Free Cancer Report

Know Your Cancer

Chemotherapy as treatment for breast cancer

Chemotherapy for Breast Cancer uses medications to destroy and kill Breast Cancer cells. Such medications are generally delivered by a needle or as a tablet directly into a vein. Besides other therapies, such as surgery, radiation, or hormone therapy, Breast Cancer Chemotherapy is commonly used. Receiving Breast Cancer Chemotherapy can improve the possibility of a cure, decrease the risk of returning cancer, reduce cancer symptoms or help people with cancer live longer with a better quality of life. Chemotherapy can control Breast Cancer if the cancer has recurred or spread to help you live longer. Breast Cancer Chemotherapy often carries a risk of side effects — some transient and mild, some more serious or permanent. The doctor is able to help you determine if Breast Cancer Chemotherapy is a safe option for you.

Why is Chemotherapy given in breast cancer?

Breast cancer Chemotherapy can be given in following situations:

Chemotherapy for early Breast Cancer after surgery

After you have a breast Surgery to remove a tumour, your doctor can prescribe Chemotherapy to kill any undetected cancer cells and to reduce your recurrent cancer risk. This known as adjuvant Chemotherapy.

The doctor may prescribe adjuvant Chemotherapy if you have a high risk of recurring or spreading the cancer to other parts of your body (metastasizing), even though after Surgery there is no evidence of cancer. When cancer cells are present in lymph nodes near the breast with the tumour, you could be at greater risk of metastasis.

When considering adjuvant chemotherapy, ask your doctor how much the Chemotherapy will lower the risk of returning to cancer. Together you should balance this decreased risk against the Chemotherapy side effects. Also, discuss other alternatives with your doctor, such as hormone-blocking therapy, which might be effective in your situation.

Chemotherapy before Surgery for early breast cancer

Chemotherapy is often given to reduce larger tumours before Surgery (neoadjuvant therapy). This could:

Allow the surgeon the best chance to fully remove the tumour

Require the surgeon to remove only the tumour, not the whole breast.

Increasing the level of disease in lymph nodes, requiring less invasive treatment of the lymph nodes

Minimize risk of cancer returning

Allow assessment of the tumour response to therapy to help explain the prognosis and choose the best drug for chemotherapy

Neoadjuvant therapy is often used for:

  • Inflammatory breast cancer
  • HER2-positive breast cancer
  • Triple-negative breast cancers
  • High-grade tumours
  • Cancers that spread to the lymph nodes
  • Large tumours

Treatment to reduce Breast Cancer risk

Preventive drugs (called chemoprevention) minimize the risk of Breast Cancer in women with high disease risk. They typically include drugs that block estrogen, such as selective modulators of estrogen receptors and aromatase inhibitors. Such medications carry a risk of side effects, so doctors reserve such medicines for women who are at high risk for Breast Cancer. Talk with your doctor about the benefits and risks.

Chemotherapy as the primary treatment for advanced breast cancer:

If Breast Cancer has spread to other areas of the body, and Surgery is not an option, the primary treatment could be Chemotherapy. This should be used alongside guided counseling.

The primary goal of advanced Breast Cancer Chemotherapy is usually to enhance efficiency and survival, rather than cure the disease.

Chemotherapy medications used for early Breast Cancer diagnosis include:

Anthracyclines: This class of drugs includes doxorubicin and epirubicin

Taxanes: This class of drugs includes docetaxel and paclitaxel

These drugs are often used with others like carboplatin, cyclophosphamide, and fluorouracil.

Drugs used to treat advanced Breast Cancer include:

  • Albumin-bound paclitaxel
  • Capecitabine
  • Eribulin
  • Gemcitabine
  • Ixabepilone
  • Liposomal doxorubicin
  • Mitoxantrone
  • Vinorelbine

Side effects of Chemotherapy in breast cancer

Chemotherapy drugs travel all over the body. Side effects depend on the medications you are taking and the reaction to them. Within the course of treatment, side effects may get worse. Most side effects are transient and subside as soon as treatment is complete. Chemotherapy can have long-term, or lasting consequences in some situations.

Short Term Side Effects

Chemotherapy drugs can also damage other fast-growing healthy cells in the process of targeting rapidly growing cancer cells, such as those in the hair follicles, bone marrow, and digestive tract.

Several Chemotherapy drugs can affect nerve endings in your hands and feet, leading to numbness, pain, burning or tingling, cold or heat sensitivity, or weakness in your limbs. Such side effects often go away after treatment is done, or within one year after Chemotherapy is done. Those can be long-lasting in some situations.

“Chemo brain,” “chemo fog” and “chemo memory” are terms used to describe the controversial and incomprehensible short-term memory and concentration issues that may arise following Chemotherapy. In most cases, these issues go away within one year after the Chemotherapy is complete.

Common short-term side effects include:

  • Hair loss
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Constipation or diarrhoea
  • Mouth sores
  • Skin and nail changes
  • Increased risk of developing infection (due to fewer white blood cells that help fight infection)
  • Nerve damage (neuropathy)
  • Problems with cognitive function that affect memory and concentration

Long-term side effects

Some Chemotherapy drugs for Breast Cancer can cause long-term side effects, including:

Infertility: Infertility is one possible side effect, which may not go away. Some anti-cancer drugs damage ovaries. This can cause symptoms of menopause, such as hot flashes and vaginal dryness. Menstrual cycles (amenorrhea) may become irregular or may cease. If ovulation stops, it becomes impossible to get pregnant.

Chemotherapy can induce a permanent premature menopause, depending on your age. Discuss your risk of enduring menopause and its consequences with your doctor.

When you keep on menstruating, you can still be able to become pregnant, even during care. However, because the results of Chemotherapy are risky for the foetus, consult with your doctor about options for birth control before beginning treatment.

Osteoporosis and Osteopenia: Women who undergo menopause early due to Chemotherapy may have a greater risk of osteopenia and osteoporosis in the bone-thinning conditions. These women are generally recommended to have periodic tests of bone density and, possibly, treatments to prevent further loss of bone.

Heart damage: Chemotherapy carries a slight risk of heart muscle weakening and causing other heart problems.

Breastfeeding: Breast Cancer Chemotherapy will rarely cause secondary cancer, such as blood cell cancer (leukaemia), several years after completion of the Chemotherapy.

Other side effects: Feelings of fear, sadness and isolation may compound the chemotherapy's physical side effects, both during and after treatment. You constantly get in touch with and help from oncologists and nurses during Chemotherapy. All involved is working for the same target-completing treatment with the best result possible. Once it is over, you will feel as though you are on your own, with no one to help you back to regular life or cope with recurrence of Breast Cancer fears.

Consider talking to a mental health professional who works with cancer-stricken people. Talking to someone who has been in the same situation could also help. Connecting with others via a cancer survivor hotline, support group or online community.

Chemotherapy for Cervical Cancer

Chemotherapy (chemotherapy) uses anticancer medications that are pumped into a vein or delivered by mouth. These medications penetrate the bloodstream and can reach almost all regions of the body making this therapy effective in most parts of the body to kill cancer cells.

Not all women with Cervical Cancer require chemo, but a few circumstances when it can prescribed are:

As part of the main treatment for cervical cancer

The recommended therapy for some stages of Cervical Cancer is radiation and chemo (called combined chemoradiation) given together.

The chemo can work better with radiation. Concurrent chemoradiation methods include:

Cisplatin given weekly during radiation. This medication is injected into a vein (IV) before appointment for radiation. (If cisplatin is not a good choice, carboplatin may be used.)

