Chemotherapy at a glance

  • Chemotherapy cancer treatment distributes chemicals into the patient designed to attack cancer cells throughout the body.
  • Chemotherapy is delivered either orally, intravenously, into the muscle tissue or by way of spinal injections.
  • Chemotherapy may expose healthy cells and tissue to powerful doses of medicine and can thus cause side effects such as fatigue, pain and nausea.
  • Patients must monitor their blood count during chemotherapy in order to reduce the risk of complications, because some forms of chemotherapy interfere with bone marrow’s ability to produce enough white blood cells, red blood cells or platelets.

What is chemotherapy?

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Chemotherapy, or chemo, delivers medicine into the patient’s body to either kill cancer cells or slow their growth. Chemotherapy is most noted as a cancer treatment but may be used on noncancerous conditions as well. While treatments such as surgery and radiation physically remove or destroy the cancerous cells by targeting on the cellular level, chemotherapy works through the entire body (called systemic therapy).

Chemotherapy is used as either a stand-alone treatment or in addition to other forms of cancer treatment, such as surgery and radiation. Because chemotherapy works throughout the body, it is likely a good treatment plan for cancers that have spread to other organs and body tissue distant from the source, which means the cancer has metastasized.

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“Looking back I see the symptoms now but didn’t think it could have been that at the time,” says Stacy. “Cancer is scary at any age, but for me at my age the diagnosis was so unexpected and I felt so unprepared.”

Cancer specialists deliver chemotherapy to achieve one of three primary goals:

  • Cure – remove all the cancer cells
  • Control – reduce the size of tumors and stop the tumor from growing or spreading
  • Palliation – when the cancer is so far advanced that it can’t be cured, palliative chemotherapy seeks to shrink the cancer to reduce symptoms, thereby enhancing a patient’s quality of life.

Chemotherapy drugs are classified based upon chemical composition, how they attack cancer cells and how they interact with other drugs. Knowing how the drug works helps oncologists decide how to combine the drugs to optimize a patient’s treatment.

How is chemotherapy delivered?

Chemotherapy treatments consist of cycles of medication doses combined with periods of rest. A cycle is the period when the patient is regularly consuming the drug. The number of cycles and rest periods is determined based on the cancer, its stage and the overall treatment plan.

Chemotherapy can be administered in a pill form (orally), intravenously (a needle inserted into a vein), or directly into muscle tissues or spinal fluid. The method of delivery is determined by the type of drug and its directed use. For example, certain stomach enzymes easily break down types of chemo pills, so the medicine may be injected into the bloodstream instead of taken orally. The cycle and rest time are also determined based on the medicine used.

Most chemotherapy drugs are delivered either in an infusion room at a cancer treatment center or directly by an oncologist. Some forms, such as chemotherapy pills, can be taken at home.

Oral medication basics

Side effects of chemotherapy

Chemo is meant to target only cancerous cells, but sometimes healthy tissue and cells are affected in the process. This can cause side effects, which may vary according to the type of drug used.

Common side effects of chemotherapy include:

  • Nausea
  • Constipation
  • Fatigue
  • Pain
  • In some cases, nerve damage in the fingers and toes that may be permanent
  • Changes in the nervous system, including neurological symptoms such as dizziness, coordination challenges and confusion.

Chemo brain

Cancer patients may experience memory and cognitive problems during and after chemotherapy, which are sometimes described as a feeling of mental cloudiness. This mental fog has been coined “chemo brain.” Research has confirmed that some forms of chemo cause changes in the brain. The brain typically recovers to its previous state once chemotherapy treatments end. In rare cases, these changes can be more long term.

Some symptoms of chemo brain may include:

  • Lapse of memory
  • Challenges concentrating
  • Inability to multitask small activities
  • Trouble remembering details such as dates and names.

Managing side effects

Pain and other side effects of chemotherapy typically go away with time. However, sometimes treatment is necessary to combat the side effects of chemotherapy. This can include treating the source of pain with medicine or blocking the pain signals with spinal treatments.

It’s important to track symptoms and speak with a doctor as soon as the side effects begin to lower quality of life. Pain relief strategies might include directly treating the source of pain and changing medicine, chemotherapy cycles or spinal procedures that interfere with pain signals sent to the brain.

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Understanding and monitoring blood count

A blood count test measures in a blood sample the level of white blood cells (infection fighting cells), red blood cells (oxygen carrying cells), and platelets (blood clotting cells). Monitoring a patient’s blood count is imperative to reduce the risk of complications during treatment. This can be done by conducting a complete blood count (CBC).

Bone marrow, the liquid material inside bones, generates blood, and chemo can interfere with bone marrow’s ability to create blood with enough white or red blood cells, and/or platelets. If the blood count drops too low, a patient may be unable to fight infections and may experience anemia, which causes excessive fatigue, and uncontrollable bleeding.

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