What is Chemotherapy?

Chemotherapy, popularly known as chemo, can be defined in two ways:

• Basic definition:

Chemotherapy is the use of drugs to treat or manage a disease or health condition.

• ii). Detailed definition:

Chemotherapy is a cancer treatment method that involves an aggressive use of chemical drugs which destroy neoplasms by targeting rapidly growing cells in the body (cancer cells proliferate much faster than normal body cells).

To ensure total cure, or the best treatment outcomes for cancer treatment, chemo is normally combined with other modes of treatment such as immunotherapy, radiotherapy, hormonal therapy, and surgery.

Did you know that….?

1. Oncology is the branch of medicine that deals with cancer management.
2. An Oncologist is a specialist doctor who provides care and treatment for cancer patients.

How Chemotherapy Works

Chemo medications can be administered topically, orally, or via intravenous injection.

The drugs used in chemo eradicate cancer cells by damaging rapidly growing cells in the body. The exact mechanism of action varies with the class of drugs used.

For instance, antimetabolites class of antineoplastics act by inhibiting DNA synthesis. On the other hand, antibiotics, intercalators, and alkylating agents act by interfering with the activity of topoisomerase enzyme, inhibiting RNA synthesis, and disrupting the DNA strand structure in cancer cells respectively.

Before a patient is put on chemotherapy, oncologists often undertake a number of tests to establish:

• The stage of the disease.
• Location of the cancer cells.
• Patient’s overall health status

Moreover, Chemotherapy often has some serious side effects that might severely impact a patient’s quality of life. In that regard, your oncologist will provide brief you on the risks and benefits associated with of the treatment option. That way, the patient can weigh options and decide whether or not they should be put on the medications.

Quick Read: How to remove acne scars

The choice of chemo drugs to be received by a particular cancer patient is determined by, among other factors, the following:

•  The type and stage of the disease
• The overall health of the patient
• Previous cancer treatments undertaken
• Patient’s expectations and preferences

Treatment Options

Chemotherapy class of medications is primarily used in the management of cancer. Be that as it may, chemo is not a preserve of cancer patients. The truth is chemo is also used in the treatment and management of a plethora of other non-cancer related disorders. Below is a detailed breakdown of some of the uses of chemotherapy….

1. In Cancer Treatment

Chemotherapy is mainly used in the management of cancer. The reason for this is attributed to its high levels of efficacy in the treatment and cure of neoplastic conditions when compared with other treatment options. Some of the uses here include:

•  Eradication of any left over cancer cells following radiotherapy or surgery operations such as lumpectomy for breast cancer or thyroidectomy for thyroid cancers.
•  Reduction of tumor size in preparation for radiotherapy or surgery.
• Relieving cancer symptoms. This can be particularly beneficial in patients diagnosed with late stage cancer.

Also Read: Best Mental Health Tips During Covid 19 Pandemic

2. Non Cancer Treatment

Despite chemotherapy being used in the treatment and management of cancer, this class of drugs is also used to treat other disorders which are not cancer-related. Some of these included:

• Bone marrow diseases
• Blood disorders
• Some autoimmune diseases e.g Vasculitis, lupus, systemic sclerosis (scleroderma) and rheumatoid arthritis (RA)

Also Read: Pregnancy and Contraception

Types of Chemotherapy

Chemotherapy can be be broadly classified into 5 main categories. These include:

• Combination chemo: Involves the use of different classes of antineoplastic drugs all together in cancer treatment. Combination chemotherapy is normally used to minimize emergence of drug resistance, enhance synergistic action of different drug classes, and to target cancer cells in different phases of the cell cycle when the cells are most sensitive to chemo drugs.
• Intermittent chemo: Involves delivering chemo drugs in a discontinuous manner. It’s aimed at providing damaged host cells ample time to recover after chemotherapy.
• Pulse Therapy: Is a type of intermittent chemotherapeutic regimen that utilizes the highest tolerated dose of chemotherapeutic agents within a short dosing interval. Pulse therapy a has high levels of efficacy with far fewer adverse effects.
• Adjuvant chemotherapy: Administered after radiotherapy or surgical cancer treatment to inhibit the development of secondary neoplasms and also to eradicate any leftover micro-metastases.
• Neo-adjuvant chemo: Administered before radiotherapy or surgery. It’s aimed at reducing the size of large primary tumors.

Also Read: Arthritis: Causes, Symptoms, and Treatment

Side Effects/ Adverse Effects

Most, if not all, chemotherapeutic drugs are associated with serious adverse effects. That’s because of their non-specific mode of action.

Chemotherapeutic drugs targets rapidly dividing cells in the body. While majority of such cells are neoplastic, some body cells also undergo rapid replication and as such, are also affected by chemotherapy. Here are some common side effects associated with this method of cancer treatment:

• Nausea, vomiting, loss of appetite, and diarrhea
• Hair loss (alopecia)
• Fever, fatigue, and lethargy
• Weight loss
• Dry mouth and mouth sores
• Hepatotoxicity (liver damage)
• Nephrotoxicity (kidney damage)
• Lymphedema, immunosuppression, and myelosuppression (bone marrow suppression)
• Insomnia
• Abortion and teratogenicity
• Sexual dysfunction: low libido, oligospermia, impotence, decreased ovulation, irregular menstrual cycles.
• cardiotoxicity, neuropathies, and respiratory complications.
• Secondary cancer

The severity of the side effects depend on the dosage of chemo you’re receiving. For instance, persons on low dosage chemotherapy for cancer or non-cancer treatment tend to experience mild to minimal adverse effects. On the other hand, patients on high dose chemotherapy (mostly for cancer treatment) normally experience very severe and debilitating adverse effects.

