+A A-

Chemotherapy

Image title


Chemotherapy means use of medicines that contain chemicals to kill cancer cells.  


Chemotherapy is also called as anti-cancer treatment or anti-neoplastic treatment.


In treatment of cancers, chemotherapeutic agents can be used alone or in combination. Chemotherapeutic drugs can be administered into a large vein of the body or the chemotherapy pill can be taken by mouth. However, thanks to advancements in the field of chemotherapy, various administration methods are now introduced into the clinical practice. For colon and rectum cancers and ovarian cancers, the chemotherapeutic agent is diluted and warmed before it is instilled into abdominal cavity; this method is also called “Hot Chemotherapy” and “Hypothermic Intraperitoneal Chemotherapy (HIPEC)”. Moreover, intrapleural (into the thoracic cage) and intrathecal (into the central nervous system) administration are available.


Since very potent active substances are used in chemotherapy preparations and they spread to the whole body, healthy cells are influenced along with cancer cells.  This is the basic underlying mechanism behind the side effects of the chemotherapy.  On the other hand, infection, multi-organ dysfunctions, heart failure and nutritional disorders are also common in cancer patients. Both those side effects and presence of comorbidities require a multidisciplinary approach in the treatment of cancer.


Chemotherapy can be used to treat a cancer, slow down the growth of tumor, reduce the size of tumor before surgery or radiotherapy, to cancer cells that may remain after surgery, and to treat or relieve tumor-related complications, if no definitive treatment is available.


There is no single chemotherapeutic agent that can be used to treat all types of cancers. There are, now, almost one hundred chemotherapy medicines with proven efficacy for different types of cancers. On the other hand, more than one chemotherapeutic preparation can be used in combination (sequentially or concomitantly) depending on the type and stage of the cancer. Chemotherapy protocol implies a chemotherapy that is planned according to type and stage of the cancer and that is administered and paused for particular intervals. In a chemotherapy protocol, one or more than one chemotherapeutic agent is administered at a certain dose, for a definite period of time (e.g., 28 days), and each chemotherapy drug is administered on a particular day (e.g., first day, fifth day). Each one of these treatments is referred to as a cycle. Your doctor will inform you in detail about the medicine(s) to be used, the doses, the day they will be administered and total duration of the treatment. While some chemotherapy drugs are taken by patients in a routine daily life, other are needed to be administered at hospital under supervision.


Since many factors should be taken into consideration while a chemotherapy is planned, you should certainly ask all your questions and concerns about the chemotherapy planned for you to your doctor.



Risks

Chemotherapy drugs cause a wide spectrum of side effects. Although each chemotherapy drug has a unique profile of side effects, severity of these side effects is also affected by your health status and the dose of the drug.




Common side effects caused by chemotherapy drugs include:

    • Fever
    • Nausea
    • Vomiting
    • Diarrhea
    • Constipation
    • Lack of appetite
    • Changes in hematological parameters (counts of white blood cells, red blood cells and platelets)
    • Mouth sore
    • Susceptibility to bleeding
    • Fatigue
    • Hair loss


Your doctor will consider the side effects listed above as well as other possible side effects you may experience in order to initiate appropriate treatments in a timely manner. Moreover, other medical specialist may also be involved in management of side effects, considering the side effects experienced and their severity.



Treatment Process

Since chemotherapy drugs affect healthy cells of your body along with cancer cells, it is necessary to check your health status to determine whether your body is ready to cope with both therapeutic and side effects of chemotherapy before a chemotherapy is started. Therefore, your heart, kidneys, lungs and liver are examined and other tests, such as blood and urine tests, imaging studies and ECG, are ordered. If a problem is identified, it is necessary to stabilize a comorbidity before chemotherapy begins.


Since chemotherapy drugs compromise blood cells that fight against infection, you will be more prone to infections after chemotherapy is initiated. Accordingly, you will need to have various tests to investigate whether there is an infection in your body, and you will also be referred to a dentist to determine a possible infection.


For couples at the childbearing age who plan pregnancy after completion of the chemotherapy, counseling to an In Vitro Fertilization specialist will also be needed. If the disease-related conditions allow, sperms or eggs are retrieved, frozen and stored for the future use.


The fact that chemotherapy drugs cause some side effects is unavoidable, irrespective of whether chemotherapy pill is taken by mouth in a routine daily life or the chemotherapeutic agent is administered into a vein at a hospital under supervision. You will need to modify your home and work life due to these side effects. The vulnerability to infection caused by chemotherapy will pose a risk both for you and your family members. You may feel fatigue and tired. In this case, you may need to institute methods to use your energy more efficiently. You should absolutely ask your treating healthcare team what to do during and after chemotherapy.


You will need to visit your medical oncologist at regular intervals throughout your chemotherapy. Response of your body to chemotherapy and your general health status will be evaluated in these visits. The dose or even the chemotherapy drug can be changed after your response to treatment, general health status and side effects are taken into consideration. In addition, you should call your doctor immediately if you experience a symptom other than ones specified by your doctor.