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Chemotherapy

Cancer chemotherapy; Cancer drug therapy; Cytotoxic chemotherapy

Cancer touches almost everybody — our friends, our family, ourselves. Wherever you or a loved one faces cancer, CHI Franciscan Cancer Care is here to fight with you. From preventive screening services and personalized treatment plans, to clinical trials with leading-edge treatments and nurse navigators who can help you access resources, our team strives to bring you through your cancer journey and into survivorship.

 Learn more about CHI Franciscan Cancer Care

The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:

  • Cure the cancer 
  • Shrink the cancer
  • Prevent the cancer from spreading
  • Relieve symptoms the cancer may be causing

Information

HOW CHEMOTHERAPY IS GIVEN

Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including:

  • Injections or shots into the muscles
  • Injections or shots under the skin
  • Into an artery
  • Into a vein (intravenous, or IV)
  • Pills taken by mouth
  • Shots into the fluid around the spinal cord or brain

When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery.

There are many types of catheters, including:

  • Central venous catheter
  • Central venous catheter with a port
  • Percutaneously inserted central catheter (PICC)

A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line.

Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy.

Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose.

Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training.

DIFFERENT TYPES OF CHEMOTHERAPY

The different types of chemotherapy include:

  • Standard chemotherapy, which works by killing cancer cells and some normal cells.
  • Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells.

SIDE EFFECTS OF CHEMOTHERAPY

Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment.

As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract.

When this damage occurs, there can be side effects. Some people who receive chemotherapy:

  • Are more likely to have infections
  • Become tired more easily
  • Bleed too much, even during everyday activities
  • Feel pain or numbness from nerve damage
  • Have a dry mouth, mouth sores, or swelling in the mouth
  • Have a poor appetite or lose weight
  • Have an upset stomach, vomiting, or diarrhea
  • Lose their hair
  • Have problems with thinking and memory ("chemo brain")

Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects.

Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include:

  • Being careful with pets and other animals to avoid catching infections from them
  • Eating enough calories and protein to keep your weight up
  • Preventing bleeding, and what to do if bleeding occurs
  • Eating and drinking safely
  • Washing your hands often with soap and water

You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to:

  • Monitor how well the chemotherapy is working
  • Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body

Test Your Chemotherapy IQ

  • The goal of chemotherapy is to:

     

    A. Cure cancer

     

    B. Keep cancer from spreading

     

    C. Relieve cancer symptoms

     

    D. All of the above

    Correct Answer
    The correct answer is all of the above. Chemotherapy refers to cancer-killing medicines. These medicines can sometimes offer a cure. But even in incurable cases, chemotherapy can help slow the spread of cancer and relieve symptoms.
  • Chemotherapy is the best treatment for all forms of cancer.

     

    A. True

     

    B. False

    Correct Answer
    The correct answer is false. Doctors often treat early-stage cancer without chemotherapy. Surgery followed by radiation therapy is standard for many early-stage cancers, including breast cancer. Your oncologist will recommend a treatment strategy based on the type and stage of your cancer.
  • Chemotherapy is given by:

     

    A. Injection

     

    B. Mouth

     

    C. Intravenous line (IV)

    Correct Answer
    The correct answer is any of the above. How you receive chemotherapy depends on the type of cancer and where it is found. If you need chemotherapy for a long period of time, doctors can put a thin catheter, called a central line, into a large vein. The catheter stays in place throughout treatment to make it easier to deliver the medicine.
  • Chemotherapy is usually given in cycles.

     

    A. True

     

    B. False

    Correct Answer
    The correct answer is true. Chemotherapy is most often given in cycles. These cycles may last one day, several days, a few weeks, or more. There will usually be a rest period with no chemotherapy between each cycle. A rest period may last for days, weeks, or months. This allows your body to recover before the next dose.
  • Taking vitamins and dietary supplements during chemotherapy:

     

    A. Is always a good idea

     

    B. Is always dangerous

     

    C. May be OK if you check with your doctor

    Correct Answer
    The correct answer is that supplements may be OK if you check with your doctor. Some vitamins, minerals, or herbs may change how chemotherapy affects your body. Make a list of any supplements you want to take and discuss it with your doctor.
  • Besides attacking cancer cells, chemotherapy may damage healthy cells in the:

     

    A. Hair

     

    B. Lining of the digestive tract

     

    C. Bone marrow

     

    D. All of the above

    Correct Answer
    The correct answer is all of the above. Chemotherapy medicines travel throughout your entire body. This means they may damage or kill some normal cells. Depending on which cells are damaged, side effects may include hair loss, nausea, anemia, fatigue, and greater risk of infection.
  • If you lose your hair during chemotherapy, it will never grow back.

     

    A. True

     

    B. False

    Correct Answer
    The correct answer is false. If you lose your hair, it will most likely grow back 2 to 3 months after you finish chemotherapy. But it may not look the same as your old hair. It may have a different texture or color. Losing your hair can be difficult. Talk with your doctor about ways to deal with hair loss.
  • To cope with a poor appetite during chemotherapy:

     

    A. Eat low-calorie foods

     

    B. Only eat when you are hungry

     

    C. Eat 5 or 6 small meals a day

    Correct Answer
    The correct answer is eat 5 or 6 small meals a day. Get the most out of each small meal by eating foods that are high in calories and protein. Set a schedule for your meals and eat even if you aren't hungry. Eating well helps your body fight your cancer.
  • To prevent infections during or soon after chemotherapy:

     

    A. Be careful what you eat or drink

     

    B. Wash your hands often

     

    C. Stay away from crowds and people were sick

     

    D. Be careful with pets and animals

     

    E. All of the above

    Correct Answer
    The correct answer is E, all of the above. Chemotherapy can make you more vulnerable to infection. Protect yourself by avoiding raw foods, unsanitary water, and crowds. Wash your hands with soap and water often, especially after handling food or doing housework.
  • It's impossible to work while receiving chemotherapy.

     

    A. True

     

    B. False

    Correct Answer
    The correct answer is false. Many people continue working during chemotherapy. It helps if you can work from home or take a day off when your energy is low. State or federal laws may require your employer to let you adjust your work schedule during chemotherapy.

References

Collins JM. Cancer pharmacology. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 29.

Doroshow JH. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 179.

National Cancer Institute website. Chemotherapy to treat cancer. www.cancer.gov/about-cancer/treatment/types/chemotherapy. Updated April 29, 2015. Accessed May 15, 2018.

  • Immune system structures

    Immune system structures - illustration

    The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.

    Immune system structures

    illustration

    • Immune system structures

      Immune system structures - illustration

      The immune system protects the body from potentially harmful substances. The inflammatory response (inflammation) is part of innate immunity. It occurs when tissues are injured by bacteria, trauma, toxins, heat or any other cause.

      Immune system structures

      illustration

    Talking to your MD

     
     

    Review Date: 4/2/2018

    Reviewed By: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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