Chemotherapy

Chemotherapy is a type of cancer treatment that uses anti-cancer drugs or a combination of different drugs to kill cancerous cells. Unlike other cancer treatments like radiation therapy and surgery that destroys cancerous cells in a particular area; chemotherapy reaches the remote areas of the body away from the original tumour site to kill cancer cells.

The human body is made of trillions of cells, which are normal cells. When they die, new cells replace them. This is, however, done in a balanced way. The production of normal cells is hindered when abnormal cells start to grow profusely in the body, thus removing normal cells out of the way. These abnormal cells that divide relentlessly and grow abnormally are the cancer cells. Chemotherapy drugs are, therefore, given to kill the cancer cells throughout the body.  

Chemotherapy works by impairing mitosis by preventing cell division; targeting the main sources of food, hormones and enzymes of the cancer cells that help them to grow and divide; preventing new blood cells from supplying to the tumours and triggering abnormal cell suicide.

What are the three basic functions of chemotherapy?

• It helps to cure cancer to the extent that all cancer cells are destroyed and none is left.
• It controls cancer from spreading, by destroying or slowing growth of cancer cells.
• Also called palliative care, chemotherapy helps to ease cancer symptoms by shrinking tumours causing pressure or pain.

Your doctor decides about the planning of chemotherapy treatments, including the types of chemotherapy drugs to be used, the chemotherapy doses, your chemotherapy schedule, etc. Chemotherapy helps to treat different types of cancer, but in many cases the procedure is combined with other therapies and surgeries for cancer treatment.

A protocol plan is determined by the doctor that specifies the types of treatment for individual cases and the duration of the treatment required. The course of chemos may require only a day or may extend up to weeks, depending upon the stage and type of cancer. After each treatment, the patient is given a rest period to allow the body to recover before the next treatment starts.

Other than a chemotherapist, there are other doctors involved in the team that includes a haematologist, a clinical oncologist, a psychologist, a pathologist and a cancer nurse.

Chemotherapy side effects are caused when active cells are affected. When a person has cancer, the active cancer cells grow and divide, but there are some healthy cells remaining in the body as well. During chemotherapy, the cancer cells die along with the normal cells, thus resulting into side effects.

The most common side effects of chemotherapy treatment due to destruction of healthy cells include pain, fatigue, throat and mouth sores, nausea, diarrhoea, blood disorders, constipation, changes in memory and thinking, appetite loss, hair loss, etc.

Once it is finalized by the doctor that you need chemotherapy, there are a few preparations to be taken.

Before chemotherapy treatment, the preparations depend upon the type and stage of cancer.

• If you have a question on mind, ask your doctor. A few common things that you may want to know are what type of chemo medications will be given to you, the side effects of chemo medications, the formalities you have to go through (like signing forms, etc), the duration of hospital stay after the treatment, the type of other medications that can be taken and the ones that need to be stopped, etc.
• Stop smoking or drinking alcohol before the treatment. Make sure you have a well-balanced diet full of proteins and calories.
• Make arrangements for transportation to and from the doctor’s office during the treatment.
• Have lots of rest before the treatment.
• Most importantly, keep sufficient finances ready; make arrangements for payment plans, set up bills that can be automatically reimbursed from your account, etc.
• You will have to undergo several blood tests to determine if you are fine to receive the chemos. When the treatment progresses, further blood tests are done to check how your body is responding to the treatment.
• Several radiologic tests like CT, PET, X-ray, MRI and ultrasounds are performed by your doctor before, during and after the chemotherapy procedure.

The two major ways of giving chemotherapy are in the form of oral pills or injecting into the veins or through an IV. Oncologists discuss with the patient or patient’s family about the best course of treatment and then start the right chemotherapy procedure. Other than oral and intravenous chemotherapy treatments, there are other ways:

• Intra-arterial (IA)- The chemotherapy reaches the artery directly where the cancer cells are found.
• Topically- Chemotherapy treatment is also available in the form of cream that you can rub on the skin where the cancer is.
• Intraperitoneal (IP)- In this procedure, chemotherapy directly reaches the peritoneal cavity, such as, the stomachs, liver, intestines, ovaries.

If chemotherapy is given through an IV, these are the steps followed:

• You are asked to lie down. A thin needle in inserted in your lower arm or hand into the vein. Chemo is administered through the channel created in your vein that reaches the cancer site in your body. The needle is removed after chemo is given.
• IV chemos are often given with pumps, ports or catheters. A catheter is a soft tube placed in your chest area in a large vein. Sometimes, doctors prefer keeping the catheters in place during the entire treatment procedure. A port may also be used for the IV chemo treatment. It is a round, small disc made out of metal or plastic that is placed under your skin. A catheter helps connect the port to a large vein. This enables the nurse to inject chemotherapy through a needle into the port or to draw blood. The nurse keeps a check for infections around the port. There are two types of pumps use, internal or external, to connect to the port or catheter. The pump ensures how fast chemo travels through the port or catheter. Internal pumps are positioned under the skin, while external pumps are kept outside the body.

The after effects of chemotherapy vary from person to person. Most people do not feel right after a chemo. The most common signs of chemotherapy are feelings of exhaustion, fatigue, etc. It is better if you chalk out a diet plan, determine your rest time and have someone to drive you home on the day of the therapy. It should be known that side effects may not show until days or weeks post the therapy.

The recovery of chemotherapy is quick for some, while it takes a lot of time for others. However, one of the common symptoms of chemotherapy is hair loss. Therefore, buy a handkerchief or a wig to for later use.