Chemotherapy

Written by Brian Krans | Published on August 7, 2012
Medically Reviewed by Peter Rudd, MD

What Is Chemotherapy?

Chemotherapy is an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body. It is usually used for cancer, as cancer cells grow and divide faster than other cells.

Chemotherapy is often used in combination with other therapies, such as surgery, radiation, or hormone therapy. However, this depends on the stage and type of cancer, your overall health, previous cancer treatments, location of cancer cells, and your personal treatment preferences.

It is considered a systemic treatment, which means it affects the entire body.

While chemotherapy has been proven to effectively attack cancer cells, it can cause serious side effects that can severely impact your quality of life. You should weigh these side effects against the risk of not getting treatment when deciding if chemotherapy is right for you.

Why Chemotherapy Is Used

Chemotherapy is primarily used for three reasons:

  • to lower the total number of cancer cells in your body
  • to reduce the likelihood of cancer spread
  • to shrink tumor size and reduce current symptoms

If you’ve undergone surgery to remove a cancerous tumor—such as a lumpectomy for breast cancer—your doctor may have you undergo chemotherapy to ensure that any stray cancer cells are killed as well. (A doctor who specializes in cancer treatment is known as an oncologist.)

Chemotherapy is also used to prepare you for other treatments. It could be used to shrink a tumor so it can be surgically removed or to prepare you for radiation therapy.

In the case of late-stage cancer, when no amount of therapy can help the patient, chemotherapy may help relieve pain.

Besides treatment for cancer, chemotherapy may be used for:

  • bone marrow diseases: to prepare a patient for a bone marrow stem cell treatment
  • immune system disorders: doses much lower than those used to treat cancer can be used to help disorders—like lupus or rheumatoid arthritis—where the body’s immune system attacks healthy cells

Side Effects of Chemotherapy

Chemotherapy is designed to kill cells that divide quickly. While cancer cells are these kinds of cells, other cells in your body divide quickly as well. Cells in the blood, hair, skin, and lining of your intestinal tract can be adversely affected.

Because of this, side effects of chemotherapy include:

  • easy bruising and excessive bleeding
  • diarrhea
  • dry mouth and mouth sores
  • fatigue
  • fever
  • hair loss
  • loss of appetite, nausea, vomiting, and weight loss
  • pain from nerve damage
  • infections

Your doctor can help you better manage these side effects with medications, lifestyle tips, and more.

Most side effects of chemotherapy subside when treatment is over. There is, however, the risk of long-lasting effects that may develop even years after the treatment, depending on the type of chemotherapy used.

These could include damage to the:

  • heart
  • kidneys
  • lungs
  • nerves
  • reproductive organs

There is also the chance of developing a second cancer as a result of chemotherapy. Before beginning treatment, talk to your doctor about possible risks, and what symptoms you should be aware of.

How to Prepare for Chemotherapy

As chemotherapy is a serious treatment for a serious condition, it’s important to plan ahead before beginning therapy. Your doctor or hospital staff will help you anticipate potential problems associated with treatment.

Before you begin therapy, you will undergo a series of tests to help determine if you’re healthy enough for chemotherapy. This will include examinations of your heart and blood tests to determine the health of your liver. These tests can also help guide your doctor in deciding which types of chemotherapy to use in your treatment.

Your doctor may also recommend that you visit your dentist before beginning treatment. As chemotherapy affects your body’s ability to heal, any infection in your gums or teeth could spread throughout your body.

Your doctor will install a port if you’re getting chemotherapy through an IV. A port is a device that is implanted in your body, typically in your chest near your shoulder. This allows for easier access into your veins and is less painful. During each treatment, the IV will be inserted into your port. After the initial installation, your treatments—at least the initial injection—will be painless.

Consider the following preparations for chemotherapy treatment.

Make arrangements for work.

Most people are able to work during chemotherapy, but you may want to be put on a lighter workload until you know what types of side effects you may be experiencing.

Prepare your house.

Do laundry, stock up on groceries, and other tasks you may be too weak to do after your first appointment

Arrange help.

Getting a friend or family member to help with household chores or caring for pets or children can be extremely beneficial.

Anticipate side effects.

Ask your doctor what side effects you may experience and how to plan accordingly. For example, you may want to store sperm or fertilized eggs if you want to conceive a child, if infertility could be a side effect. You may want to purchase head covers or wigs if hair loss is likely.

Begin therapy or join a support group.

Talking to someone outside your family and circle of friends about what you’re going through can help you remain optimistic. It can also help calm any fears you may have about treatment.

How Chemotherapy Is Performed

Determining the course of your treatment will be between you and your doctor with all variables considered. Chemotherapy is typically delivered in pill form or directly into your veins by injection or IV tubing. However, there are other ways it can be delivered.

Chemotherapy delivery options include:

  • directly into the tumor: this depends on the tumor’s location. If you undergo surgery to remove the tumor, your doctor can implant slow-dissolving discs that release medications over time
  • creams: some skin cancers can be treated with chemotherapy creams
  • localized treatments: chemotherapy can be delivered to a specific part of the body, such as the abdomen, chest, central nervous system, or bladder (through the urethra)
  • pills: some types of chemotherapy can be delivered by mouth
  • shots or infusions: liquid chemotherapy drugs can be delivered in single shots, or you can have a port installed where a needle is inserted for each treatment. The infusion method with a port only involves pain at the injection site during the first visit. However, the port needle can come loose depending on your level of activity.

Where you receive treatment depends on your chosen delivery method. For instance, if you use creams or pills, you can give yourself treatments at home. Other procedures are usually performed at a hospital or a specialized facility.

Your chemotherapy schedule, as in how often you receive treatment, will be customized for you. It can be changed if your body doesn’t handle the treatment well, or increased or decreased depending on how well the cancer cells react to treatments.

After Chemotherapy

Your doctor and cancer team will regularly monitor the effectiveness of your treatments. These will include imaging techniques, blood tests, and possibly more.

Your doctor may adjust your treatment at any time.

The more you share with your doctor about how chemotherapy is affecting you, the better your treatment experience will be. You will want to be forthcoming about any side effects or treatment-related problems you are experiencing so that necessary adjustments can be made.

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