Cisplatin plus 5-fluorouracil (5-FU) given on radiation every 3 weeks.

For Cervical Cancer that has spread or come back after treatment

Chemo can be used to treat Cervical Cancer that has spread (advanced cervical cancer) to other organs and tissues. This can also help if Cervical Cancer returns after chemoradiation (recurring cervical cancer) diagnosis.

The Chemotherapy most widely used for treating Cervical Cancer that has returned or spread to other areas include:

  • Cisplatin
  • Carboplatin
  • Paclitaxel
  • Topotecan

Combinations of these drugs are often used.

Some other drugs can be used as well, such as docetaxel, ifosfamide, 5-fluorouracil, irinotecan, gemcitabine and mitomycin. Bevacizumab, a targeted drug, may be added to chemo.

How is Chemotherapy given?

Chemotherapy for Cervical Cancer is typically administered into a vein (IV), either as an injection over a few minutes or as a vein infusion over a longer period of time. It can be done in the office of a doctor, in the infusion center, or in a hospital setting.

Chemo is administered in cycles, followed by a rest period to give you time to recover from the drug effects. Cycles usually last weekly or for 3 weeks. Timing varies according to the medications used. Of example, the chemo is given only on the first day of the cycle, for other medications. It is given, together with others, in a row for a few days, or once a week. Then the chemo schedule repeats at the end of the cycle, in order to continue the next cycle.

Often giving chemo needs a slightly larger and sturdier IV. These are known as CVCs, Central Venous Access Devices (CVADs), or Central Lines. They are used right into your blood to put medicines, blood products, nutrients, or fluids. These can also be used for blood testing.

Numerous different types of central venous catheters (CVCs) exist. The most common types are the PICC line and the port.

Side effects of Chemotherapy for cervical cancer

Chemotherapy destroys cancer cells but also damages some normal cells, which may contribute to certain side effects. Side effects depend on the form and dosage of the medications and how long you are being treated. Many side effects are short-term and go away after treatment has been completed, but some can last a long time, or even be permanent. If you have some side effects, it is important to inform your health care team, because there are many ways to reduce them.

Common short-term Chemotherapy side effects may include

  • Nausea and vomiting
  • Loss of appetite
  • Hair loss
  • Mouth sores
  • Fatigue (tiredness)

Because Chemotherapy can damage the bone marrow's blood-producing cells, the counts of blood cells may become low. This might lead to:

  • An increased risk of infection from white blood cell deficiencies (called neutropenia)
  • Bleeding or bleeding following minor wounds or fractures due to a lack of Platelets in the blood (called thrombocytopenia)
  • Breath shortening or weakness due to low rates of red blood cells (called anaemia)

The side effects are also more severe when chemo is combined with radiation. Nausea, tiredness, Diarrhoea and low blood issues also get worse.

Your health care staff will be monitoring for side effects and will be able to give you medications to help avoid or treat them so that you feel better. You can be given medications for example to help avoid or reduce Nausea and Vomiting.

Long-term Chemotherapy side effects can include:

Menstrual changes: Changes in menstrual periods are a common side effect of chemo for younger women who have not had their uterus removed as part of the treatment. Yet even though you interrupt your cycles while on chemo, you may still be able to get pregnant. It is not safe to get pregnant while receiving chemo, as this could lead to birth defects and interfere with treatment. Patients who have finished treatment (such as chemo) and also want to have kids, it is important to speak to the doctor about what this is safe to do.

Premature menopause (with no more menstrual periods) and infertility (without being able to become pregnant) can occur and can continue. Some chemo-drugs are more likely than others to cause this. The older a woman gets chemo, the more likely she will become infertile as a result, or go into menopause. There is an increased chance of bone loss and osteoporosis if this occurs. Medicines are available which can cure or help prevent bone loss problems.

Neuropathy: Some drugs used in the treatment of cervical cancer, including paclitaxel and cisplatin, can damage nerves outside the brain and spinal cord; Sometimes the injury can lead to symptoms such as numbness, pain, burning or tingling sensations, cold or heat sensitivity, or weakness, mostly in the hands and feet. This was known as Peripheral Neuropathy. In most cases this gets easier or even goes away until the medication is stopped, but in some women it through last a long time.

Nephrotoxicity: Cisplatin, the primary chemo drug to treat cervical cancer, can damage the kidneys (also called nephrotoxicity). The damage is avoidable and reversible at times, but the damage can be long lasting at times. There are often no symptoms but the damage can be seen on routine blood work done while chemo is given. Cisplatin is typically stopped when kidney damage occurs, and carboplatin can be used instead.

Additional side effects are likely, too. Some of these are more common in other chemotherapies. Ask the cancer care team to tell you about the potential side effects of the medications that you get. Source: www.cancer.org/cancer/cervical-cancer/treating/chemotherapy.html

Chemotherapy for Bone Cancer

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 affects 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 to take a hearing test before they give cisplatin. Doxorubicin can harm the heart, over time. The risks increases 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 any one. 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.

Chemotherapy Treatment for Brain Tumours

For some brain tumours, drugs can be directly given into the cerebrospinal fluid ( CSF, the fluid that bathes the brain and spinal cord). Chemotherapy can be given either in the brain or into the spinal canal below the spinal cord. A thin tube known as a ventricular access catheter may be inserted through a small hole in the skull and into a brain ventricle to help with this.

Chemo is typically used for more rapidly growing brain tumours. Some forms of brain tumours, such as medulloblastoma and lymphoma, appear to respond to chemo better than types of tumours. Chemo is not as effective in the treatment of certain other tumour types, such as tumours in the spinal cord, and it is less widely used for such tumours.

Chemo is most often used in conjunction with other treatments, such as Surgery and/or radiation. Chemo can also be used on its own, particularly for more advanced tumours or tumours that have returned after other treatments.

Some of the chemo drugs used to treat brain and spinal cord tumours include:

  • Carboplatin
  • Carmustine (BCNU)
  • Cisplatin
  • Cyclophosphamide
  • Etoposide
  • Irinotecan
  • Lomustine (CCNU)
  • Methotrexate
  • Procarbazine
  • Temozolomide
  • Vincristine

Depending on the type of Brain Tumor these drugs may be used alone or in combinations. Chemo is given in cycles, with each treatment period followed by a recovery period to allow the body time to heal. Each period usually lasts for a couple of weeks.

Possible side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs, and how long treatment lasts. Common side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Increased chance of infections (from having too few white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets)
  • Fatigue (from having too few red blood cells, changes in metabolism, or other factors)

Many of the most effective brain tumour drugs appear to have less of such side effects than other popular Chemotherapy drugs. Typically, majority of side effects go away after treatment is complete. Other side effects are also reduced.

Some chemo-drugs can also cause some rare side effects. Cisplatin and carboplatin for example can also cause kidney damage and loss of hearing. A doctor will monitor a kidney function and hear if you have these drugs. Many of those side effects can last after stopping treatment.

Chemotherapy for Colorectal Cancer

Chemotherapy is commonly used to treat Colorectal Cancer. Chemotherapy is the use of drugs to kill cancer cells.

When is Chemotherapy used for colorectal cancer?

Chemo can be used for Colorectal Cancer at various times during treatment:

Adjuvant Chemotherapy is given after Surgery. The aim is to destroy any cancer cells that may have been left behind during Surgery because they were too small to see, as well as cancer cells that may have dispersed from the main tumor and spread in other areas of the body but are too small to be seen on imaging tests. This helps to reduce the risk of cancer returning. Neoadjuvant chemo (sometimes with radiation) is administered before Surgery to try to shrink the cancer and make removal easier. Often this is based on Rectal Cancer. For advanced cancers that have spread to other organs like the liver, chemo can be used to help shrink tumours and ease problems they are causing. While it is not likely to cure the cancer, this often helps people feel better and live longer.

