What to expect at your first chemotherapy session

If you have been diagnosed with cancer, here is your infallible guide to chemotherapy.

When a person is diagnosed with cancer, one of the most common modes of treatment is chemotherapy. But what the treatment entails is often unknown. In this post Dr. J.B. Sharma, Senior Consultant, Medical Oncology, Action Cancer Hospital, Delhi, tells you all you need to know about chemotherapy, how it is done, the different types and remedies to beat the side effects of the treatment.

What is chemotherapy?

Chemotherapy commonly known as chemo is a treatment for cancer. It mainly uses drugs to destroy cancer cells. These drugs get mixed with blood, go through out the body and destroy cancerous cells.

How is it performed?

Chemotherapy can be performed in various ways. They are:

• Oral chemo medications (administered through the mouth)

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  As the name suggests, medicines which can be swallowed orally like capsules, pills, liquids or tablets are Oral Chemo Medications.

• Subcutaneous injection of chemo treatments

  Use of a small needle through which medicine is injected between the skin and the muscle is known as Subcutaneous injection. Usually the injection used to inject Insulin, is used in this process.

• Intra-muscular chemo injections

  These injections are given with a comparatively bigger needle in order to have deeper penetration. In this process, medicine is injected in the muscle layer so as to deposit the medicine in the muscle tissue. Here the absorption of the medicine happens at a faster pace and in a better way.

• Intravenous chemo treatments

  Intravenous treatment allows the medicine to directly get into the blood through the vein and start affecting the patient. This is the most common and most popular way of treatment as they allow flexibility with drug dosing.

• Intra-ventricular or Intrathecal chemo treatments

  This treatment process is used when drugs are required to reach the cerebrospinal fluid (CSF), the fluid which is present in spinal cord and brain.

• Intra-peritoneal chemo treatments

  While giving medicines directly to abdominal cavity this treatment is used. This treatment allows tumor to bathe in the medicines so that the effect is maximum.

• Intra-arterial chemo treatments

  During Intra-arterial treatment, drugs are injected directly into the artery which supplies blood to the tumor. Angiography helps locate blood vessels via special x-ray, so that we can give medicine in the arteries that supply blood to the tumor.

• Intra-vesicular chemo treatments

  Intra-vesicular medications are given with the use of a urinary catheter directly into the bladder.

• Topical chemo treatments

  In case of skin cancer, some creams are directly applied on the lesions which skin absorbs on its own.

How long does each cycle last?

Treatment can be done by giving a single drug or a combination of various drugs, either on a single day or several consecutive days. They can also be given continuously over a period of a few days. Chemotherapy treatment might last a few minutes, hours, or days, depending upon the goal or the protocol doctors are following; and the chemo cycles can be a weekly, bi-weekly, or a monthly cycle.

What kind of immediate effects does the therapy have?

Chemotherapy shrinks tumors that cause pain or pressure and makes tumor cells smaller, reducing their ill effects. In some cases chemotherapy is followed by radiation which is meant to destroy any cancer cells that may have survived chemotherapy. Due to rigorous treatment being done, there can be some immediate side effects of the treatment like anemia, low TLC count (white blood cells), low platelet count, hair loss, blood clotting problems, mouth gum and throat problems like ulcers, loose motions, constipation, nausea, vomiting, effects on skin and nail and flu like symptoms. These are all short term side effects. They stop when the treatment stops.

What long term side effects does it have?

Chemotherapy has very few long term side effects. People who get affected with long term side effects may suffer from permanent organ damage to heart, lung, liver, kidneys, nerves (neuropathy) or reproductive system. In some cases, cognitive functions like concentrating, memory and thinking also get affected. Important point to note down here is that chemotherapy does not have the same side effects in everyone. It affects everyone differently.

How can one help reduce the intensity of the common symptoms?

Intensity directly relates to the amount of chemotherapy which has been given over a specific period of time. In case of severe side effects, a doctor might decide to delay chemo, decrease dose and increase the frequency, which will ultimately lessen the dose intensity. It is important that you ask your doctor about how you can manage the side effects. For this you need to know the following things:

• Have sound knowledge about the treatment plan.
• Follow your doctor's plan or chart about your diet, drinking plenty of liquids, and managing stress.
• Ask your doctor about the side effects which may occur and how they can be treated.
• Talking to people who have already had chemo can also help as they can give you first-hand information about the process.
• Ask for help and support from your family and friends as compassion and someone to talk to can go a long way in helping you cope.

Are there any latest advancements to help people beat the side effects of chemotherapy?

There are many new drugs like Aprepitant, Palonosetron which prevent nausea and help in dealing with drugs very well. Filgrastim is used to prevent neutropenia (low TLC count) 24 hrs after chemotherapy is completed.

Image source: Getty images

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