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
Cancer chemotherapy; Cancer drug therapy; Cytotoxic chemotherapy
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 by experienced nursing staff 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. Patients may receive radiation therapy before, after, or while they are getting chemotherapy.
Chemotherapy is most often given in cycles. These cycles may last one 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. Patients and their family members will receive special training.
SIDE EFFECTS OF CHEMOTHERAPY
Because these medicines travel through the blood to the entire body, chemotherapy is described as a body-wide treatment.
As a result, chemotherapy may damage or kill some normal cells, such as those found in the bone marrow, hair follicles, and 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 patient reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects.
Your doctor and nurse will explain what you can do at home to prevent or treat side effects, such as:
- 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
- Practicing safe eating and drinking habits
- Washing your hands often with soap and water
- Monitor how well the chemotherapy is working
- Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body
Collins JM. Cancer pharmacology. Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 29.
National Cancer Institute. Chemotherapy and you: support for people who have cancer. Available at: www.cancer.gov/cancertopics/coping/chemotherapy-and-you. Accessed May 29, 2014.
Perry MC. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 182.
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 09/09/2015.