How is Chemotherapy given?

Chemotherapy can be given in different ways.

Systemic chemotherapy: Drugs are inserted into a vein in your blood or you administer them by mouth. The medications go through the bloodstream, entering all parts of the body. That can help to reduce the risk of spreading Colorectal Cancer to other parts of the body. Regional chemotherapy: Drugs are put right into the artery leading to the part of the tumour in the body. Which focuses the chemo on the area's cancer cells. It eliminates side effects by constraining the amount of medication that enters the rest of the body. Hepatic artery injection, or chemo delivered directly into the hepatic artery, is an example of often used regional Chemotherapy for cancer that has spread to the liver.

Doctors give chemo in cycles to give the body time to recover, with each treatment followed by a rest period. Chemotherapy cycles generally last approximately two to four weeks. People usually get a minimum of several treatment cycles.

Chemotherapy drugs used to treat colorectal cancer

Some drugs commonly used for Colorectal Cancer include:

  • 5-Fluorouracil
  • Capecitabine
  • Irinotecan
  • Oxaliplatin
  • Trifluridine and tipiracil, a combination drug in pill form

Side effects of chemo

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. However, other cells in the body, such as those in the bone marrow (where new blood cells are formed), mouth and intestine lining, and hair follicles, are also rapidly dividing. Chemo can affect these cells too, which can result in side effects.

Chemo's side effects depend on the type and dosage of drugs given, and how long you are taking them.

Common Chemo side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Increased chance of infections (from having too few white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets)
  • Fatigue (from having too few red blood cells)

Other side effects are specific to certain drugs. Example:

Hand-foot syndrome can develop by capecitabine, when given as an infusion. This can begin in the hands and feet as redness, and then progress to Pain and discomfort in the palms and soles. The skin will blister or peel, if it worsens, often leading to painful sores. It is important to inform your doctor about any early signs right away, so you can take action to prevent things from getting worse.

A common side-effect of oxaliplatin is neuropathy (nerve damage). Symptoms include tingling, numbness and even Pain in the hands and feet. This may also cause extreme heat and cold discomfort in your mouth, oesophagus (the tube that connects the mouth to the stomach), and the palms of your hands. When swallowing liquids or holding a cold glass this may cause discomfort. When you are having oxaliplatin, discuss side effects with your doctor beforehand, and let him or her know immediately when you experience numbness and tingling, or other side effects.

Oxaliplatin can cause allergic or adverse reactions in some people, while receiving the drug. Symptoms can include skin rash; tightness of the chest and breathing difficulties; back pain, or feeling dizzy, lightheaded or weak. If you notice any of these symptoms while you are getting chemo, be sure to tell your nurse immediately.

Diarrhoea is a common side effect of all of these medications, but with irinotecan it can be especially severe. To avoid serious dehydration it must be treated promptly — at the first loose stool. This involves taking a drug such as loperamide. If you receive a chemo drug that is likely to cause diarrhoea, your doctor will advise about what medications to should take, and how long to take them to control this problem.

Most of these side effects tend to fade in the course of time after ending treatment. Others, such as oxaliplatin hand and foot numbness, will last long. Complementary and alternative medicine cane also relieve the side effects.

Be sure to answer any questions with your cancer care team about side effects. Please record any adverse effects or changes that you experience when you get chemo, and they can be treated immediately. In certain cases, the doses of the chemo medications may need to be increased, or therapy may need to be postponed or halted to help prevent the condition going. Some types of chemo for Colorectal Cancer seem to be fairly well tolerated by the older people. Age is no excuse for otherwise safe people to refuse medication

Chemotherapy for Gallbladder Cancer

Chemo may benefit certain people with cancer of the gallbladder although it is not yet clear how effective it is for this form of cancer. Also, in this way, chemo may be used:

After Surgery to remove cancer: Chemo can be given following Surgery (often with radiation therapy) to try to reduce the chance of cancer returning. This is called adjuvant treatment. Doctors are still not sure how effective it is in the treatment of cancer in the gallbladder. As part of the primary treatment for advanced cancers. Chemo may be used (with or without radiation therapy) for more advanced cancers that can not be removed or have spread to other areas of the body Chemo does not cure such cancers, but it can help people live longer. As a palliative therapy: Chemotherapy can help shrink tumours or delay their growth for a period of time. This can help relieve cancer symptoms, for example by shrinking tumours that press on the nerves can relieve Pain.

Doctors give chemo in cycles, with each treatment period followed by a rest period giving the body time to heal. Chemo cycles usually last around two to four weeks. Chemotherapy is not generally prescribed for patients with poor health.

Hepatic artery infusion (HAI)

Since it is not always effective for gallbladder cancer to administer chemo through a vein (IV), doctors have found a better way to deliver it directly through the main artery that goes through the liver. The artery is called the hepatic artery. Also, the healthy liver removes much of the medication left before it reaches the rest of the body. That can reduce the side effects of the chemo. HAI can help some people whose cancer can not be removed via Surgery live longer, but more work is required. Sometimes this procedure involves Surgery to insert a catheter in the hepatic artery but many people are not well enough to have this Surgery.

Drugs used to treat gallbladder cancer

The chemo drugs most often used for gallbladder cancer include:

  • Gemcitabine
  • Cisplatin
  • 5-fluorouracil
  • Capecitabine
  • Oxaliplatin

In some cases, 2 of these drugs are combined. Combining gemcitabine and cisplatin, for example, can help people live longer than just having gemcitabine on its own. When administering chemo with radiation, capecitabine is most widely used.

Possible chemo side effects

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. However, other cells in the body, such as those in the bone marrow (where new blood cells are made), mouth and intestine lining, and hair follicles, divide rapidly as well. Chemo can damage certain cells, which can result in side effects.

Chemo's side effects depend on the type and dose of drugs given, and the length of time taken. Its side effects may include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Increased chance of infections (from having too few white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets) Fatigue (from having too few red blood cells)

Generally, these side effects are short-term, and go away at the completion of treatment. There are often ways of reducing or even preventing these side effects. Drugs may be prescribed for example to help avoid or reduce Nausea and Vomiting. Be sure to inquire about medications from the doctor or nurse to help avoid side effects.

Some medications can have their own particular side effects, in addition to the potential side effects above. Cisplatin and oxaliplatin, for example, can damage nerves (so-called neuropathy). This, especially in the hands and feet, can cause numbness, tingling, weakness and sensitivity to cold or heat. This goes away in most patients after stopping treatment, but in some cases, the effects can last a long time.

Report to your medical team any side effects that you experience, so that they can be treated immediately. In some cases, the doses of the Chemotherapy may need to be reduced or treatment may need to be delayed or stopped in order to keep the effects worse.

Chemotherapy for Laryngeal and Hypopharyngeal Cancers

Chemotherapy (chemo) uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancers that have spread.

Chemo may be used in these ways for laryngeal and hypopharyngeal cancers:

Along with radiation as the main treatment for more advanced cancers of the larynx. This treatment, called chemoradiation, can allow some patients to avoid laryngectomy and be able to speak. Chemoradiation is a common treatment for laryngeal and hypopharyngeal cancers. As part of chemoradiation following Surgery to remove the cancer. The goal is to try to kill any small areas of cancer that might remain to lower the risk of the cancer returning. This is called adjuvant treatment.

