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What is Chemotherapy?

What is Chemotherapy?

Chemotherapy has been used since the days of the ancient Greeks. Chemotherapy for cancer care, however, began with the use of nitrogen mustard in the 1940s. Since then, several new medicines have been created and tested in an effort to discover what is effective in Chemotherapy.

Chemotherapy is most commonly used to identify medications that specifically destroy cancer cells. These are sometimes called “anti-cancer” drugs or “antineoplastic.” The current treatment uses more than 100 medicines to treat cancer. There are still more chemotherapeutic drugs under development and research.

Chemotherapy is often abbreviated as ‘chemo’ and sometimes ‘CTX’ or ‘CTx’. It may be used with curative intent, or it may aim to prolong life or reduce symptoms (palliative chemotherapy).

If Chemotherapy is an effective treatment for you, and what medications you should have, depends on:

  • Your type of cancer
  • The appearance of the cancer cells when looked under a microscope
  • Whether cancer has spread
  • Your overall health

Who Can Take Chemotherapy

Several tumours are susceptible to Chemotherapy. For them, Chemotherapy will work really well. However, certain cancer types do not appear to respond to Chemotherapy well. For that scenario, the doctor might not recommend this as a treatment for you. Chemotherapy can be a difficult procedure, and you need to be well enough to receive it. Older people may have other health issues, which may make them more likely to experience severe or long-term side effects. Some treatments may put pressure on organs like the heart. Doctors ensure that you are healthy enough to start chemotherapy, by testing your pulse, lungs, kidneys and liver functions. Before deciding on a care plan, they look at the advantages and disadvantages of the care and will discuss it with you.

When is Chemotherapy Used?

  • Attempt to absolutely cure cancer (curative chemotherapy)
  • Allow more effective other therapies for example; it can be combined with Radiotherapy (chemoradiation) or used before Surgery (neoadjuvant chemotherapy)
  • Reduce the chance of cancer returning following radiation or Surgery (adjuvant chemotherapy)
  • Relieve symptoms if cure (palliative chemotherapy) is not possible.

How is Chemotherapy Given?

Chemotherapy drugs can be given in different ways. The method of administering the Chemotherapy drug depends on the type of cancer diagnosed and the effectiveness of the drug. Common methods include:

  • Intravenous (IV) Into a vein:IV “intravenous” means “into the vein”. A syringe or central venous catheter is used to deliver the drug directly into a vein. It is the only possible route of administering certain chemo drugs because of its chemical composition. Drugs administered intravenously can also be expected to have a more rapid effect. Intravenous administration may be done either as a rapid injection called “bolus” or as an infusion for a short or long duration.
  • Oral (PO)- By mouth: It is also called PO “per os” meaning “orally” or “by mouth”. The drug may be taken as a tablet, capsule, with water or juice and is absorbed into the blood through the mucosa of the mouth, stomach, and intestine. The medication travels through the bloodstream and is transported to organs that further process. Not every drug can get through the digestive tract to the blood; therefore, other routes of administration may be required.
  • Intramuscular (IM) injection Into a muscle:Intramuscular means “into the muscle”. In this process of administering chemo, the drug is inserted into the muscles, using is a fine needle.
  • Subcutaneous (SC) injection Under the skin:Subcutaneous means “under the skin”. A thin cannula or needle is used to inject the Chemotherapy drug, just below the skin.
  • Intrathecal Therapy(I.Th) Within the spinal canal:

    Intrathecal means “into the cerebrospinal fluid (CSF)”. With the help of a lumbar puncture, the Chemotherapy drug is injected into the CSF to reach the central nervous system (CNS).

  • Intraventricular (I.Ven) Into the brain:Intraventricular means “into the ventricle” of the brain. The Chemotherapy medication is delivered into one of the ventricles in the brain from where it distributes into the central nervous system (CNS).

Where you can have chemotherapy

  • Chemotherapy day-care centres
  • Chemotherapy in hospital
  • Chemotherapy at home

What does Chemotherapy do?

The use of Chemotherapy depends on the type of cancer you have and how spread it is.

