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Chemotherapy Treatments

Chemotherapy Treatments

Chemotherapy is a type of treatment that includes a drug or combination of drugs to treat cancer. The goal of chemotherapy is to stop or slow the growth of cancer cells. Chemotherapy is considered a systemic therapy. This means it may affect your entire body. Chemo drugs target rapidly growing cancer cells, but they can also affect healthy cells that grow rapidly.

The term chemotherapy, or chemo, refers to a wide range of drugs used to treat cancer. These drugs usually work by killing dividing cells. Since cancer cells have lost many of the regulatory functions present in normal cells, they will continue to attempt to divide when other cells do not. This trait makes cancer cells susceptible to a wide range of cellular poisons.

Sometimes, chemotherapy is used as the only cancer treatment. But more often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy.

Chemotherapy can make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy. It can destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy. It could also help radiation therapy and biological therapy work well, and destroy cancer cells that have come back (recurrent cancer) or spread to other parts of the body (metastatic cancer).

The chemotherapy agents work to cause cell death in a variety of ways. Some of the drugs are naturally occurring compounds that have been identified in various plants and some are man-made chemicals. A few different types of chemotherapy drugs are briefly described below.

Depending on your type of cancer and how advanced it is, chemotherapy can:

Treatment schedules for chemotherapy vary widely. How often and how long you get chemotherapy depends on:

The patient may receive chemotherapy in cycles. A cycle is a period of chemotherapy treatment followed by a period of rest. For instance, 1 week of chemotherapy followed by 3 weeks of rest. These 4 weeks make up one cycle. The rest period gives the body a chance to build new healthy cells.

Chemotherapy may be given in many ways.

During chemo, you may be vulnerable to infection. There are ways to help protect yourself. Here are some things you can do:

Side Effects with Chemotherapy

The side effects of chemotherapy depend on the type of chemotherapy and the amount given. Anticipating and managing side effects can help to minimize them and provide the best possible experience for the person receiving chemotherapy.

As each person’s individual medical profile and diagnosis is different, so is his/her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.

1. Nausea / Vomiting

According to the National Cancer Institute (NCI), based on the time when the side effects occur, the following are four types of nausea and vomiting associated with chemotherapy to treat cancer:

    • Anticipatory nausea and vomiting
      After receiving a few treatments, some patients feel nausea and begin vomiting in anticipation of the next treatment. The reaction is usually caused by something related to the treatment, like the smell of alcohol or the sight of a medical uniform. Antinausea drugs do not always prevent anticipatory nausea and vomiting. Actions that calm or distract the person work more often. These actions may include guided imagery, hypnosis, relaxation, behavioral modification, or other activities like video games.
    • Acute nausea and vomiting
      The physical reaction that occurs within 24 hours of administration of the chemotherapy can be mild, moderate, or severe. Additional drugs may be given to control the nausea and vomiting. According to the National Cancer Institute, drugs that are commonly given alone or in combination to prevent or treat nausea and vomiting include the following:

    • Delayed nausea and vomiting
      In some patients, nausea and vomiting may occur more than 24 hours after taking chemotherapy. This is more common in patients receiving high doses of chemotherapy, patients who experienced acute nausea and vomiting, women, patients who drink little or no alcohol, and young patients. Drugs that are used for acute nausea and vomiting can also be used in delayed nausea and vomiting.

The brain controls nausea and vomiting. Nausea is controlled by autonomic nerves, which control involuntary bodily functions such as heartbeat and breathing. Various irritants such as smells, taste, anxiety, pain, motion, or digestive chemicals can trigger a vomiting center in the brain to initiate vomiting as a reflex. Many factors influence whether a person will experience nausea and vomiting. Some chemotherapy drugs are more likely to cause reactions than others. Females and persons under the age of 50 are more likely to experience nausea and vomiting. People who are prone to motion sickness or anxiety are more likely to react to chemotherapy with nausea and vomiting.

Managing Nausea and Vomiting:

Sometimes, a combination of antinausea drugs and alternative therapies will help to minimize nausea and vomiting. It is very important to maintain the proper electrolyte balance and to ensure that vomiting does not deplete the body of important nutrients. Report vomiting that lasts more than a day to your physician.