In order to help shrink a large tumour before Chemotherapy or surgery, it may be easier to treat or relieve issues. It could be called induction Chemotherapy or neoadjuvant treatment. It is also thought that tumour response to chemo induction may help in making plans for the next therapy. If there is a good response (the tumour shrinks), it may be best to get chemoradiation and preserve the organ. If tumour response is low, Surgery may be required.

To help alleviate symptoms of cancers that are too large or that have spread too far to be completely removed by Surgery. It is called palliative or compassionate treatment.

Chemo drugs

Chemo drugs function by targeting rapidly dividing cells, which includes cancer cells. Many of the widely used chemo-drugs for larynx and hypopharynx cancers include:

  • Cisplatin
  • Carboplatin
  • 5-fluorouracil
  • Docetaxel
  • Paclitaxel
  • Epirubicin

Treatment can require the combination of a single drug, or 2 or more. Cisplatin and 5-FU are a common combination but other combinations are also used. Doctors administer chemo in cycles, with each treatment phase followed by a recovery period to allow the body time to heal. Each cycle normally lasts for a few weeks.

Chemoradiation

Chemoradiation (also known as chemoradiotherapy) is Chemotherapy that is given simultaneously with radiation. This has been shown to shrink laryngeal and hypopharyngeal tumours more than either treatment alone. Some call this organ preservation treatment because instead of surgery, chemoradiation can be used so that the structures in and near the larynx are not altered.

Chemoradiation can be used in different situations:

As the primary treatment for certain laryngeal and hypopharyngeal cancers. If the tumour goes away with chemoradiation completely, then no further treatment may be required. However, if there is still any cancer, Surgery might be needed.

As the primary treatment for people who are too sick for Surgery or who do not want Surgery.

Trying to reduce the risk of cancer returning after Surgery. This may be necessary if cancer is found at the edges (margins) of the removed tumour, or if the cancer has other properties that make it more likely to return after Surgery. Where cancer has spread to lymph nodes.

A common practice is to give a dose of cisplatin every 3 weeks (for a total of 3 doses) during radiation. For people who cannot tolerate chemoradiation, the targeted drug cetuximab is often used with radiation instead.

Chemo side effects

Chemo drugs destroy rapidly dividing cells and they function against cancer cells. However, other cells, such as those in the bone marrow (where new blood cells are made), mouth and intestine lining, and hair follicles, are dividing rapidly, too. Chemo can affect these cells as well. That results in side effects. Side effects depend on the drugs used specifically, their dose and the length of treatment. If chemo is delivered along with radiation, side effects begin to get worse.

Common Chemo side effects include:

  • Nausea and vomiting
  • Loss of appetite
  • Mouth sores
  • Diarrhea
  • Hair loss
  • An increased chance of infection (from a shortage of white blood cells)
  • Problems with bleeding or bruising (from a shortage of blood platelets)
  • Fatigue or shortness of breath (from low red blood cell counts)

Some chemo drugs can cause other side effects, in addition to the above risks. Cisplatin, docetaxel, and paclitaxel, for example, can cause nerve damage (called neuropathy), which can result in numbness, tingling, or even Pain in the hands and feet. Cisplatin-induced nerve damage can also cause hearing loss. This often improves once treatment has been stopped, but in some people it can last a long time.

Even though most side effects improve after treatment is ended, some can linger for a long time or even forever. If your doctor is planning chemo treatment, be sure to discuss the medications that will be used and the possible side effects. When you have side effects, let the health care team know once chemo is underway, so they can be treated. There are ways to avoid or treat many of the chemo's side effects. For instance approaching complementary and alternative medicine can effectively manage side Chemotherapy related side effects.

Chemotherapy for Leukaemia

Chemotherapy involves the use of active drugs or chemicals to destroy or damage the cancer cells in the body, often in combinations or intervals. Drugs used in Chemotherapy are sometimes referred to as anticancer agents. The drugs must be toxic enough to kill leukemic cells, which is why Chemotherapy can be rough on your body; the toxicity of the drugs can also affect your healthy cells. Effective Chemotherapy however relies on the fact that the cancer cells are more responsive to the chemicals than regular cells are.

In patients with blood cancers, the improvement in diagnosis and recovery is primarily attributed to the advancement of Chemotherapy drugs over the past 40 years. Today's leukemia, lymphoma, and myeloma treatments occasionally combine Chemotherapy with Radiation therapy. Very high-dose Chemotherapy can also be used, followed by stem cell transplantation.

The purpose of Chemotherapy is to destroy or kill cancer cells so that there is no evidence of disease (remission) or progression of the disease is slowed down. For many people, Chemotherapy can produce long-term remission or outright cure, depending on the type and extent of the cancer.

Treatment Phases for Acute Myeloid Leukemia (AML) and Acute lymphoblastic leukaemia (ALL)

Most patients with AML and ALL usually receive treatment in two phases, or cycles:

Induction therapy

Post-remission, or consolidation, therapy

Induction Therapy

Induction therapy is the first step of both AML and ALL Chemotherapy. Patients with AML and ALL need to start induction therapy immediately. The aim of induction therapy is to “induce,” or promote remission — when there is no diseases evidence left. The induction therapy explicitly aims to:

  • Kill as many AML and ALL cells as possible
  • Have blood counts returned to normal
  • Reduce the symptoms for prolonged time

Patients may need to go through multiple rounds of induction therapy, or cycles, before all leukaemia cells are killed. Doctors know the effectiveness of induction therapy when they are unable to see leukaemia cells in the blood or marrow. Patients continue feeling better too. This is what is considered to be a remission.

Induction therapy is done at a hospital, where most patients spend four to six weeks completing multiple Chemotherapy cycles. A cycle of Chemotherapy usually consists of one week of taking the drugs followed by several weeks of letting the body heal. Based on patient's health status, patients who have a full-time caregiver can be discharged sooner.

Post-Remission Therapy

After patients complete induction therapy and get into remission, additional therapy is still needed. This second recovery phase is known as post-remission therapy, or consolidation therapy. In this second phase the cancer may probably come back.

Post-remission treatment requires chemotherapy, and often a transplant of stem cells. The aim is to kill the stray leukaemia cells that blood or marrow tests do not find. Patients receive post-remission therapy at the hospital or in an outpatient environment for a period of four to six weeks, often longer, depending on the post-remission medication and its side effects.

Doctors decide type of post-remission therapy by looking into:

  • Overall health of the patient
  • Certain types of changes to the genes in leukemic cells
  • The availability of a stem cell donor

Patients who do not undergo stem cell transplantation are usually administered four Chemotherapy cycles. Strong Chemotherapy with high doses of cytarabine or other medications is given for better results.

Maintenance Therapy for ALL

Patients with ALL need a longer duration of post-remission therapy than patients with AML do. A continuing treatment is called maintenance treatment after the initial post-remission therapy, which lasts about two years.

Side effects of Chemotherapy in leukaemia.

Chemo drugs can affect some of the body's normal cells which can lead to side effects. Chemo's side effects depend on the type and dose of drugs given, and the length of time taken. May include common side effects:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea or constipation

Chemo drugs also affect the normal cells in bone marrow, which can lower blood cell counts. This can lead to:

  • Increased risk of infections (from having too few normal white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets)
  • Fatigue and shortness of breath (from having too few red blood cells)

When therapy is over, most side effects from chemo go away. Low counts of blood cells will last for weeks but will return to normal afterwards. There are often ways of lessening the side effects of chemo. Be sure to ask the cancer care team about medications that help mitigate side effects and let the doctor or nurse know when you have side effects so that they can be easily handled.

