Learn more about cancer chemotherapy

Cancer is a condition in which abnormal cells form in the body and keep growing in an uncontrolled manner. Treating cancer therefore aims at killing these cells or preventing their multiplication, at the very least. The use of drugs for such a purpose is known as chemotherapy, sometimes abbreviated as chemo. Traditional drugs used in chemotherapy act on cancerous cells that undergo rapid division; however, they cannot distinguish these from other cells that normally divide rapidly such as those in the bone marrow and this results in several side effects. The more recent drugs however have the ability to target specifically the cancerous cells and therefore, have fewer side effects.

How Chemotherapy Acts

Depending on the particular drug used, chemotherapy acts in different ways to achieve one of several objectives it can destroy the abnormal cells or slow down their growth. Some drugs act to prevent the cancerous cells spreading from one area to another. This form of treatment may be combined with radiation therapy or surgery for better results.

Depending on the specific result to be achieved, chemotherapy drugs may be injected into the vein or muscle, or be administered as a liquid or a pill to be swallowed, or even applied on the skin.

Types of Drugs Used

An oncologist chooses the chemotherapeutic drug depending on the nature of the cancer being treated.

Alkylating agents are drugs that damage the DNA of the cancerous cells and therefore, stop their reproduction.

Anti-metabolites interfere with the growth of both DNA and RNA in the cancer cells.

Certain antibiotics are also used in chemotherapy, and they disrupt the action of the enzymes that participate in the reproduction of cells by acting on the process of DNA replication.

A few plant-based alkaloid compounds inhibit the formation of proteins that play a role in cell reproduction.

Some cancers can also be treated with steroids although more often, steroids are used to suppress the vomiting that accompanies chemotherapy.

Cancers that affect organs of the reproductive system may be treated by the use of sex hormones or drugs that are chemically similar to these; these agents cannot destroy the cancer cells, but prevent them from using the hormones they need for growth.

A more recent form of chemotherapy is the use of drugs that stimulate the body's immune system to recognize and fight against the cancer cells.

Important Points to Remember

Chemotherapy treatment is generally administered in the form of a cycle, made up of doses of medication, with gaps in between. A doctor decides when, how often and for how long to administer the drugs depending on the extent of cancer, the strength of the drug, as well as the patient's ability to cope with the side effects. Missing a dose can reduce the effectiveness of the treatment and therefore, it is critical that patients stick to the prescribed cycle of chemotherapy. Of course, there may be situations when the doctor may delay a cycle or change the dosage or frequency of the cycle based on an assessment of how the patient is responding.

Chemotherapy does not necessarily require hospitalization; some drugs may be administered on an outpatient basis, too.

Many patients receive well-meaning advice from members of the family, friends and neighbours regarding some herbal or traditional medicine that has helped someone they know with cancer. However, it is important to realize that the ingredients in these may interfere with the action of the chemotherapeutic drugs; so, always speak to your doctor before combining such medicine with chemotherapy

Chemotherapy can lead to several side effects, with fatigue, vomiting and hair loss being the most common ones. While you may not generally require bed rest, it is almost definite that you should give yourself enough time to rest, and avoid strenuous or stressful activity till you feel better. Therefore, it is vital you plan your day depending on how you feel and how much rest you need. Many patients find that hiring someone to help with the housework, or having a family member to come over and help during chemotherapy makes the situation easier for the entire family. Working people who experience the side effects intensely will probably need to take leave for a few days following a cycle of chemotherapy, until they feel strong enough to cope with the demands of the workplace.

Side effects

Chemotherapy can have a few side effects but not everyone will suffer from them with the same intensity. One of the most common side effects is a sense of fatigue accompanied by nausea and vomiting and hair loss. Some people also experience a distinct loss of appetite along with dry and sore skin.

When a person is on chemotherapy, the immune system is drastically suppressed and this can make him or her highly susceptible to infections. Any episode of a high fever accompanied by muscle pain, shivering, difficulty in breathing, vomiting and diarrhea and bleeding from the nose, gums or other body parts can be indicative of a severe infection and requires immediate medical attention.

Quite a few patients may also experience a loss of libido that lasts throughout the duration of the chemotherapy; this, however, gets corrected once the treatment is completed.

Fertility Preservation for Patients on Chemotherapy

Certain chemotherapeutic agents may render the patient infertile; if there is a risk of permanent infertility, the doctors will caution the patients and discuss this aspect before beginning treatment. Thanks to the advances in medical technology, it is now possible to preserve fertility in both men and women before they undergo chemotherapy. Sperm can be obtained from male patients and frozen to preserve them for use in the future; in women, the mature eggs can be extracted out of the body, fertilized with sperm from the partner, and the resulting embryo can be frozen to preserve it for later implanting into the uterus. In girls who have not yet attained puberty, mature eggs are not available, but it is possible to preserve the ovarian tissue that contains immature eggs, which can be later re-implanted into the patient, to produce mature eggs.

Cost of Chemotherapy

The cost of chemotherapy varies from one patient to another depending on the drugs being used, the number of cycles, and the frequency with which they are administered. If the cycle is given on an inpatient basis, there will be additional costs of hospitalization and some patients may also need to spend on diagnostic tests that are necessary to help the doctor fine-tune the dosage. All in all, these costs could range anywhere between Rs. 2,00,000 to Rs. 5,00,000 and you could expect some relief if you have a health insurance policy. Most health policies provide for cover for chemotherapy expenses even without the rider of minimum hospitalization duration of 24 hours.

Dealing with the Stress

More than the physical discomfort, many patients on chemotherapy find the emotional roller-coaster ride tends to drain them out. In some persons, constant anxiety and stress about the treatment and the side effects may even lead to depression and it is vital to take steps to avoid this. Speaking to a family member or a close friend or joining a support group can help to reduce the sense of being isolated; however, if the feelings of depression persist, it is best to speak to the doctor who may recommend medication to help cope better.

Although chemotherapy is becoming increasingly common as a mode of cancer treatment, several myths abound regarding its use. On the one hand, there are patients who worry that they will have all the unpleasant side effects they have heard someone vividly describe; on the other, we have patients who think chemotherapy will be the only thing they need to get cured of the cancer. The truth actually lies somewhere in between.

While it is true that chemotherapy causes side effects, the intensity of these depends on the nature of the cancer, the specific drug used and the doses that are used and also how a particular individual's body reacts to the medication. Following completion of chemotherapy, a patient may experience relief from the side effects, but the actual recovery process can take some time. It may take a few months to begin feeling the results of the chemotherapy and in some cases, a doctor may choose to combine this treatment with radiation or surgery.

Read more about causes, symptoms, diagnosis and treatment of cancer.

For more articles on cancer, visit our cancer section. Follow us on Facebook and Twitter for all the latest updates! For daily free health tips, sign up for our newsletter. And to join discussions on health topics of your choice, visit our forum.