Chemotherapy

When chemotherapy drugs travel through the bloodstream to reach cancer cells, it's known as systemic chemotherapy. When the drugs are directed to a specific area of the body, it's called regional chemotherapy.

Chemotherapy may be used:

• As a primary treatment to destroy cancer cells
• Before another treatment to shrink a tumor
• After another treatment to destroy remaining cancer cells
• To relieve symptoms of advanced cancer

How and where chemotherapy drugs may be given depends on a variety of clinical factors and personal preferences. You may receive your chemotherapy at home, in a clinic or outpatient care center, at a hospital or doctor’s office.

Chemotherapy drugs may be administered:

• Orally: In pill or liquid form are taken by mouth
• Infusion: Delivered directly into a vein through an intravenous drip. This process may take several hours.
• Injection: Delivered through a needle injected into a vein, muscle or under the skin
• Topically: In cream form and are spread on the skin
• Intrathecal: Delivered directly into the central nervous system
• Intraperitoneal: Given directly into the abdominal cavity

Chemotherapy drugs are very powerful and may cause side effects in caregivers and family members who come in contact with them. Patients should talk to their doctor before deciding whether to administer their own chemotherapy drugs (in pill, liquid or cream form), or whether to have them given by a medical professional. Patients who may require frequent injections or infusions may opt to get a port or catheter through which drugs may be administered more efficiently and with less pain. How your chemotherapy drugs are administered depends on a variety of factors, including:

• The drug prescribed
• The cancer being treated
• The stage of the disease
• The health of the patient
• The patient’s health history, including previous cancer treatments
• The patient’s personal preference

Depending on your treatment needs, chemotherapy drugs may be given in combinations, in addition to, or before and/or after other treatments, such as surgery, targeted therapy or radiation therapy. At Cancer Treatment Centers of America (CTCA), our medical oncologists and cancer care experts are trained in diagnosing cancer and delivering chemotherapy drugs. They will work closely with you and the rest of your care team to discuss chemotherapy options based on your individual needs.

Because chemotherapy drugs kill rapidly growing cancer cells, they also can harm healthy cells in the process. This can cause several different side effects.

• Fatigue: Fatigue is a common reaction to chemotherapy due to the treatment itself and the toll it takes on your body and mind, but also other physiological changes from chemotherapy that cause fatigue, like anemia or appetite loss.
• Hair loss: Some types of chemotherapy drugs damage the cells that are responsible for hair growth.
• Anemia (low red blood cell counts): Some types of chemotherapy drugs make it harder for your bone marrow to make new red blood cells.
• Infection: Chemotherapy drugs may impede the production of new white blood cells, which help fight infection.
• Easy bruising and bleeding: When chemotherapy drugs affect the bone marrow's ability to make platelets (which help your blood clot when you bleed), you may bleed or bruise more easily or excessively.
• Nausea and vomiting: Some types of chemotherapy can cause nausea and/or vomiting.
• Appetite changes and weight changes: Some chemotherapy drugs may diminish your appetite and cause weight loss, while others may boost your appetite and lead to weight gain.
• Constipation: Some chemotherapy drugs, as well as medicines used to manage pain, can cause constipation.
• Diarrhea: When chemotherapy drugs damage the healthy cells in your intestines or cause your bowels to speed up, diarrhea may occur.
• Mouth, tongue and throat problems, such as sores and pain with swallowing: If the fast-growing cells in your mouth, throat and lips are damaged by chemotherapy, you may experience problems like mouth sores and infections of your gums, teeth or tongue.
• Peripheral neuropathy or other nerve problems, such as numbness, tingling and pain: Chemotherapy drugs can damage your nervous system.
• Skin and nail changes such as dry skin and color change: Some types of chemotherapy drugs may damage the fast-growing cells in your skin and nails.
• Urine and bladder changes and kidney problems: Chemotherapy can harm cells in the kidney and bladder, causing symptoms like burning or pain when urinating.
• Fertility problems and changes in libido and sexual function: Some types of chemotherapy drugs can damage the ovaries in women or sperm cells in men, potentially resulting in infertility. Chemotherapy’s effects on the reproductive system may also alter hormone levels, impacting sexual function and libido.

Your chemotherapy prep checklist

Planning ahead for chemotherapy treatments may help make you more comfortable, keep track of important information and limit the number of things you’ll have to do after treatment.

• Connect with your cancer care team on questions about treatment and what to expect. Before you start chemotherapy treatment, you’ll be asked to sign a consent form. Prior to signing, it’s important that you fully understand details of your treatment, such as the types of drugs you’ll be given, side effects and other options you might have.
• Schedule an appointment with your dentist. Seeing the dentist a month before your treatment begins may help get a check on your oral health and help prevent serious mouth problems from side effects. Chemotherapy can make you more susceptible to infections, including in your mouth. An appointment ahead of your chemotherapy treatments may help your dental care team address outstanding concerns.
• Call your pharmacist. Part of planning for chemotherapy treatments includes preparing for potential side effects afterward. Call your pharmacist to have your medication prescriptions filled ahead of time.
• Ask a loved one to escort you to and from your appointment. It’s also helpful to have a loved one with you to take notes and help with medication instructions and other to-dos after treatment. If you’re going by yourself, recording notes on your phone may be helpful to review later.

At CTCA^®, our medical oncologists work closely with integrative care providers who offer services intended to help manage your side effects and improve your quality of life. Supportive care services that may be helpful to chemotherapy patients under certain circumstances include:

Results

During treatment with chemotherapy, you’ll visit your doctor often to determine how the treatment is going, how it’s affecting you and how well it’s doing its job and destroying cancer. During your visits, you may need to have several tests and exams, such as blood tests or magnetic resonance imaging (MRI) scans, to see how well your treatment is working. Your doctor is the best resource to ask about the results of chemotherapy. He or she will keep you updated on your treatment's progress.

While you should pay close attention to your side effects and share them with your doctor, you should not assume that their severity is associated with the treatment's success. In fact, side effects are not at all related to how well the chemotherapy is working.