Chemotherapy

What is chemotherapy?

Chemotherapy or ‘chemo’ is a type of treatment for cancer. It is one of a number of cancer treatments that use drugs to fight certain types of cancer. Chemotherapy may be given as the only treatment, or in combination with surgery or radiation therapy.

When you have cancer, the cancerous cells grow and divide in an uncontrolled way. Chemotherapy works by destroying the cancer cells so they don’t multiply and prevents tumor growth.

Chemotherapy is one of the most effective types of cancer treatments available. It is also used as a treatment for other conditions including autoimmune diseases and blood disorders.

Chemotherapy can be used in different ways:

• Adjuvant therapy: Chemotherapy is given to destroy cancer cells after radiation therapy or surgery.
• Curative therapy: Chemotherapy is given to eliminate cancer and it doesn’t return. Chemotherapy may be given alongside radiation therapy and/or surgery.
• Neoadjuvant therapy: Chemotherapy is given to shrink the tumor before radiation therapy or surgery.
• Palliative therapy: Chemotherapy is given to shrink tumors and reduce symptoms but doesn’t cure the cancer.

When is chemotherapy given?

Chemotherapy is used to treat a number of different cancers, including cancer that hasn’t spread to other parts of the body (called primary cancer) and cancer that has spread (metastatic cancer).

Are there different types of chemotherapy?

There are many different types of chemotherapy. The drug you receive will depend on many different factors including the type of cancer, its location, how advanced it is and your overall health. You may be given one type of chemotherapy drug, or a combination.

Chemotherapy medicines are grouped according to what they are made of and how they work. Some kill cancerous cells at certain stages of their life cycle and others kill the cells at all stages.

• Alkylating agents: These drugs damage a cell’s DNA so cancer cells cannot divide. Nitrosoureas, a certain type of alkylating agent, can move to the brain to kill cancer cells and treat certain brain tumors. Alkylating agents are the most common type of chemotherapy and were the first to be developed.
• Antimetabolites: These drugs stop cancer cells from making genetic material which is needed to create new cells.
• Topoisomerase inhibitors: Prevent the topoisomerase enzyme from allowing DNA to replicate, which prevents cancer cells multiplying. It also damages the cancer cell’s DNA.
• Mitotic inhibitors: Made of the same material that plants produce to protect themselves against predators, mitotic inhibitors interfere with the cancer cell’s ability to divide and multiply.
• Antitumor antibiotics: These drugs stop the cancer cell’s DNA from replicating. Anthracyclines are a type of antitumor antibiotic.
• Corticosteroids: Not typically considered a chemotherapy drug, they may be given to manage side effects. They can also kill cancerous cells and stop them from dividing.

How is chemotherapy given?

Chemotherapy treatment is usually systemic, which means it travels throughout the whole body. Systemic chemotherapy is usually given:

• Intravenously, called IV, via a vein known as an infusion. The drug is delivered into the vein via a needle, catheter, port or pump.
• As an injection.
• As a tablet or liquid that is swallowed.
• Topically, as a cream that is rubbed into the skin.

Some cancers require chemotherapy to be delivered directly to the part of the body they are affecting as they don’t respond to systemic chemotherapy. This includes:

• Intra-arterial chemotherapy: Chemotherapy is delivered into an artery which supplies blood to the tumor.
• Intracavitary chemotherapy: The drugs go straight into a body cavity, such as the belly or bladder.
• Intrathecal chemotherapy: Is delivered into the space between the brain and spinal cord.

The duration of chemotherapy treatment will depend on the type of drug you are receiving, ranging from several minutes to hours. A continuous infusion may last several days. Multiple rounds of chemotherapy are usually needed.

What are the risks and side effects of chemotherapy?

Chemotherapy targets all the cells in the body that are fast-growing. This includes cancer cells, as well as other healthy cells, which can cause side effects.

Our blood cells, hair follicles, skin cells and digestive tract all have cells that are fast-growing meaning they are affected, and common side effects include:

• Hair loss
• Anemia
• Constipation
• Bleeding
• Diarrhea
• Tiredness/fatigue
• Infection
• Nausea and vomiting.

Side effects will depend on the type of drug you are receiving.

Chemotherapy drugs may also put you at risk of a condition called neutropenia, as they lower your blood count. This condition makes it more difficult for the immune system to fight infections.

What are the benefits of chemotherapy?

Chemotherapy is an effective cancer treatment that has been used for many decades. It can rid the body of cancer completely and reduce the symptoms of the disease to improve quality of life. Chemotherapy can also improve the effectiveness of other treatments, such as radiation therapy and surgery.

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