherapy. But it may be wise to opt for a lighter workload unless you are clear about any side effects you may experience. Making domestic preparations such as stocking up on groceries or doing the laundry or other tasks that are physically demanding before the chemo is also advisable. Make sure you arrange for any help that might be needed. Additionally, you need to anticipate the side effects too.
Ask your healthcare provider about the side effects you may experience and how to plan effectively. In the case of infertility could be a side effect and one wants to conceive a child, it is essential to store and freeze sperms, fertilized embryos or eggs.
Beginning therapy or joining a support group is also important. Ensure that you talk to a person within your friend or family circle who can understand your concerns.
How Is Chemotherapy Performed?
The doctor and the patient need to work hand-in-hand to consider variables and determine the best treatment course. Chemo is provided in pill form or injected directly into the veins through an injection or an IV. Along with these two forms, chemo is administered in other ways as well.
Deliver options for chemo treatment range across the following.
Chemotherapy can be directly delivered to the tumor, depending on the location of the tumor. If surgery is undergone to remove the tumor, slow dissolving discs can be used to release medication over an extended period of time. Certain skin cancers can also be cured through chemotherapy creams.
Chemo can also be delivered to certain body parts directly, as a localized treatment, into the abs, chest, CNS or bladder through the urethra. Certain types of chemo can be taken through the mouth or pills.
Liquid chemo drugs need to be delivered in single shots, or there can also be a port installed where the needle undergoes insertion for every therapy session. Pain is experienced at the injection site during the first visit with the infusion method with a port. But the port needle can also loosen based on activity levels.
When treatment is received, it should depend on the chosen delivery method. For instance, if creams or pills are used, treatment can be given at home. Other procedures need to be carried out at cancer or hospital treatment centers. The chemotherapy schedule, in terms of how treatment is received, is customized. If the body does not respond to the treatment well, or it increases or decreases depending on how the cancer cells react to treatment.
Post Chemotherapy Treatment
Once chemotherapy is over, the doctor, as well as the cancer team, monitor the effect of the treatment. This includes imaging techniques, blood tests and way more. Additionally, doctors can adjust treatment at just about any time.
The more one shares with the doctor about how chemo is impacting one, the better the treatment experience is. Study any side effects or treatment-related issues so adjustments to the treatment can be made if necessary.
Additionally, the types of medication used and how these are administered are based on the situation of the patient, the kind of cancer and the goal of cancer therapy.
Chemotherapy options are individualized for each patient. Treatment decisions are a collaboration between the patient, cancer doctor and family.
There are different goals for chemo. The treatment may be required to treat cancer, control its spread and growth or provide comfort to patients. Chemotherapy impacts people in different ways. The most common side effect is fatigue, but other serious complications may also take place, based on chemotherapy treatment.
There are many options to treat cancer. New chemotherapy types, drugs and treatment protocols are being developed. A clinical trial is an important option for some individuals with cancer, but there is no guarantee that a new medication or treatment works better than standard treatment methods available.
How Does Chemotherapy Work?
Chemotherapy functions by decreasing or stopping the growth of cancerous cells. These cells grow and divide quickly. It also harms regular cells which divide and replicate rapidly, such as those that line the intestines or mouth or are within hair follicles for triggering the growth of tresses. Damage to healthy cells can lead to side effects. Often, side effects improve or go away once chemotherapy is over.
Based on the type of cancer and the level of its advancement, chemotherapy cures and controls cancer. It also eases cancer symptoms through palliative care. So whether chemotherapy destroys cancer cells when the body does not detect them and they do not grow back, or it keeps cancer from spreading, slows the growth or destroys cancer cells and shrinks tumors that cause pressure or pain.
How is Chemotherapy Used?
Chemotherapy is used only as a form of cancer treatment. Chemo often accompanies surgery, biological therapy or radiation therapy. Chemo can make a tumor smaller prior to surgery or radiation therapy. This is called neo-adjuvant chemo. Chemo can also destroy cells that are cancerous post surgery or radiation therapy; this is called adjuvant chemotherapy. Help radiation therapy work better with biological therapy. Destroy cancer cells that return or recurrent cancer and spread to other body parts or metastatic cancer.
FAQs or Frequently Asked Questions
Q. What type of drugs are used for chemotherapy?
A. The type of drugs that are used for chemotherapy depends on the following factors:
The cancer type: Certain types of chemotherapy drugs are used for different types of cancer. Other drugs are used for just a single or two types of cancer.