The NCI provides the following tips for dealing with nausea and vomiting:

Eating and drinking

Eating before treatment

Other Tips

2. Hair Loss

Many chemotherapy agents are designed to kill fast growing cells, which means that they attack healthy growing cells as well as cancer cells. Because cells in hair follicles are fast growing, many chemotherapy drugs cause hair loss, or alopecia. People can lose hair from anywhere on the body – the head, eyebrows, eyelashes, and facial and pubic hair. Loss usually occurs one to three weeks into treatment, depending on the specific drugs being given. Once it starts to fall out, hair may simply become thinner or it may fall out altogether.

How to manage the hair loss:

People often choose to wear wigs, scarves, or hats while after losing their hair. If this is what you would like to do, pick them out ahead of time and start wearing them before your hair is completely gone. Other ways to manage your hair during treatment include the following:

Will my hair return

Yes. The color or texture may be different but it usually begins to grow about six weeks after you have completed chemotherapy.

3. Mucositis / Mouth Sores

Mucositis (also known as stomatitis) is the swelling, irritation, and ulceration of the cells that line the digestive tract. These cells reproduce rapidly and have a shorter life span than other cells in the body. Because chemotherapy agents do not differentiate between healthy cells and cancer cells, they can quickly destroy digestive tract cells, breaking down the protective lining and leaving them inflamed, irritated, and swollen. Mucositis can occur anywhere along the digestive tract from the mouth to the anus, and can be aggravated by nausea and vomiting.

What are the symptoms of mucositis?

The following are the most common symptoms of mucositis. However, each individual may experience symptoms differently. Symptoms may include:

The symptoms of mucositis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

What can be done to manage the symptoms?

Symptoms may occur a week or longer after treatment is completed and may not be preventable. However, there are things you can do to reduce the severity of symptoms and provide some level of comfort. To relieve symptoms of oral mucositis, consider the following:

4. Bone Marrow Suppression

Nearly all chemotherapy agents suppress the bone marrow that, in turn, causes a reduction in the number of blood cells. The timing of this reduction varies according to which agents are used for your treatment. Red blood cells carry oxygen, white blood cells fight infection, and platelets help to control bleeding and bruising. Thus, the risks for anemia, fatigue, infection, bleeding, and bruising are increased with bone marrow suppression.

What are symptoms of bone marrow suppression?

The following are the most common symptoms of bone marrow suppression. However, each individual may experience symptoms differently.

Symptoms of a low red blood cell count may include:

Symptoms of a low white blood cell count may include:

Symptoms of a low platelet count may include:

The symptoms of bone marrow suppression may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

5. Anemia

Red blood cells (RBCs) carry oxygen to other cells throughout your body. Chemotherapy can damage your body’s ability to make RBCs, so body tissues do not get enough oxygen, a condition called anemia. People who have anemia may feel short of breath, very weak or tired, dizzy, faint, or short of breath, or may feel that their hearts are beating very fast. Consult your physician immediately if you experience any of these symptoms.

You will be given frequent tests to measure your hemoglobin and hematocrit during your therapy. If these measurements are low, you may be given a medication that can boost the growth of your red blood cells.

If your blood is too low in red blood cells, you may need a blood transfusion or a medication called erythropoietin (also called EPO) to raise the number of red blood cells in your body.

What can I do if I am anemic?

Consider the following strategies to help manage anemia and fatigue:

6. Infection

Many chemotherapy drugs can damage the bone marrow, where blood cells are made. White blood cells are the cells that fight many types of infections, which means that chemotherapy can leave you at risk for infection. The bacteria that cause most infections are normally found on your skin and in your mouth, intestines, and genital tract. Sometimes, the source of an infection is unknown. Infections can happen to people even when they are very careful.

How can I help prevent infections?

The National Cancer Institute (NCI) offers the following suggestions for reducing your risk of infection:

What are the symptoms of an infection?

If you experience any of the following symptoms, consider it a medical emergency and consult your physician right away, before taking any medications:

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