Side effects of specific drugs: Certain drugs might cause specific side effects. For example:

Cytarabine can cause dryness in the eyes, particularly when used at high doses, and can affect certain parts of the brain, which can lead to coordination and balance problems. Vincristine can damage the nerves, resulting in numbness, tingling or weakness of the hands or feet. Anthracyclines (such as daunorubicin or doxorubicin) can harm the heart, and the overall dosage needs to be carefully monitored, so these medications should not be used in anyone who has heart problems already.

Other organs that certain chemo drugs could damage include the kidneys, liver, testicles, ovaries, and lungs. Doctors and nurses monitor the medication closely to minimize the likelihood of these side effects. When there are severe side effects, the chemo can need to be decreased or halted, at least for a while.

Second cancers: One of the most severe side effects of ALL treatment is an elevated risk of later developing acute myeloid leukaemia (AML). This happens in a small proportion of patients after receiving certain chemo-drugs. Less frequently, people who are cured of leukaemia can develop non-Hodgkin Lymphoma or other cancers later on. Of course, the possibility of developing these second cancers needs to be weighed against the apparent advantage of using Chemotherapy to treat a life-threatening illness like leukaemia.

Tumour lysis syndrome: This side effect of chemo is most common in patients with large numbers of leukaemia cells in the body, and it is more commonly seen in the first (induction) treatment process. When leukaemia cells are destroyed by chemo, they split open and spill their contents into the bloodstream. This can overload the kidneys, that cannot get rid of all these substances at once. Excess quantities of these substances can affect the heart and nervous system, too. This can also be prevented by giving extra fluids during treatment and by administering certain drugs, such as bicarbonate, allopurinol and rasburicase, that help the body get rid of these substances.

Chemotherapy for Liver Cancer

Chemotherapy is a treatment for the killing of cancer cells with medications. Chemo may be a choice for people whose Liver Cancer cannot be treated with surgery, who have not responded to local therapies such as ablation or embolization, or who are no longer effected with Targeted therapy.

What Chemotherapy medications are used to treat liver cancer?

Unfortunately, most chemo medications do not have a significant effect on hepatic cancer. Recent research has shown that a mixture of medications may be more effective than only using a single chemo drug. Yet even such drug combinations shrink only a limited number of tumours and sometimes the responses do not last long. Moreover, most studies indicate that systemic chemo do not enable patients to live longer.

The most common Chemotherapy drugs for treating Liver Cancer include:

  • Gemcitabine
  • Oxaliplatin
  • Cisplatin
  • Doxorubicin
  • 5-fluorouracil
  • Capecitabine
  • Mitoxantrone

Combinations of 2 or 3 of these medicines are sometimes used. GEMOX (gemcitabine plus oxaliplatin) is a choice for people who are relatively stable and who can handle more than one drug.

How is Chemotherapy given in liver cancer?

You can get Chemotherapy in different ways.

Systemic chemotherapy

Drugs are injected or taken by mouth directly into a vein (IV). Such medications penetrate the bloodstream and touch almost all regions of the body, making this therapy potentially effective for cancers that have spread to other parts of the body.

With IV chemo, delivering chemo requires a slightly larger and more durable catheter in the venous system. They are known as CVCs, Central Venous Access Devices (CVADs), or Central Lines. They are used right into your blood to put medicines, blood products, nutrients, or fluids. They can also be used for checking blood flow. There are a number of different kinds of CVCs. The two most popular forms are the PICC line and the port.

Doctors administer chemo in cycles, with each treatment phase followed by a recovery period to allow you time to recover from the drug effects. Cycles most often last for 2 or 3 weeks. Timing varies according to the medications used. Of example, the chemo is given only on the first day of the cycle, for other medications. It is given, together with others, in a row for a few days, or once a week. The chemo schedule repeats at the end of the cycle, in order to continue the next cycle.

Advanced Liver Cancer Treatment is dependent on how well it functions, and the side effects that you have.

Regional chemotherapy

Drugs are inserted straight through an artery that has the tumour heading to the section of the body. That focuses the chemo on that area's cancer cells. It eliminates side effects by constraining the amount of drug that enters the rest of the body. Hepatic artery infusion, or chemo given directly into the hepatic artery, is regional Chemotherapy that can be used for Liver Cancer.

Hepatic artery infusion

Doctors have studied putting chemo drugs directly into the hepatic artery to see if it could be more effective than systemic chemo. This technique is known as hepatic artery infusion (HAI). It is somewhat different from chemoembolization, as it involves Surgery to insert an infusion pump under the abdomen ‘s skin (belly). The pump is mounted on a catheter connecting with the hepatic artery. This is done under general anaesthesia when the patient is sleeping. The chemo is injected into the reservoir of the pump with a needle through the skin, and is released into the hepatic artery slowly and steadily.

Most medication is broken down by healthy liver cells before it can reach the rest of the body. This method gives the tumour a greater dose of chemo than systemic chemo but does not increase side effects. The most commonly used medications for HAI include floxuridine, cisplatin and oxaliplatin.

HAI can be used for people with very large liver cancers that can not be surgically removed. This procedure may not be appropriate in all cases, because installing the pump and catheter requires surgery, an operation that many cases with Liver Cancer may not be able to handle.

Early studies have shown that HAI is often effective in shrinking tumors, but it still needs further work.

Possible side effects of Chemotherapy for liver cancer

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. Yet other cells in the body, such as those in the bone marrow, mouth and intestine lining, and hair follicles, divide rapidly, too. Chemo is also likely to affect these cells, and this can lead to side effects.

Chemo's side effects depend on the form and dosage of drugs given, and the amount of time taken. Typical side effects include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Increased chance of infections (from low white blood cell counts)
  • Easy bruising or bleeding (from low blood Platelet counts)
  • Fatigue (from low red blood cell counts)

Usually these side effects do not last long and go away once treatment is over. Some means of lessening them. To help reduce side effects, be sure to ask your doctor or nurse about the drugs.

Along with the potential side effects in the above list, certain medications may have special side effects of their own. Ask what to expect from the health care team.

When undergoing chemotherapy, you should mention any side effects you experience to your medical team so you can be treated promptly. In some cases, the doses of the Chemotherapy drugs may need to be lowered or care may need to be postponed or halted so that side effects do not get worse

Chemotherapy for Lung Cancer

Chemotherapy is a common term for the use of medications to cure cancer. Patients with various forms of Lung Cancer are likely to get various Chemotherapy drug combinations. Upon reviewing treatment choices with patients, physicians will determine which medications are most appropriate for the Chemotherapy.

Chemotherapy can be used to treat Lung Cancer in several ways:

Cure early or locally advanced inoperative Lung Cancer combined with Radiotherapy (chemoradiotherapy) Check for tumour shrinkage before Surgery or Radiotherapy (neoadjuvant chemotherapy) Extend life if treatment (palliative chemotherapy) is not possible; Kill any undetectable cancer cells that may still remain after successful Lung Cancer Surgery or to help prevent recurrence (adjuvant chemotherapy); Reduce symptoms such as breathlessness (palliative chemotherapy)

Chemotherapy for small cell lung cancer

If you are suffering from small cell Lung Cancer ( SCLC), Chemotherapy is typically the first form of treatment you receive. This is because SCLC can grow and spread rapidly, and when the Lung Cancer is detected, it has often spread outside the lung, and responds well to Chemotherapy.

Systemically treating it with Chemotherapy typically leads to symptom relief and longer survival. After chemotherapy, Radiotherapy can be performed to try to stop the cancer from returning.