  • Cure: In some cases, the treatment may kill cancer cells to the point where your doctor can no longer detect them in your body. The best result after that is that they may never grow back again.
  • Control: In some cases, cancer can either be stopped from spreading to other areas of the body or can delay cancer tumour development.
  • Symptoms of easiness: In some cases, Chemotherapy cannot cure or regulate cancer spread, and is only used to shrink tumours that cause pain or strain. Such tumours also keep on growing again.

What is a Chemotherapy Regimen and Cycle?

A regimen of Chemotherapy is usually administered in cycles. A regimen is the specific combination of Chemotherapy drugs that you will receive and the number of cycles you will undergo at this stage of treatment. Over time, the prescription can change as doctors and nurses see how the body responds to the different medicines. Many patients may have to change their medication several times before finding the one that works best for them.

One of the common terms used when speaking of Chemotherapy is “cycle”. A cycle of Chemotherapy is the repetition of the way a drug or group of drugs is delivered for a given number of days. For example, one cycle may mean taking the medication every day one week and then taking rest the next week. The loop repeats several specified times. The doctors select the drugs and the number of Chemotherapy cycles. They also determine the dosage of the drugs to be administered and how frequently they should be given. Often you will have to change the dosage or dose of a chemo drug because of the way the body reacts to the medications.

Before, during, and after Chemotherapy

Preparing for Chemotherapy

Because Chemotherapy is a serious treatment for a serious condition, it is crucial to plan ahead before the therapy begins. Your doctor and staff at the hospital will help you anticipate possible treatment-related issues. You will undergo a series of tests before you start chemotherapy, to help determine if you are healthy enough for the therapy. You will require heart and Blood Test tests to assess the kidney and liver health. These tests will guide your doctor when deciding what kinds of Chemotherapy can be used for you.

Your doctor may also suggest that you visit your dentist before treatment begins. As Chemotherapy affects the ability of your body to heal, any infection in your gums or teeth may potentially spread all over your body. If you are receiving Chemotherapy via an intravenous ( IV ) line, your doctor may install a port. It is a device that is implanted in your body, typically near your shoulder in your chest. This makes it easier to enter the veins and less painful. The IV line will be inserted into your port over each treatment.

Preparation Tips

Consider these preparation tips for Chemotherapy treatment:

  • Make work arrangements. During chemotherapy, most people can work, but you may want to put yourself on a lighter workload until you know what kinds of side effects you may have.
  • Get your house ready. Stock up on groceries, do your laundries and perform other tasks before starting chemotherapy, as you may be too weak to do these after Chemotherapy.
  • Arrange whatever help you may need. It can be incredibly helpful to have a friend or family member to assist with household tasks or to look after pets or babies
  • Anticipate side effects. Talk with your doctor about potential side effects and how to prepare appropriately. If infertility can be a side effect and you want to conceive a child, you might want to store sperm, eggs or fertilized embryos and freeze them. If Hair loss is likely, you may want to buy head-covers or wigs.
  • Become part of a support group. Talking to someone outside your family and about what you are going through can help you stay optimistic. This will also help to ease any concerns that you may have about medication.

During Chemotherapy

You and your doctor can work together to consider all variables and determine the best course of your treatment. Chemotherapy is usually given in the form of a pill or by injection or an IV directly into the veins. It may also be administered in several other ways, in addition to these two forms.

Chemotherapy administering options include:

Chemotherapy can be administered directly into the tumour, depending on the location of the tumour. If you have to undergo Surgery to remove the tumour, your doctor can, over time, implant slow-dissolving disks that release medicines. Chemotherapy creams can be used to treat some skin cancers. They can be applied directly on the skin. Chemotherapy may be delivered through localized treatment to a specific part of the body, such as directly into the abdomen, chest, central nervous system or through the urethra into the bladder. Some forms of Chemotherapy can be taken as pills by mouth. Drugs for liquid Chemotherapy may be delivered in single shots, or you may have a port. On the first visit, the infusion method with a port may involve discomfort at the injection site, but the port needle will loosen gradually. Where you get treatment depends on the delivery system you have chosen.

