What is chemotherapy?
Treatment with drugs to kill cancer cells is called chemotherapy.
How is chemotherapy given?
Most anticancer drugs are injected into a vein (IV) or a muscle. Some are given by mouth. Chemotherapy is systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body.
Often, patients who need many doses of IV chemotherapy receive the drugs through a catheter (a thin flexible tube). One end of the catheter is placed in a large vein in the chest. The other end is outside the body or attached to a small device just under the skin. Anticancer drugs are given through the catheter. This can make chemotherapy more comfortable for the patient. Patients and their families are shown how to care for the catheter and keep it clean. For some types of cancer, doctors are studying whether it helps to put anticancer drugs directly into the affected area.
When and where is chemotherapy given?
Chemotherapy is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient at the hospital, at the doctor’s office, or at home. However, depending on which drugs are given and the patient’s general health, the patient may need to stay in the hospital for a short time.
What are side effects of chemotherapy?
The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. Generally, anticancer drugs affect cells that divide rapidly. These include blood cells, which fight infection, help the blood to clot, or carry oxygen to all parts of the body. When blood cells are affected by anticancer drugs, patients are more likely to develop infections, may bruise or bleed easily, and may have less energy. To prevent infections, patients taking chemotherapy should wash their hands frequently, avoid sick people and crowds, immediately clean cuts and scrapes, avoid contact with animal waste, and notify their doctor if they develop chills, sweats or fever at 101 degrees or greater. To prevent bleeding, they must avoid aspirin, ibuprofen, or any medication without the consent of their doctor and avoid cuts with razors, knives, etc. The doctor should be notified with any signs of bleeding, such as blood in stools, vaginal spotting, bleeding gums, vomiting or coughing up blood, and bruising.
Cells that line the digestive tract also divide rapidly. As a result of chemotherapy, patients can have side effects the affect the mouth, stomach and intestines, such as loss of appetite, nausea and vomiting, or mouth sores. For some patients, medicines can be prescribed to help with side effects, especially with nausea and vomiting. To reduce nausea and vomiting, patients can eat frequent, small meals, have liquids at least one hour before or after eating, eat foods at room temperature, eat slowly, avoid offensive odors, rest after eating, and breath through the mouth if nausea develops. Usually these side effects gradually go away during the recovery period or after treatment stops. Mouth soreness can be minimized with the use of a soft toothbrush, soothing mouth rinse with a teaspoon of baking soda in warm water, and lip balm. High acid foods and juices, such as tomato, orange or grapefruit, should be avoided.
Hair loss, another side effect of chemotherapy, is a major concern for many patients. Some chemotherapy drugs only cause the hair to thin out, while others may result in the loss of all body hair. Patients may feel better if they decide how to handle hair loss before starting treatment.
In some men and women, chemotherapy drugs cause changes that may result in a loss of fertility (the ability to have children). Loss of fertility can be temporary or permanent depending on the drugs used and the patient’s age. For men, sperm banking before treatment may be a choice. Women’s menstrual periods may stop, and they may have hot flashes and vaginal dryness. Periods are more likely to return in young women.
In some cases, bone marrow transplantation and peripheral stem cell support are used to replace tissue that forms blood cells when that tissue has been destroyed by the effects of chemotherapy or radiation therapy.
What does the future hold for chemotherapy?
The medications used in chemotherapy treatments and the timing of their use will continue to change and be improved upon as medical scientists discover the optimal courses for the various foms and stages of cancer.