Whether chemo has been done before.
Whether there are health issues like heart disease, diabetes or problems with kidneys or the liver.
Q. Where can chemotherapy be received?
A. Chemotherapy is received during the hospital stay, at home or in an outpatient unit, doctor’s office or clinic at a hospital. This means patients may not have to stay overnight for treatment. Regardless of whether one goes for chemo, the doctor and the nurse watch out for side effects and make the needed changes.
Q. How often is chemotherapy received?
A. Treatment schedules for chemo depend on a lot of factors. How often and how extended a period of time one gets chemotherapy is based on the type of cancer and how advanced it is. Additionally, the goals of treatment are also important, whether chemotherapy is used for curing cancer, easing symptoms or controlling growth.
Q. How does the body react to chemotherapy?
Chemotherapy is received in cycles. A cycle is a chemo period of treatment followed by rest. For instance, one week of chemotherapy may be followed by three weeks of rest. These 4 weeks constitute a single cycle. Rest gives your body a chance to create new healthy cells.
Q. Can a dose of chemotherapy be missed?
A. It is not advisable to skip the chemo treatment. Sometimes, the schedule may be changed by a doctor or nurse. This could be on account of the side effects experienced. In case this happens, your healthcare practitioner explains how to proceed and when to commence with treatment again.
Q. How is chemotherapy administered?
A. Chemotherapy can be provided in different ways. Injection is when the chemotherapy is given through a shot in the muscles of the hip, thigh or arm or even the fatty part of the belly, arm, and leg.
Intra-arterial is a chemotherapy form that goes directly into the artery feeding cancer.
Intraperitoneal/IP chemo goes directly into the peritoneal cavity which contains the following organs: stomach, intestine, liver, and ovary.
IV or intravenous chemotherapy goes directly into the vein. Typically, the chemotherapy creams can be applied to ward off skin cancer. Orally, it comes in liquids, pills or capsules that are swallowed.
Q. How does one get chemotherapy through an IV?
A. Chemotherapy is given via a thin needle placed in a vein on the lower arm or the hand. The nurse puts the needle in at the start and close of the treatment. Doctors or nurses need to know if pain or burning is felt when an IV chemo is injected.
IV chemo is administered through ports or catheters, with the aid of a pump.
Catheters are soft, thin tubes. A surgeon places one end of it in the large vein, in the chest area. The other end of the catheter stays outside the body. Most catheters are in place, till chemo treatments are carried out. Catheters can be used for drugs other than chemotherapy and must be well sterilized.
Ports are small, round discs made of metal or plastic placed beneath the skin. Catheters connect ports to the large vein in the chest. The nurse may insert the needle into the port to provide blood samples or carry out chemo. The needle needs to be left in place for chemo treatments for more than a single day. Signs of infection around the port should also be avoided.
Pumps are attachments to ports or catheters. These control the amount and quickness with which chemo drugs enter into cancer or port. Pumps can be external or internal. While the external ones are placed outside the body and are generally portable, internal pumps are placed beneath the skin during the surgery. Internal pumps are placed beneath the skin at the time of surgery.
Q. How do you feel during chemotherapy?
A. Chemotherapy impacts people in various ways. How one feels depends on how healthy one is prior to the treatment, the nature of cancer, how advanced the symptoms are, the kind of chemotherapy one is receiving and the dose. How you feel during chemotherapy will depend on these factors.
Certain patients do not feel well immediately after the chemotherapy. Others feel fatigue, exhaustion, and tend to become worn out.
Q. Can I work at the time of chemotherapy?
A. Many people can function effectively, as long as the schedule is matched to how one feels. Whether you can work or not depends on the kind of work done. If the job permits it, one should opt for work at home options on days one is not feeling well. Sometimes, medical healthcare practitioners may advise a chemo patient to not work for a period of time, such as when the immune system is low at the time of chemotherapy.
Q. Can I take OTC and prescription drugs when I opt for chemo?
A. This depends on the kind of chemotherapy one gets and the type of drugs one plans to take. Taking only drugs approved by the nurse or doctor matters. You need to tell the nurse or doctor about OTC and prescription drugs such as allergy medicines, cold medications, pain relievers, aspirin, laxatives, and ibuprofen.
One way to check and let the doctor or nurses know about the drugs is to bring in your pills. The doctor or medical practitioner also needs to know the drug’s name, the reason for taking it, how often and how much to take. Check with your nurse and doctor before taking vitamins, supplements, minerals, herbs, OTC or prescription drugs.