If you are using creams or tablets, for example, you can give yourself home treatments. Other procedures usually take place in a hospital or Cancer Treatment centre. Nowadays Chemotherapy can be taken at home itself. Your Chemotherapy schedule will be personalized to suit you, as will how frequently you undergo medication. It can be changed if your body does not respond to the treatment well, or it can be increased or decreased depending on how well the cancer cells respond to treatments.

After Chemotherapy

Your health care provider will track the efficacy of your medications regularly. These will include imaging, blood testing and possibly more. Your health care team can adjust your treatment at any time. The more you will share how Chemotherapy impacts you with your doctor, the better the care experience will be. You must tell them about any side effects or treatment-related issues you are having so they can adjust to your treatment if necessary.

When Do You Need Chemotherapy?

Whether you need Chemotherapy as part of your treatment depends on what type of cancer you have, how big it is and whether it has spread or not. Chemotherapy circulates in the bloodstream in the body. Therefore, cancer can be treated almost anywhere in the body, using Chemotherapy.

Surgery only eliminates cancer from that part of the body where it is located. Radiotherapy also treats only the region of the body to which it is intended.

You might need chemotherapy:

  • For shrinkage of cancer before Surgery or radiotherapy
  • For trying to stop cancer recurrence after Surgery or radiotherapy
  • As a stand-alone therapy if the cancer type is susceptible to it
  • Treat cancer that has spread from where it originated

Chemotherapy before Surgery or radiotherapy

Before surgery, Chemotherapy aims to shrink a tumour so that you will need smaller Surgery or to make it easier to get rid of all the cancer. Shrinking the tumour with Chemotherapy may also mean you can have Radiotherapy to a smaller body area.

This reason for receiving Chemotherapy is called neoadjuvant care before other therapies. Doctors may sometimes call it primary treatment.

Chemotherapy after Surgery or radiotherapy

Following Surgery or radiotherapy, Chemotherapy is aimed at lowering the risk of cancer recurrence in the future. This is called adjuvant therapy. Chemotherapy circulates throughout the body and kills any cancer cell that has travelled away from the primary tumour.

Chemotherapy for blood cancer

Sometimes you may not need Surgery or radiation for Cancer Treatment. You may need only Chemotherapy as treatment. This is for cancers that are very sensitive to chemotherapy, such as Blood Cancer.

Chemotherapy for cancer that has spread

When the cancer has already spread, or there is a risk that the cancer might spread, in the future, the doctor may recommend Chemotherapy. Cancer cells often split free from a tumour and pass through the bloodstream or lymphatic system into other parts of the body. They can settle on different parts of the body and grow into new tumours. Those are called metastases or secondary cancers. The Chemotherapy medications circulate throughout the body inside the bloodstream to kill any spreading cancer cells.

Chemotherapy with radiotherapy

Doctors also recommend both Chemotherapy and Radiotherapy at the same time. That is known as chemoradiation. It may make radiation more effective but may increase side effects as well.

Goals of Chemotherapy treatment

When your doctor has prescribed Chemotherapy as an option to cure your cancer, while making medical choices, it is important to consider the goals of the procedure. Chemotherapy (chemo) has three main goals in cancer treatment:

Cure

Whenever possible, chemo is used to cure cancer, ensuring that the cancer is destroyed it goes away and does not come back. Most doctors use the word “cure” only as a possible or expected result of treatment. So when offering treatment that may have a chance of curing a person’s cancer, the doctor might describe it as a curative-intentioned treatment.

Though cure can be the goal in these circumstances and is the expectation of those who have cancer, this is not always the way it turns out. Knowing that a person’s cancer is truly cured often takes several years.

Control

When a cure is not achievable, Chemotherapy may try to control the disease. Chemo is used in such situations to shrink tumours and/or avoid the development and spread of cancer. This can help cancer patients feel better and live longer.

The cancer does not go away entirely in many cases, but it is monitored and treated as a chronic condition, much like heart disease or diabetes. The cancer can go away for a while in many cases but it is likely to come back.

Palliation

Chemo may also be used to relieve cancer-caused symptoms. It is called palliation, or palliative chemotherapy, or palliative-intentioned therapy.

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