Description

Chemotherapy

Chemotherapy

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.