Q. Can I take supplements like herbs, vitamins, and minerals during chemotherapy?
A. Some of these can impact how chemotherapy functions, for which reason it is important to tell the doctor or nurse about vitamins, minerals, herbs, and dietary supplements before starting chemotherapy. At the time of chemotherapy, check with your doctor before taking these products.
Q. How is chemo effective in treating cancer?
A. Chemotherapy is the use of a drug to treat the disease. But for most people, the word chemotherapy means drugs for cancer treatment. While surgery or radiation therapy removes, damage or kills cancer cells in a certain area, chemo works throughout the entire body. Chemo can kill cancer cells that spread to different parts of the body, from the original primary tumor.
If the doctor has proposed chemotherapeutic treatment to manage/cure cancer, it is important to comprehend the goals of treatment.
If possible, chemo can be used to cure cancer in that there is no chance of remission. The cure is not used except as a possibility or a potential outcome. So, when the treatment has a chance of curing a person’s cancer, the doctor can describe it as treatment with curative intent. The cure is the goal, but it does not always work out this way. It takes many years to know if cancer has been cured.
If a cure is not workable, the goal becomes to control or manage the disease. Chemo is used for treating tumors and stopping cancer from spreading or growing. This can make a person with cancer feel better and live for extended periods of time.
In different cases, cancer does not remit completely but is controlled and managed as a chronic disease, much like diabetes and heart disease. Cancer may seem elusive for some time, but it may return. Chemo needs to be given again, in such cases.
Chemo can be used for easing symptoms caused by cancer. This is known as palliation or palliative chemotherapy. It is important to know treatments for reducing the symptoms or improving the quality of life. Anti-nausea treatments or pain medicines are palliative wherein the aim is to add value to the remaining days; this form of chemo can be tried in all treatment stages where chemo is used as a palliative treatment used to cure or control cancer. When it comes to the goal of comfort, chemo turns into palliative care.
You and the oncologist decide which drug or combination of drugs one gets. The doctor will choose the doses, how the drugs will be administered and the duration and length of treatment. All of these decisions depend on the kind of cancer, where it is located, how big it is and how it affects the normal body functionalities and overall health.
Cancer can be treated with a single chemo drug, but several drugs are used in a combination. This is called combination chemotherapy. Different drugs work in different ways. This helps to lower the chance that cancer can be resistant to anyone chemotherapy drug.
Chemo is sometimes the only treatment needed. Chemo may be used with radiation therapy or surgery or both.
In some cases, the best choices of schedules and doses for chemo drugs is clear. Most doctors recommend the same treatment. In certain cases, less may be known about the single best way to treat and cure people with certain types and cancer stages. Different doctors may recommend different combinations of drugs with different schedules.
The factors that determine the type of treatment include the cancer type and stage, the patient’s age and overall health. Other serious health problems such as liver, heart, or kidney disease. You also have to know how the types of cancer treatments given in the past.
Doctors can take these factors into account, along with the data published in textbooks and medical journals describing the outcomes of similar patients, treated with chemo.
Q. How can chemotherapy doses be administered?
A. Most chemo drugs are strong medications with fairly narrow range for dose effectiveness and safety. Taking a little of the drug does not cure cancer, and takes on life-threatening side effects in the bargain. For this reason, chemo doses are very precisely calculated by the doctor. Depending on the kind of drug to be given, there are different ways to assess chemo doses. Most chemo drugs are measured in mg. The overall dose is based on the patient’s weight in kilograms generally. Specific chemo doses are even based on body surface or calculations using height and weight.
Doses for children and adults differ. This is even after BSA is taken into account. Children can be sensitive to medication in different ways. The same holds true for those who are elderly, have poor nutritional status, are obese, have taken medicines or radiation therapy previously. Those with low blood cell counts or liver and kidney diseases can also be sensitive to the chemo in unique ways.
Q. How is the most effective chemotherapeutic dose found?
A. In most cases, the most effective schedules and doses of drugs to treat certain cancers have been found by testing these in clinical trials. It is important to get the complete course of chemo, the complete dose and keep cycles on schedule. This ensures maximum benefit from treatment. There may be times when serious side effects require adjusting the dose or schedule and offer the time to recover. One might be given supportive medicines to help the body recover more quickly. The key is to give enough chemo to kill cancer cells without causing a lot of problems.