Small cell Lung Cancer has a number of different types of Chemotherapy medications. A combination of etoposide and one which contains platinum (cisplatin or carboplatin) is the most common first-line treatment.

Many medications that can be used after initial Chemotherapy as a further treatment (second or third line) include:

  • Topotecan
  • Cyclophosphamide
  • Doxorubicin
  • Vincristine .

The first drug, topotecan, is used on its own, and the other three are used together in what is known as the “CAV regime”.

Chemotherapy for non-small cell lung cancer

Non-small cell Lung Cancer (NSCLC) may also be treated with Chemotherapy. It may be used as the only therapy, as a pre- or post-operative treatment, or for treating symptoms of advanced Lung Cancer.

If Lung Cancer Surgery is not suitable for you, and your type of Lung Cancer means that a Targeted therapy or Immunotherapy drug is likely to be less effective, either Chemotherapy on its own or in combination with Radiotherapy (if you are fit enough) may be offered.

When you have had Lung Cancer Surgery and all cancer cells have been removed, then Chemotherapy (adjuvant chemotherapy) can still be given afterwards. If you have had Surgery and cancer cells stay, however, your cancer doctor will talk to you about whether you should have Radiotherapy and/or Chemotherapy (chemoradiotherapy).

For people with NSCLC the most widely used Chemotherapy includes platinum (cisplatin or carboplatin) with one of the following drugs:

  • Pemetrexed
  • Vinorelbine
  • Gemcitabine
  • Paclitaxel.

The cancer doctor may use a variety of Chemotherapy medicines to treat the Lung Cancer either as a first after diagnosis treatment, or if it returns (called a relapse). Second or third line treatments can include different Chemotherapy drugs, targeted therapies or immunotherapies.

Side Effects:

Everyone responds to Chemotherapy differently:

  • Fatigue
  • Nausea and vomiting
  • Mouth sores
  • Taste changes
  • Loss of appetite
  • Anaemia
  • Hair loss
  • Skin changes
  • Fingernail changes
  • Depression
  • Peripheral neuropathy
  • Fertility problems
  • Kidney problems
  • Thrombocytopenia

Chemotherapy to treat Non-Hodgkin lymphoma

The cancer doctor may use a variety of Chemotherapy medicines to treat the Lung Cancer either as a first after diagnosis treatment, or if it returns (called a relapse). Second or third line treatments can include different Chemotherapy drugs, targeted therapies or immunotherapies.

Which chemo drugs are used to treat non-Hodgkin lymphoma?

Many chemo-drugs are effective in Lymphoma care. Many medicines are also mixed. The number of drugs, their doses, and the duration of treatment depend on the Lymphoma type and stage. Here are some of the most widely used medications for Lymphoma care (divided into categories depending on how they work):

Category Drug Name Alkylating agents Cyclophosphamide Chlorambucil Bendamustine Ifosfamide Corticosteroids Prednisone Dexamethasone Platinum drugs Cisplatin Carboplatin Oxaliplatin Purine analogs Fludarabine Pentostatin Cladribine Anti-metabolites Cytarabine Gemcitabine Methotrexate Pralatrexate Anthracyclines Doxorubicin Liposomal doxorubicin Others Vincristine Mitoxantrone Etoposide Bleomycin

Drugs from various categories are often combined. CHOP is one of the most common combinations. It includes the medicines cyclophosphamide, doxorubicin, vincristine, and prednisone. Chemo, particularly rituximab, is often paired with an Immunotherapy drug.

Doctors give chemo in cycles, where a period of rest is followed by treatment to allow the body time to heal. Generally, each chemo cycle lasts for several weeks. Most Chemotherapy treatments are given as out-patient (in the physician's office or clinic or hospital emergency department), but some may require a hospital stay.

Sometimes a patient may get one chemo combination for several cycles and later switch to a different one if the first combination does not seem to be working.

Possible side effects

Chemo drugs can cause side effects. These depend on the type and dose of drugs given and how long treatment lasts. Common side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea or constipation
  • Increased chance of infection (from a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (from a shortage of platelets)
  • Fatigue and shortness of breath (from too few red blood cells)

Usually these side effects go away once treatment is complete. If there are severe side effects, the chemo dosage may be reduced or the medication may be postponed. Those side effects can be managed using medicine or complementary and alternative therapies.

Some chemotherapies can have other potential side effects. For instance:

Platinum drugs such as cisplatin can cause nerve damage (neuropathy), leading to numbness, tingling or even Pain in the feet and hands.

Ifosfamide can cause damage to the bladder. This risk can be that by prescribing it along with a medication called mesna.

Doxorubicin can cause cardiac damage. Before starting on this drug, your doctor can order a test of your heart function (like a MUGA scan or echocardiogram).

Bleomycin can cause lung damage. Doctors also check lung function before anyone begins on this drug.

Many chemo drugs (the desire to have children) can influence fertility.

Some chemotherapies can increase your risk of developing leukaemia a few years later.

Chemotherapy for Esophageal Cancer

Chemotherapy (chemo) is anti-cancer drugs that may be given intravenously (injected into your vein) or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body.

By itself, chemo rarely cures esophageal cancer so it is often given with Radiation therapy (called chemoradiation).

When is Chemotherapy used for esophageal cancer?

Chemo may be used at different times during treatment for esophageal cancer.

After Surgery (adjuvant chemotherapy): Adjuvant chemo might be given (often with radiation) to kill any cancer cells that might have been left behind or have spread but are too small to see on imaging tests. If these cells were allowed to grow, they could form new tumors in other places in the body. It isn't clear that adjuvant chemoradiation is as helpful as giving it before Surgery.

Before Surgery (neoadjuvant chemotherapy): For some cancers, neoadjuvant chemo might be given (often with radiation) to try to shrink the cancer so it can be removed with less extensive Surgery. This can lower the chance of the cancer coming back and help people live longer than using Surgery alone.

Chemo for advanced cancers: For cancers that have spread to other organs, such as the liver, chemo can also be used to help shrink tumors and relieve symptoms. Although it is not likely to cure the cancer, it often helps people live longer.

Drugs used to treat esophageal cancer

Some common drugs and drug combinations used to treat esophageal cancer include those below which can be given along with radiation or without:

  • Carboplatin and paclitaxel (Taxol)
  • Oxaliplatin and either 5-FU or capecitabine
  • Cisplatin and either 5-fluorouracil (5-FU) or capecitabine
  • Cisplatin and Irinotecan (Camptosar)
  • Paclitaxel (Taxol) and either 5-FU or capecitabine

Other common drugs and drug combinations that can be used to treat esophageal cancer but are usually not given with radiation include:

ECF: epirubicin (Ellence), cisplatin, and 5-FU (especially for gastroesophageal junction tumors) DCF: docetaxel (Taxotere), cisplatin, and 5-FU Trifluridine and tipiracil (Lonsurf), a combination drug in pill form

For some esophagus cancers, chemo may be used along with the targeted drug trastuzumab (Herceptin) or ramucirumab (Cyramza).

How is Chemotherapy given?

Chemo drugs for esophageal cancer are typically given into a vein (IV), either as an injection over a few minutes or as an infusion over a longer period of time. Some drugs you take by mouth. All of these drugs enter your bloodstream and reach most areas of your body. These drugs can be given in a doctor's office, infusion center, or in a hospital.

Often, a slightly larger and sturdier IV called a central venus catheter (CVC) is needed to administer chemo. It might also be called a central venous access device (CVAD), or central line. Once put in place, a CVC can stay in as long as you're getting treatment so you won't need to be stuck with a needle in the arms or hands each time to put in an IV catheter. It can be used to put medicines, blood products, nutrients, or fluids right into your blood. It can also be used to take out blood for testing. There are many different kinds of CVCs. The most common types are the port and the PICC line.

Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given for a few days in a row, or once a week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.

Adjuvant or neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. The length of treatment for advanced esophageal cancer depends on how well it is working and what side effects you might have.

Possible side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common side effects of chemo include:

  • Nausea and vomiting
  • Loss of appetite
  • Hair loss
  • Mouth sores
  • Diarrhea or constipation

Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:

Increased chance of infection (from having too few white blood cells)

Easy bleeding or bruising (from having too few blood platelets)

Fatigue (from having too few red blood cells and other reasons)

Other side effects are also possible. Some of these are more common with certain chemo drugs.

For example:

Hand-foot syndrome. During treatment with capecitabine or 5-FU (when given as an infusion), this can start out as redness in the hands and feet, and then progress to Pain and sensitivity in the palms and soles. If it worsens, blistering or skin peeling can occur, sometimes leading to painful sores. It's important to tell your doctor right away about any early symptoms, such as redness or sensitivity, so that steps can be taken to keep things from getting worse.

Neuropathy (nerve damage). This is a common side effect of oxaliplatin, cisplatin, docetaxel, and paclitaxel. Symptoms include numbness, tingling, and even Pain in the hands and feet. Oxaliplatin can also cause intense sensitivity to cold in the throat and esophagus (the tube connecting the throat to the stomach) and the palms of the hands. This can cause problems swallowing liquids or holding a cold glass. If you will be getting oxaliplatin, talk with your doctor about side effects, and let him or her know right away if you develop numbness and tingling or other side effects.

Allergic or sensitivity reactions. Some people can have reactions while getting the drug oxaliplatin. Symptoms can include skin rash, chest tightness and trouble breathing, back pain, or feeling dizzy, lightheaded, or weak. Be sure to tell your nurse right away if you notice any of these symptoms while you are getting chemo.

Diarrhea. This is a common side effect with many of these drugs, but can be particularly bad with irinotecan. It needs to be treated right away — at the first loose stool — to prevent severe dehydration. This often means taking drugs like loperamide (Imodium). If you are on a chemo drug that is likely to cause diarrhea, your doctor will give you instructions on what drugs to take and how often to take them to control this symptom.

Weight loss. People with esophageal cancer often have already lost weight before the cancer was found. Treatments such as chemo, radiation, or both can make it hard to eat well enough to get good nutrition, making weight loss worse. Depending on your situation, the cancer care team might recommend placement of a feeding tube to keep up your nutrition and weight during treatment. This feeding tube may be used short-term (during treatment and a bit afterwards) or it may be permanent depending on your cancer.

Most of these side effects tend to go away after treatment is finished. Some, such as hand and foot numbness, may last for a long time. There are often ways to lessen these side effects. For example, you can be given drugs to help prevent or reduce Nausea and Vomiting.

Be sure to discuss any questions about side effects with your cancer care team. Report any side effects or changes you notice while getting chemo right away so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

Chemotherapy for Oral Cavity and Oropharyngeal Cancer

Chemotherapy is the use of anticancer drugs for Cancer Treatment. The medications are injected into a vein or taken by mouth. This enables drugs to enter the bloodstream and kill cancer that has spread across the body.

How is chemo used to treat oral cavity and oropharyngeal cancers?

Chemo may be used in several different situations:

Chemo, typically combined with Radiation therapy may be used as the primary treatment for certain cancers, instead of Surgery.

Chemo combined with Radiation therapy may be administered after Surgery to try to kill any small deposits of cancer cells left behind.

This is called adjuvant Chemotherapy.

Chemo, sometimes with Radiation therapy can be used before Surgery to try to shrink some of the larger cancers. This is called induction Chemotherapy or neoadjuvant. In some cases this would allow less radical Surgery to be used and less tissue to be removed. It can lead to less severe surgical side-effects.

Chemo, with or without radiation therapy, can be used to treat cancers that are too large or have spread too far to be removed by Surgery. The goal is to slow the growth of the cancer for as long as possible and to help relieve any symptoms the cancer is causing.

Which chemo drugs are used?

The chemo drugs used most often for cancers of the oral cavity and oropharynx are:

  • Cisplatin
  • Carboplatin
  • 5-fluorouracil
  • Paclitaxel
  • Docetaxel
  • Hydroxyurea

Other drugs that are used less often include

  • Methotrexate
  • Bleomycin
  • Capecitabine

Possible side effects of chemotherapy

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. But other cells within the body, such as those in the bone marrow, mouth and intestine lining, and hair follicles, divide rapidly and are also affected. That can result in side effects.

Chemo's side effects depend on the type and dose of drugs given, and how long they are used. Its side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Low blood counts

Chemo can affect the blood-producing cells of the bone marrow, leading to low blood cell counts. This can lead to:

  • Increased chance of infections (due to low white blood cell counts)
  • Easy bruising or bleeding (due to low blood Platelet counts)
  • Fatigue (due to low red blood cell counts)

Along with the above dangers, other side effects of other chemo drugs are more commonly seen. 5-FU for instance also causes Diarrhoea. This could need to be treated with such drugs as loperamide. Cisplatin, docetaxel, and paclitaxel can cause damage to the nerves (called neuropathy). That can lead to tingling and numbness in the hands and feet. This often improves once treatment is discontinued, but it can last a long time for some people. Cisplatin also can cause damage to the kidneys. The intravenous (IV) fluid is administered before and after each dose to help avoid this.

While most side effects improve over time after treatment is discontinued, some may last a long time or may even be permanent. When your doctor is considering chemotherapy, be sure to clarify the drugs that will be used and the potential side effects. If you note any changes, or have any side effects, inform your health care team once chemo is underway. Many of the side effects of chemo are prevented or treated in ways.

Chemotherapy for Ovarian Cancer

Chemotherapy is the use of pharmaceutical drugs to treat cancer. Chemo is most frequently a systemic treatment, meaning the medications penetrate the bloodstream and touch almost all parts of the body. Chemo can be useful for killing very small quantities of cancer cells that may still be needed after surgery, for cancers that have metastasized (spread), or for shrinking very large tumours to facilitate Surgery. Chemo most commonly uses medications that are either injected into a vein (IV) or delivered by mouth. Chemotherapy can also, in some cases, be administered directly into the abdominal cavity through a catheter (thin tube). It is called Chemotherapy intraperitoneal (IP).

Chemotherapy for epithelial ovarian cancer

Ovarian cancer Chemotherapy typically requires bringing together two different types of medications. For a first treatment for ovarian cancer, using a combination of medications instead of just one medication alone appears to be working well. The combination usually includes a type of Chemotherapy called a platinum compound (usually cisplatin or carboplatin), and another type of Chemotherapy called a taxane, such as paclitaxel or docetaxel. These medications are normally administered as IV (inserted into a vein) every 3 to 4 weeks.

The standard chemo course for epithelial Ovarian Cancer requires 3 to 6 treatment cycles, depending on the stage and form of cancer in the ovary. A cycle is a series of daily doses of a drug followed by a time of rest.

Epithelial Ovarian Cancer sometimes shrinks, or even appears to go away with chemo, but eventually the cancer cells can start to develop again. When the first chemo appeared to work well and the cancer remained away for at least 6 to 12 months, then the first time it should be treated with the same Chemotherapy. In some cases different medications can be used.

