Chemotherapy

What is Chemotherapy?

Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. It works by targeting fast-growing cells in the body, a characteristic of most cancer cells. Chemotherapy can be used to:

- Cure cancer: The aim of chemotherapy is to cure cancer by eradicating (destroying) the cancer cells. This is more the case for a primary cancer diagnosis.

- Control cancer growth. In the case of a secondary cancer diagnosis, chemotherapy is used not as a cure, but to 'stop the cancer in it's tracks'. Chemotherapy can be used to add years to a life by slowing or halting the cancer spread.

- Relieve symptoms caused by cancer. Particularly in a secondary cancer diagnosis (where the hope of curing the cancer has passed), chemotherapy is used to slow, shrink or delay the cancer therefore help provide releif from symptoms caused by the cancer.

Chemotherapy can be administered in various settings, including hospitals or outpatient clinics, depending on the specific treatment plan and the patient's health.

What to Expect

1. Treatment Schedule: Chemotherapy usually involves a series of treatment cycles, often lasting several weeks. Each cycle typically includes a treatment day followed by a rest period, allowing your body time to recover. You will quickly come to learn your new routine based on how many days after treatment you will feel side effects vs how many days you will feel better. This can help plan activities and the need for extra support.

2. Administration: Chemotherapy can be given in different ways:

- Intravenous (IV) infusion

- Oral pills or capsules

- Injections into a muscle or under the skin

- Directly into the cerebrospinal fluid or pleural cavity, depending on the type of cancer

3. Monitoring: During treatment, you will have regular check-ups, including blood tests, to monitor your response to the drugs and manage any side effects.

Types of Chemotherapy

There are many different chemotherapy drugs, and they can be classified by their action or purpose:

- Alkylating agents: Damage DNA to prevent cancer cells from dividing (e.g., cyclophosphamide).

- Antimetabolites: Disrupt cell growth by mimicking natural substances (e.g., methotrexate).

- Anti-tumour antibiotics: Kill cancer cells by interfering with DNA (e.g., doxorubicin).

- Topoisomerase inhibitors: Block enzymes involved in DNA replication (e.g., irinotecan).

- Mitotic inhibitors: Prevent cell division (e.g., paclitaxel).

Side Effects

Chemotherapy affects everyone differently, and side effects depend on the specific drugs used and individual tolerance. Common side effects include:

- Nausea and vomiting

- Fatigue or tiredness

- Hair loss (not every chemotherapy will cause hair loss)

- Changes in appetite or taste preferences

- Increased risk of infections due to low blood counts (neutropenia)

- Mouth sores

- Diarrhoea or constipation

- Skin changes, including rashes or sensitivity

Some side effects may begin shortly after treatment, while others can develop over time. It is essential to communicate any adverse effects to your healthcare team.

Managing Side Effects

1. Nausea and Vomiting: Anti-nausea medications (antiemetics) are commonly prescribed. Eating small, frequent meals and avoiding strong smells can also help.

2. Fatigue: Rest is crucial. It’s important to balance activity and rest and engage in light physical activity when possible.

3. Hair Loss: This does not affect everyone and is often dependent on the type of chemotherapy. There is a treatment available to attempt to preserve hair follicles called the 'cold cap' which your team will discuss with you. The cold cap is not a guarantee and can be quite painful to tolerate (often described like having an ice cream headache but for an hour). Some people have said the cold cap works better if you cut your hair shorter first so that it can get close to the skin. Hair usually regrows after treatment ends, but there are risks of something called Chemotherapy Induced Alopecia whereby the hair loss is permanent and is more of a risk with some cancer treatments than others.

4. Changes in Appetite: Eating small amounts of nutritious food can help. Consulting a dietitian for tailored advice can also be beneficial.

5. Infection Risk: Maintain good hygiene, avoid contact with sick individuals, and schedule regular blood tests to monitor white blood cell counts.

6. Mouth Sores: Rinse with warm salt water, and consider soft or pureed foods that are easier to swallow.

7. Diarrhoea or Constipation**: Dietary adjustments, hydration, and medication can be effective in managing these symptoms.

8. Skin Care: Use gentle skincare products and protect the skin from sun exposure.

Conclusion

Chemotherapy can be a challenging but crucial part of cancer management. Understanding the process, its side effects, and how to manage them can help improve your experience. Always discuss any concerns or symptoms with your healthcare provider to receive the necessary support. Your team will give you specific information about the type of chemotherapy you will be having and how to manage the side effects.

It is often very useful to find community support groups or other people sharing their own story on social media. Reaching out to people who have had similar treatments can help with everyday questions.