Quick Read: Best Treatment for Acne

How to prepare for chemotherapy

Preparation for chemo depends on a number of factors including, but not limited to, the class of drugs and how they’ll be administered. Though pre-treatment preparations are often standard for most types of cancer, there are significant differences depending on the stage of disease and the drugs used. Furthermore, your doctor will give you the necessary help and support needed before you are put on chemotherapy. That being said, here are some pre-chemo preparations you might want to familiarize with:

• Surgical implantation of an intravenous device: If your type of cancer requires intravenous infusion chemo, the oncologist may recommend implanting an intravenous device such as a catheter onto one of the large veins on your chest. That makes for a convenient delivery of the drugs into the systemic circulation.
• Pre-chemo patient health checks: Because of the aggressive nature of chemotherapy, your doctor may recommend a couple of tests to check your body’s capacity to withstand the therapy. Common pre-therapy tests include liver, heart, and kidney tests. The results of the tests are used to decide the type of chemotherapy drug regimen for you, not to mention assessing your body’s readiness. Moreover, the test results may also inform your doctor’s decision to delay the treatment until such a time when he or she deems appropriate or even opt for a different treatment option altogether.
• Research more and ask the doctor about the expected side effects: While some chemo adverse effects are reversible, others are long term and life changing. For instance, sterility is a common side effect associated with most types of chemotherapy drugs. You might want to consult with your doctor on how to deal with that reality, especially if you still had plans of having kids in the future.
• Treat existing infections before hand: Chemo often leads to bone marrow suppression (myelosupression) and immunesupression. That means the functions of your white blood cells and other immune cells will be severely impacted. If you had an existing infection pre-chemo, the condition is likely to worsen due to the impaired body’s ability to fight infections. To avert that, its recommended to treat such infections before you commence chemotherapy. Oh, and don’t forget to make date with your dentist.
• Plan ahead for a change in your daily routine: That’s right. You should be ready for a change in the manner you normally run your day at work or at home. Be sure to discuss further with your employer so that appropriate adjustments are made in terms of working hours and work load. Also, don’t forget to share the details of your treatment with friends and family. They’ll give you the support you need, whenever you need it.

Administration of Chemotherapy drugs

How will you receive your chemo drugs?

Did you know that….?

i.) The adverse effects of chemotherapy vary depending on the type and dose of drugs used.
ii.) Most of the side effects of chemotherapy (short term), disappear at the end of the prescribed treatment duration. However, long term effects may take a while to resolve, if at all they do.

As mentioned above, this cancer treatment option can be administered via different routes. The choice of any of the methods depends on the class of drugs (you doctor will brief you accordingly). Here are the common chemotherapy administration methods:

1. Intravenous & Intramuscular injections

These are the most common methods of administration, the former being more preferred. Intramuscular injections are basically chemo shots.

2. Oral: Besides intravenous infusion, some chemo drugs are also taken via the oral route in the form of capsules or pills.

Quick Read: Anti-dandruff hair oils

3. Topical: Skin cancer patients can also be put on chemotherapy creams and gels which are applied directly on the skin.

4. Intravesical: This procedure is used in bladder cancer patients. It involved a targeted administration of chemotherapy agents into the bladder.

Quick Read: Health benefits of lavender oil

5. Intrathecal: Intratheral chemotherapy is used to treat cancers that are likely to spread to the central nervous system via the cerebrospinal fluid e.g. Burkitt’s lymphoma, Acute lymphoblastic leukemia, etc. The procedure is conducted via lumbar puncture or Ommaya reservoir.

6. Intrapleural: Involves the administration of chemo drugs directly to the chest cavity. As the name suggests, this chemo procedure is used in the treatment of lung cancer and related conditions.

7. Intraperitonial: This procedure involves a targeted administration of chemotherapy drugs to the abdomen. The technique is often used in ovarian cancer treatment.

Chemo Dosing intervals/ Frequency

How long will you be on chemotherapy?

The duration of chemo is determined by your doctor after a careful evaluation of a number of factors. Some of the considerations include:

• Drug classes used: Some drugs used in the therapy are very effective and can be used for short dosing intervals. However, such medications often have very severe side effects. As such, you doctor might want to go easy on them. Then there are the slow acting class of chemo drugs that require more frequent dosing and have very “few” severe side effects.
• Type & stage of Cancer: The treatment duration varies depending on type of cancer. While some types of cancer require a protracted chemo treatment duration, others are administered over a short dosing period to resolve the symptoms. Chemotherapy dosing frequency also varies with the stage of cancer – late stage requires more frequent dosing compared to early and intermediate stages of the disease.

Despite sterility, hair loss, and nausea, among other effects related to chemotherapy, the truth is this aggressive and life changing cancer treatment has given many a loved ones second chance in life. It grants us an opportunity to win back our bodies from the manacles of the disease.