Breast CancerCancer / Oncology

All you need to know about chemotherapy

Chemotherapy for cancer is often recommended by doctors. Chemotherapy uses medications that kill and prevent the splitting of cancer cells.

Many chemotherapy medications have serious adverse effects. However, if a doctor recommends a person to have chemotherapy, the benefits are usually overweight over any adverse events.

As part of an overall treatment plan, a person also undergoes chemotherapy, including surgery and radiation therapy. In many cases of cancer, these treatments are successful. The efficacy, among other factors, is often dependent on the stage of cancer.

If you speak to your doctor, a person can understand what chemotherapy can mean.

What is chemotherapy?

Chemotherapy medicines treat cancer by preventing the division of cancer cells.
Chemotherapy medicines treat cancer by preventing the division of cancer cells.

A healthy body replaces cells continuously through a dividing and increasing cycle. Cells multiply uncontrolled as cancer happens.

Since they are rapidly forming cells in part of the body, they begin to occupy the space used by useful cells.

The ability of a cancer cell to differentiate and multiply is hampered by chemotherapy medicines.

This can be achieved by a single drug or drug mixture.

Treatment can either:

  • attack cancer cells throughout the body or
  • target specific sites or processes

What does chemotherapy do?

Chemotherapy drugs can:

  • prevent cell division
  • target the cancer cells’ food source (the enzymes and hormones they need to grow)
  • trigger apoptosis, or the “suicide” of cancer cells

Some new therapies aim to stop new blood vessels from growing, which supply a tumor to hunger it. Some scientists are concerned that in some cases this strategy may stimulate cancer growth and spread.

However, other researchers concluded in 2018 that some people could be helped.

Why the use of chemotherapy?

Doctor may recommend chemotherapy:

  • to shrink a tumor before surgery
  • Just after surgery or remission, to remove any remaining cancer cells and delay or prevent a recurrence
  • to slow disease progression and reduce symptoms in the later stages, even if a cure is unlikely

What to expect

Chemotherapy is a procedure that is invasive and which can have serious adverse effects during and after the treatment. The reason for this is that the drugs also kill both cancer cells and healthy cells.

Early treatment, however, may sometimes be completed with chemotherapy. This is worth many of the side effects. However, after the treatment stops, most of the unwanted effects go away.

How long does chemo last?

The doctor will make a plan for the person, specifying when and how many treatments will be necessary.

Depending on the type and stage of cancer, a single dose may vary from one day to several weeks.

Those who need more than one operation have a recovery period in order to heal their body.

A person can undergo therapy on a day, then a week’s rest, a day’s treatment and then a three-week rest period. A person can repeat it multiple times.

Many people may find mental and emotional cancer and chemotherapy helpful to speak to a counselor.

Blood tests

Blood tests assess the health of the individual to ensure that the possible side effects are met.

Health of the liver: the liver breaks up chemotherapy and other medication. Another problem can occur if the liver is overloaded. If a blood test detects hepatic problems prior to treatment, the individual may have to postpone treatment until he or she recovers.

Low red or white blood cell counts or platelets: if the blood counts are low before treatment, a person might have to wait until beginning chemotherapy for them to reach healthy levels.

In order to keep the blood and liver functions as healthy as possible and to control the effectiveness of treatment, regular blood tests should be performed during the treatment period.

How do you administer the dose?

In a clinical setting most of the guests undergo chemotherapy, but sometimes they can go home.

Ways of taking chemotherapy include:

  • by mouth, as tablets, liquid or capsules
  • intravenously, as an injection or infusion
  • topically, onto the skin

A person can take the medicine at home in some cases. We must however visit the hospital regularly to check their health and how we respond to therapy.

The dosage is to be administered exactly as prescribed by the doctor. When you forget to take a dose at the right time, call your doctor.

A person often needs an ongoing dosage. This means that a pump that gradually supplies the medication for several weeks or months may be required. As they go about their daily lives, they can wear the pump.

Side effects

Chemotherapy may lead or adverse effects ranging from mild to severe, depending on treatment type and scope. Most individuals will have little to no adverse effects.

There may be a wide range of adverse effects.

Nauseas and vomiting

Nausea and vomiting Medicines can be administered to reduce the effects by antiemetical medications. EOLBREAK EOLBREAK According to one study, taking ginger or ginger supplements will improve the efficiency of antiemetics.

Hair, nails, and skin

A few weeks after some types of chemotherapy are initiated, some people may suffer from hair loss or their hair might become thin or broken. Any part of the body will suffer.

Using a special mask, the scalp can remain cool during chemotherapy, which can avoid hair loss or rising it. But this is not possible if the procedure must reach the scalp.

A consultant may give advice on getting a hairstyle or another appropriate cover. Many people find that their hair grows back after the treatment has been completed.

Nails may also become brittle and flaky.

The skin may get swollen, sore and sun-sensitive. Under direct sunlight, people should be careful including:

  • avoiding the sun around midday
  • using sunblock
  • wearing clothes that provide maximum protection

Fatigue

Many people may be tired. This can be felt most of the time or only after those events.

A person should try to:

  • get plenty of rest
  • avoid tasks that are overtiring

People with severe fatigue should talk to their doctor, as this may be a symptom of anemia

Hearing impairment

The toxins can affect the nervous system in some forms of chemotherapy, which lead to:

  • tinnitus, or ringing in the ears
  • temporary or permanent hearing loss
  • balance problems

Any changes in the hearing should be reported to the doctor.

