What is chemotherapy?

Chemotherapy is the use of drugs or medication to treat disease. The term comes from two words that mean “chemical” and "treatment.” Cancer chemotherapy can consist of one drug or a group of drugs that work together (combination chemotherapy).

A treatment plan that also includes surgery and/or radiation therapy is called combined modality treatment. Adjuvant chemotherapy is when anti-cancer drugs are used after another treatment, such as surgery or radiation, to destroy any cancer cells that may remain after surgery or radiation therapy.

How do chemotherapy drugs work?

Cancer cells grow in an uncontrolled manner, and they may break away from their original site and spread to other parts of the body. Chemotherapy drugs disrupt the cancer cell’s ability to grow and multiply. These drugs can affect normal tissue as well, because they act on any rapidly dividing cells in the body. Most normal cells are able to recover quickly when the treatment is over.

How are chemotherapy drugs prescribed?

The choice of chemotherapy drugs for each patient depends on the type and location of the cancer, its stage of development, how it affects normal body function, and the general health of the patient. You may be treated with one drug or several. A combination may be used, because cancer cells that are not affected by one anti-cancer drug may be destroyed by others. Also, drugs sometimes work better together than they can alone.

How long and how often will I receive treatments? How is chemotherapy given?

The length and frequency of your chemotherapy depends on the kind of cancer you have, the drugs being used, and how your body responds to them. Chemotherapy may be given daily, weekly, monthly, or at different intervals. Sometimes treatment is given in an on-and-off cycle that includes rest periods so that your body has a chance to build healthy new cells and regain strength.

Most chemotherapy drugs are given in one of the following ways:

  • Usually, chemotherapy drugs are delivered directly into your bloodstream through an intravenous needle.
  • Sometimes, you might be given a pill. If your chemotherapy is in pill form, take it as your doctor has prescribed.

Your doctor should be able to estimate how long you will be receiving chemotherapy. The planned schedule may be adjusted over time to suit your individual responses and treatment needs..

Why do some people have side effects from chemotherapy?

Cancer cells divide and reproduce rapidly, so the drugs chosen for chemotherapy are the ones most likely to stop fast-growing cells. Since some normal cells also grow quickly, they can be likewise affected by some of the anti-cancer drugs and unwanted side effects may result. Common side effects reported include nausea, vomiting, fatigue, and hair loss. Whether you have side effects or not depends on the particular drug used and your individual response to it.

What are the side effects of chemotherapy?

Parts of the body affected by chemotherapy may include:

  • Cells in your hair and bone marrow (can cause hair loss and a tired feeling).
  • Cells of the skin and mouth (can cause sores in your mouth, and dry skin and hair).
  • Cells in your stomach and intestines (can cause you to feel nauseated).

Should I take other medicine the day I get chemotherapy?

It is a good idea to discuss with your physician what medications you are currently taking to determine if there are any drug interactions that may occur between them and the chemotherapy agents prescribed.

Should I eat the day I get chemotherapy?

For first-time patients, it is strongly recommended that you eat if you have an appetite. You may also want to pack some snacks or a lunch, depending on the length of your treatment. Hard candy is good for taste alterations. Usually after the first treatment, patients are able to determine their body’s response to chemotherapy.

Why is infection more likely?

Most anti-cancer drugs affect the bone marrow, decreasing its ability to produce blood cells. The white blood cells produced in the bone marrow help to protect your body by fighting bacteria that cause infection. If the number of white cells in your blood is reduced, there is a higher risk of your getting an infection. During the course of your therapy, your doctor will closely watch your blood cell count.

What are the signs of possible infection?

  • A fever of over 100.4 degrees Fahrenheit (38.0 degrees Celsius)
  • Chills
  • Sweating (especially at night)
  • Loose bowels
  • A burning feeling when urinating
  • A severe cough or sore throat

Are all blood cells affected by chemotherapy?

Anti-cancer drugs may affect any of the blood cells that bone marrow produces. This includes red blood cells and platelets, as well as the white blood cells that fight infection. Each type of blood cell plays an important role in your body’s normal functions:

Red Blood Cells: The red blood cells carry oxygen to all part of the body. When your red blood cell count is low (a problem called anemia), your body tissues do not get enough oxygen to do their work. With anemia, you may feel tired, dizzy, chilly or become short of breath. Be sure to report any of these symptoms to your doctor.

Platelets: Platelets help make your blood clot to stop the bleeding when you hurt yourself. If there are not enough platelets in your blood, you may bleed or bruise more easily than usual. Be sure to tell your doctor if you are bruising easily. Also report any unusual bleeding, such as from the gums or nose.

What is a nadir and how does it affect my blood cells?

All anti-cancer drugs have a cycle of destroying cancer cells. Normal cells can be affected as well. The nadir is the time following chemotherapy at which blood counts reach lowest levels before blood cells begin to recover. Typically the nadir after most anti-cancer drugs are given is about 10 days to 2 weeks. Your doctor will have you follow up at the office and check blood levels approximately at the time of your nadir.