Some of the other chemo drugs that are helpful in treating Ovarian Cancer include:

  • Albumin bound paclitaxel
  • Altretamine
  • Capecitabine
  • Cyclophosphamide
  • Etoposide
  • Gemcitabine
  • Ifosfamide
  • Irinotecan
  • Liposomal doxorubicin
  • Melphalan
  • Pemetrexed
  • Topotecan
  • Vinorelbine

Intraperitoneal (IP) chemotherapy

For women with stage III Ovarian Cancer (cancer that has not spread beyond the abdomen) and whose cancers have been optimally debulked (no tumors greater than 1 cm after surgery), intraperitoneal (IP) Chemotherapy may be offered in addition to systemic Chemotherapy (paclitaxel administered in a vein).

In IP chemotherapy, the cisplatin and paclitaxel drugs are injected through a catheter (thin tube) into the abdominal cavity. During the staging / debulking surgery, the tube may be placed but it is sometimes placed later. If done later, it may be put under X-Ray supervision by a surgeon using laparoscopy, or by an interventional radiologist. The catheter is normally attached to a tube, a half-dollar disk surmounted by a pliable diaphragm. The port, like a rib or pelvic bone, is placed under the skin against a bony surface of the abdominal wall. To offer chemo and other medicines, a needle may be inserted through the skin and into the harbour. Problems with the catheter may occur over time (for example, it might become plugged or infected), but this is rare.

Giving chemo this way directly to the cancer cells in the abdominal cavity provides the most intense dose of the medications. This chemo is also absorbed into the bloodstream, and can enter cancer cells beyond the cavity of the abdomen. IP Chemotherapy tends to help some people live longer than intravenous Chemotherapy alone, but the side effects are also greater. People who undergo IP Chemotherapy may experience more stomach Pain , Nausea , vomiting, and other side effects which may lead some people to avoid early care. The risk of side effects also means that a woman must have normal kidney function before beginning an IP chemo and be in good overall heath. Women also cannot have a lot of adhesions or scar tissue inside their abdomen (belly), because this can prevent the chemo from reaching all the cancer cells that are exposed to it.

Side effects of chemotherapy

Chemotherapies can cause side effects. These depend on the type and dose of drugs given, and the treatment length. Some of the commonest side effects imaginable include:

  • Nausea and vomiting
  • Loss of appetite
  • Loss of hair
  • Hand and foot rashes
  • Mouth sores

These side effects usually go away after treatment is finished. While you are in treatment, tell your cancer care team about any side effects you are having. There are often ways to lessen these side effects.

Chemotherapy for Prostate Cancer

Chemotherapy (chemo) uses anticancer drugs that are injected into a vein or administered by mouth. These drugs travel through the bloodstream in most parts of the body to kill cancer cells.

When is Chemotherapy used?

Chemo is often used when Prostate Cancer has spread beyond the gland of the prostate and Hormone therapy does not function. Recent work has also shown that if given along with hormone therapy, Chemotherapy may be effective. Chemo is however not a standard treatment for early Prostate Cancer.

Chemo drugs used to treat prostate cancer

For prostate cancer, chemo drugs are typically used one at a time. Some of the chemo drugs used to treat Prostate Cancer include:

  • Docetaxel
  • Cabazitaxel
  • Mitoxantrone
  • Estramustine

In most cases, the first chemo drug given is docetaxel, combined with the steroid drug prednisone. If this does not work (or stops working), cabazitaxel is often the next chemo drug tried (although there may be other treatment options as well).

Docetaxel and cabazitaxel have been shown to help men live longer, on average, than older chemo drugs. They may slow the cancer's growth and reduce symptoms, resulting in a better quality of life. Still, chemo is very unlikely to cure Prostate Cancer.

Other chemo drugs being studied for use in Prostate Cancer include carboplatin, oxaliplatin, and cisplatin.

Possible side effects of chemotherapy

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), mouth and intestine lining, and hair follicles, divide rapidly as well. Chemo can also damage these cells, and this can lead to side effects.

Chemo's side effects depend on the type and dose of drugs given, and how long they are used. Could include some common side effects:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Increased chance of infections (from having too few white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets)
  • Fatigue (from having too few red blood cells)

Typically, these side effects go away until treatment is done. Those side effects are also reduced.

Along with the above risks, other side effects of other chemo drugs are more commonly seen. For instance:

Docetaxel and cabazitaxel also cause severe allergic reactions. Medicines are given to help avoid this before each procedure. These medications can also affect the nerves (known as peripheral neuropathy), which can cause symptoms of numbness, tingling, or burning in the hands and feet.

Very rarely, mitoxantrone may cause leukaemia some years later.

The risk of blood clots increases with estramustine.

When you experience any side effects when undergoing chemo report them to the cancer care team for prompt treatment. In certain cases, chemo drug doses may need to be reduced, or therapy may need to be postponed or halted to prevent the symptoms from getting worse.

Chemotherapy for Stomach Cancer

Chemotherapy (chemotherapy) uses anti-cancer drugs that are either pumped into a vein, or given through the mouth as tablets. These medicines enter the bloodstream and reach every part of the body, making it useful for cancer that has spread to organs beyond where it originated.

Chemo can be used in different ways to help treat stomach cancer:

Chemo can be given to treat Stomach Cancer before Surgery. It is known as neoadjuvant treatment. It may shrink the tumour, and can make Surgery possible. It can also help to prevent the cancer from returning and to help patients live longer. Neoadjuvant chemo is one of the preferred treatment methods for certain stages of the Stomach Cancer. Chemo is then also given again following Surgery. Chemo can be given to treat cancer following Surgery. This is called adjuvant therapy. The adjuvant chemo's purpose is to destroy any cancer cells that could have been left behind but are too small to be seen. That can help to prevent the cancer from returning. Sometimes, chemo is provided with Radiation therapy after Surgery for Stomach Cancer. This combination is called chemoradiation. This may be especially helpful for cancers that could not be removed completely by Surgery. Chemo can be given to distant organs as the primary (main) Treatment for Stomach Cancer that has spread (metastasised). It can help shrink the cancer or delay its development, which can ease some patients' symptoms and help them live longer.

Doctors give chemo in cycles, with each treatment period followed by a rest period giving the body time to heal. Every period usually lasts for a couple of weeks.

Several chemotherapies can be used to treat stomach cancer, including:

  • Fluorouracil, often given along with folinic acid
  • Capecitabine
  • Carboplatin
  • Cisplatin
  • Docetaxel
  • Epirubicin
  • Irinotecan
  • Oxaliplatin
  • Paclitaxel
  • Trifluridine and tipiracil, a combination drug in pill form

These drugs may be used alone or together with other Chemotherapy or targeted drugs depending on the situation (including the stage of the cancer, the overall health of the person and whether chemo is combined with radiation therapy).

Side effects of chemotherapy

Chemo drugs kill rapidly dividing cells, which is the reason why they function against cancer cells. Yet certain cells in the body, such as those in the bone marrow (where new blood cells are made), mouth and intestine lining, and hair follicles, often break quick. Chemo can affect these cells too, which can lead to side effects. The type of side effect depends on the form of drug, the quantity taken and the length of treatment. Short term side effects common to most medications for Chemotherapy can include:

  • Nausea and vomiting
  • Loss of appetite
  • Hair loss
  • Diarrhoea
  • Mouth sores
  • Increased chance of infection (from a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (from a shortage of platelets)
  • Fatigue and shortness of breath (from a shortage of red blood cells)

Such side effects are typically short-term and will go away once therapy is complete. Generally hair grows back after treatment ends, for example. Make sure to mention any side effects you encounter to the cancer care team because there are many ways to reduce them. You may get medications for example to avoid or develop Nausea and Vomiting.