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Chemotherapy

Definition

Chemotherapy is the use of drugs to kill bacteria, viruses, fungi, and cancer cells. Most commonly, the term is used to refer to cancer-killing drugs. This article focuses on cancer chemotherapy.

Alternative Names

Cancer chemotherapy; Cancer drug therapy; Cytotoxic chemotherapy

Information

Chemotherapy drugs can be given by mouth or injection. Because the medicines travel through the bloodstream to the entire body, chemotherapy is considered a body-wide (systemic) treatment.

Chemotherapy may be used to:

• Cure the cancer
• Keep the cancer from spreading
• Ease symptoms (when the cancer cannot be cured)

HOW CHEMOTHERAPY IS GIVEN

Depending on the type of cancer and where it is found, chemotherapy may be given in a number of different ways, including:

• Injections or shots into the muscles
• Into the veins (intravenous, or IV)
• Pills
• Shots into the fluid that surrounds the spinal cord or brain

Different chemotherapy drugs may be given at the same time or after each other. Patients may receive radiation therapy before, after, or while they are getting chemotherapy.

Chemotherapy is most often given in cycles. These cycles may last one day, several days, or a week or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months.

Often, the chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home, even when the chemotherapy is given into the veins. Patients and their family members will receive special training.

When chemotherapy is given over a longer period of time, a thin catheter can be placed into a large vein near the heart. The catheter is placed during a minor surgical procedure. This is called a central line or a percutaneously inserted central catheter (PICC).

SIDE EFFECTS OF CHEMOTHERAPY

Chemotherapy medicines work best on cells that divide often to make new cells. This is typical of most cancer cells.

However, some normal cells -- including those found in the blood, hair, and the lining of the gastrointestinal tract -- also divide very quickly. Chemotherapy can also damage or kill these healthy cells.

When this damage occurs, there can be side effects. Some people who receive chemotherapy:

• Are more likely to have infections
• Become tired more easily
• Bleed too much, even during everyday activities
• Feel pain from damage to the nerves
• Have a dry mouth, mouth sores, or swelling in the mouth
• Have a poor appetite and lose weight
• Have an upset stomach, vomiting, and diarrhea

Side effects of chemotherapy depend on many things, including the type of cancer, and which drugs are being used. Each patient reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer side effects.

Your doctor and nurse will explain what you can do at home to prevent or treat side effects, such as:

• Being careful with pets and other animals
• Eating enough calories and protein to keep your weight up
• Preventing bleeding, and what to do if bleeding occurs
• Practicing safe eating and drinking habits, including:
  • Being careful when eating out
  • Knowing how to cook and store foods safely
  • Making sure your water is safe
• Washing your hands often with soap and water

You will need to have follow-up visits with your doctor and nurse during and after chemotherapy. Blood tests and imaging tests, such as MRI or CT scans, will be done to:

• Monitor how well the chemotherapy is working
• Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body

References

Perry MC. Principles of cancer therapy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 192.