The use of medicines to treat cancer, is called Chemotherapy. In Chemotherapy medications go into the bloodstream and spread around the body to enter and kill cancer cells. Chemo is a frequent part of treatment for bone cancers like Ewing sarcoma and osteosarcoma treatment.

Chemotherapy is not commonly used for other cancers of the bone, such as giant cell tumours, chordomas and chondrosarcomas. These types of bone cancer do not react to Chemotherapy. In a certain form of chondrosarcoma called mesenchymal and high-grade dedifferentiated chordomas chemo can be useful. This can be used for other giant cell tumours, along with Targeted therapy.

Chemo is also used to treat bone cancer, which has spread to the lungs and/or other organs via the bloodstream.

Commonly used Chemotherapy drugs, in bone cancer include:

• Doxorubicin
• Cisplatin
• Etoposide
• Ifosfamide
• Cyclophosphamide
• Methotrexate
• Vincristine

Side effects of chemotherapy

Chemo destroys cancer cells, but some normal cells still get hurt. During treatment, you will be closely monitored, and your team will try to prevent or reduce side effects. Side effects of chemothrepay depend on the type of medications, the dosages used, and the amount of time they are administered.

Some common side effects to the short term include:

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores

Telling the cancer care team of any side effects you have is crucial so they can be treated. Chemotherapy can affect the bone marrow cells that produce blood, so you could have low blood cell counts. The outcome could be low blood cell counts:

• Increased risk (too few white blood cells) of infection.
• Quick bleeding or swelling (too few platelets) following minor cuts or injuries.
• Fatigue (too few red blood cells) or shortness of breath

The doctor will prescribe laboratory tests when you are having chemo to make sure the blood cell counts are at healthy levels.

Some side effects are related to specific drugs. Example:

Ifosfamide and cyclophosphamide have the ability to damage the bladder lining and cause bloody urine. This is called hemorrhagic cystitis. It can be avoided by using a drug called mesna along with the Chemotherapy. Cisplatin can cause nerve damage (referred to as peripheral neuropathy) leading to numbness, tingling, and even Pain in the hands and feet. Even kidney damage (called nephropathy) may occur after cisplatin treatment. Giving lots of fluid can help prevent this. Cisplatin may occasionally cause hearing problems (known as ototoxicity). Most frequently patients with this problem have difficulty hearing high-pitched sounds. Your doctor may suggest you take a hearing test before they give cisplatin. Doxorubicin can harm the heart, over time. The risks increase as the overall quantity of medication increases. Your doctor can check your heart function before you give doxorubicin to make sure it is safe for you.

It is important to know that many of the extreme side effects are uncommon but may occur to anyone. Speak to the cancer-care team and you know what to expect from the chemo.

The doctors and nurses will be closely watching for side effects. There are remedies for most side effects, but it is important to prevent them. Some side effects, if not all, should go away over the course of time after treatment is over. You should not hesitate to ask any questions about side effects to your cancer care team.