Infections

The number of white blood cells that protect the body against infection will fall due to chemical therapy. The immune system has been compromised and the risk for infections has been increased.

People should be careful to reduce the risk of infection.

These include:

  • washing hands regularly
  • keeping any wounds clean
  • following appropriate food hygiene guidelines
  • getting early treatment if a person suspects an infection

An antibiotic can be prescribed by a doctor to reduce the risk.

Bleeding problems

A person’s platelet count can be decreased by chemotherapy. It means that the blood no longer coagulates as normal.

The person may experience:

  • easy bruising
  • more bleeding than normal from a small cut
  • Always nosebleeds or bleeding gums

The person might need a blood transfusion if the platelet count is too low.

People should pay extra attention to cooking, gardening and rashing activities in order to minimize the risk of damage to themselves.

Anemia

Oxygen is transmitted to all body tissues by red blood cells. The levels of red blood cells may fall by chemotherapy. This causes anemia.

Symptoms include:

  • tiredness
  • shortness of breath
  • heart palpitations

The body may be able to take more red blood cells to drink additional iron. People can take their diet in additional iron. The good sources of food include:

  • dark green leafy vegetables
  • beans
  • meat
  • nuts
  • prunes, raisins, and apricots

Call your doctor if you are suffering from serious or worsening signs of anemia. Others may need a transfusion of blood.

Mucositis

The mouth to anus may affect any part of the digestive system, causing mucositis, or inflammation of the mucous membrane.

The mouth is affected by oral mucositis. Self-treatment also occurs 7–10 days later. Symptoms, which may differ by dosage, can cause pain in eating or talking. Several suffer in their mouths or lips from burning pain. Bleeding may mean that a person is infected or at risk. After treatment is finished, symptoms usually disappear for some weeks.

A physician may prescribe medicines to prevent or treat them.

Loss of appetite

Chemotherapy, cancer or the two may affect the way in which the body processes nutrients that may lose appetite and weight.

The severity depends on the type of cancer and chemotherapy, but the person usually recovers after therapy.

It provides advice for resolving:

  • eating smaller, more frequent meals
  • consuming nutrient rich drinks, such as smoothies, through a straw, to help maintain fluid and nutrient intake

People who find it too hard to eat may have to spend some time in the hospital, where health workers may provide nutrition either intravenously or through a feeding tube.

Pregnancy and fertility

Sexual interest is often lost during chemotherapy, but usually returns after treatment.

Fertility: some chemotherapy forms in men and women can decrease fertility. This returns after treatment often, but not always. But people who want to have kids in the future may consider freezing sperm or embryos for subsequent use.

Pregnancy: How different forms of chemotherapy affect a developing fetus is not entirely clear. If a woman needs chemotherapy while pregnant, the doctor may suggest waiting for the first 12–14 weeks, since it is when the bodies of the fetus develop quickly. After the first trimester, chemotherapy may be started if a doctor deems it necessary.

A pregnant woman is given the last procedure about 8 weeks prior to delivery to reduce her or her mother’s and baby’s risk of infection.

Since chemotherapy can have serious side effects, it may be best to prevent pregnancy during treatment. A doctor can tell you about effective methods of birth control.

Anyone who is pregnant or who gets pregnant will tell the doctor straight away.

Bowel problems

Diarrhea, constipation and expulsion of damaged cells by the body can also result from chemotherapy.

Symptoms often start a couple of days after starting treatment.

Cognitive and mental health problems

Up to 75% of the population report problems with chemotherapy, thinking and short-term memory. Cognitive problems can continue for months or years after medication for up to 35 percent of these may.

Chemotherapy can also make thought, planning and multitasking difficult. Many people have mood and depression swings.

Such symptoms can also be caused or worsened by both the treatment and an uncertainty about the disease.

Types

Chemotherapy types include:

alkylating agents: these damage the DNA and destroy the cells at various stages during the process of cell life.

Antimetabolites: These mimic proteins to live in cells. These are of no use if the cells eat them, and the cells are starving.

Plant alkaloids: Those prevent a growth and breakdown of the cells.

Antibiotics: Those keep cells from breeding. Antibiotics: These differ from those used to treat an infection with antibiotics.

A suitable alternative would be recommended by the doctor. You may recommend that chemotherapy be combined with other treatments, such as radiation or procedure.

Effectiveness

Factors that influence the type and function of chemotherapy include:

  • the location, type, and stage of the cancer
  • the person’s age, overall health, and any existing medical conditions

Outlook

The outlook for a person receiving chemotherapy will largely depend on the cancer type, stage, and location and overall health of that person. This can achieve complete remission in some cases.

However, adverse effects can occur and during treatment, a person may need to adjust their lifestyle or work routine. These usually resolve after termination of treatment, however.

A person may wish to discuss with his or her doctor before starting treatment:

  • why they are recommending chemotherapy
  • what the other options are
  • which types are available
  • how much it will cost
  • what to expect in terms of adverse effects

They should also speak to:

  • their insurance provider about covering the costs
  • their employer about how treatment may affect their work routine
  • their loved ones about what to expect

A doctor may often contact a person with a counselor or support group, who may help.

Q:

I knew some people who had declined chemotherapy when they had cancer at a later stage. Is that really a good idea?

A:

The situation is different for every person. No-one should make a decision without exploring all the options available. Getting an frank, open discussion with friends, family, and their doctors about outcome potentials and expectations is very critical.

Alan Carter, PharmD

Answers represent the views of our experts in medicine. All content is strictly informative, and the medical advice should not be considered.

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