Chemotherapy

Introduction

Chemotherapy refers to medicines that can kill or control cancer. Chemotherapy medicines target and treat a specific area affected by cancer. These medicines travel to all parts of the body through the bloodstream. Chemotherapy is a systemic treatment, which means it is a treatment that affects the whole body.
There are many kinds of chemotherapy. The medicine chosen will depend on the type and the extent of the cancer, as well as the potential side effects of the medicine. Each medicine will have its own specific side effects. Most of the time, chemotherapy is given as an outpatient procedure in a clinic or a doctor's office. People generally do not need to stay overnight in the hospital to receive chemotherapy.

Who is a candidate for the procedure?

Following are some of the common uses of chemotherapy:
Some types of cancer respond better to chemotherapy than others. Leukemia, lymphoma, breast cancer, and colorectal cancer are often treated with chemotherapy.

How is the procedure performed?

Most chemotherapy medicines are given directly into a vein. This allows them to enter the bloodstream quickly. Some medicines are given by mouth. These medicines are absorbed from the stomach into the bloodstream. Combinations of medicines are often used for the most effective treatment

to control the growth of the cancer

to cure the cancer

to relieve the symptoms or pain caused by the cancer   

What happens right after the procedure?

Before chemotherapy medicines are given, the person will receive medicines that help prevent or lessen side effects. After the procedure, additional medicines are given if needed. Also, the person will be sent home with instructions on how to manage expected side effects. The person will be told how to reach the healthcare provider to report problems.

What happens later at home?

Side effects can usually be well managed. Medicines are often given after the person returns home to prevent or manage these problems. The person will need to stay in close contact with the healthcare providers administering the medicine.

What are the potential complications after the procedure?

Complications vary depending on the type of medicines used. Hundreds of medicines are available to be used for chemotherapy. Each medicine will have a specific set of side effects. Many people have only mild problems related to the therapy. Most side effects are temporary and resolve when treatment ends. Few medicines cause permanent problems.
Chemotherapy not only affects cancer cells. It also affects normal body tissues, such as bone marrow and hair. These tissues are very active. In other words, the cells in these tissues are multiplying rapidly. Normal tissue is usually able to completely recover from the effects of chemotherapy. Cancerous tissue is usually not able to recover. The following are common side effects that people have when they are undergoing chemotherapy. However, not all medicines used for chemotherapy will cause each of these problems.
Bone marrow suppression. The bone marrow is very active, producing components of the blood continuously. Most of the time, chemotherapy causes a temporary decrease in the number of normal blood cells. Low numbers of white blood cells make a person more vulnerable to infections. Low numbers of red cells make a person tire easily. Low numbers of platelets may cause the person to bleed more easily. The complete blood count, or CBC, will be monitored closely. Blood counts generally recover in time for the next cycle of treatment.
Hair loss. Not all chemotherapy causes hair loss. The person may only have thinning of the hair on the head. Rarely does chemotherapy cause a person to lose all body hair. Usually only the hair on the head is involved. When hair loss occurs, it is temporary. There is no proven way to prevent hair loss. Many times, hair growth will resume before the end of planned treatment.
Nausea. Not all chemotherapy causes nausea, vomiting, or other stomach upset. However, these symptoms can be significant with some chemotherapy. Medicines can usually prevent this side effect at the time the chemotherapy is given. Other medicines can be offered to help with nausea when the person is at home. Changing the diet by avoiding strong-smelling or spicy foods may be helpful. Food that can be tolerated will be different for each person.
Fatigue. Many people undergoing chemotherapy experience fatigue. The emotional toll of having cancer and undergoing therapy can contribute to the loss of energy. Radiation therapy, surgery, or chemotherapy can place demands on the person's energy reserve. Low numbers of red blood cells also make the person feel weak. Many times, increasing activity can actually improve energy. Too much napping or resting may actually make fatigue worse. After chemotherapy has been completed, fatigue usually resolves.
Other side effects. Each medicine used for chemotherapy will have specific side effects. It is important for the person receiving these medicines to know what might occur. The person should expect to receive clear instructions for managing side effects. If there are any questions, the person should ask the healthcare provider to make instructions clear. Knowing what to expect and how to handle problems will help the person through the cancer treatment experience.

Reference  
Perry, M.C; Anderson, C.M; Dorr, V.J; Wilkes, J.D. (1999)

Principles of Cancer Management: Chemotherapy in Cancer: Principles and Practice in 5th Edition. Lippincott-Raven: Philadelphia. Pp. 333-345