What is chemotherapy?
Chemotherapy is medication used to kill cancer cells in the body. It works by interfering with the growth cycle of cancer cells, usually by damaging their DNA. In many cases, chemotherapy is used in conjunction with other therapies such as surgery and radiotherapy to treat cancer.
Why is chemotherapy used?
Chemotherapy can be used as part of a treatment plan with the aim to cure a cancer, or in more advanced cancers it can be used as part of a palliative treatment plan. In the curative setting, chemotherapy is most often used after surgery to mop up any small cells which remain. This is called adjuvant chemotherapy. It is also sometimes used before surgery or radiotherapy, in order to shrink a tumour before these treatments. This is called neoadjuvant chemotherapy.
The aim of palliative treatment is primarily to improve quality of life. Chemotherapy can help improve quality of life by controlling the growth of a cancer and in this way alleviating symptoms. In some cases, palliative chemotherapy can also prolong the life of patients.
What are the side effects of chemotherapy?
Chemotherapy is not specific for cancer cells. Because of its effect on the growth of cells, it specifically damages cells which are rapidly dividing. Most normal cells in the body are either resting or slowly dividing and are not affected by chemotherapy. Those cells which divide more quickly, however, such as cells of the tissues which line the gut, skin cells, hair cells and blood cells may be affected by chemotherapy, causing side effects. Some of the most common side effects of chemotherapy include nausea, fatigue, decreases in blood counts, and changes to the hair, skin and nails. Certain chemotherapy drugs have other side effects specific to the drug. These side effects are very rare but may include nerve damage, kidney damage, damage to the heart, and damage to the lungs. Prior to starting any chemotherapy treatment, these side effects are discussed in detail.
What does chemotherapy treatment involve?
Most chemotherapy is given in cycles. A cycle consists of a day or a few days of treatment followed by a break. Prior to each cycle, blood tests are done to check that blood counts, kidney functions and liver functions are good enough to give chemotherapy. You will also meet with your oncologists who will check that you tolerated the last cycle, and discuss any side effects that may have bothered you. It is very important to tell the health care staff caring for you about any side effects so that they may be addressed.
Chemotherapy may be administered in the form of oral medications, or intravenously.
Intravenous chemotherapy is the most common. This can take minutes, hours or several days depending on the regimen. The chemotherapy is given by specially trained nursing sisters. Prior to starting treatment, the sister will check your vitals, and your height and weight and speak to you about the chemotherapy you are going to receive.
She will then take bloods, if not already done, insert an intravenous line (a drip) and give some fluids through the drip to hydrate your body. Medication to prevent nausea is given into the drip, following which the chemotherapy is given.
What happens after the IV chemotherapy is given?
After the treatment is finished the nurse will take out the intravenous line and speak briefly again about the possible side effects. She will give you medication to take home and explain when and how to take this medication. She will advise you to drink lots of fluids for the first two days after chemotherapy and to avoid being around people with colds and other infections, especially for the first 7-10 days after chemotherapy. This is because of the effect of chemotherapy on the immune system. You will be given a contact number for your oncologist to use in case of an emergency.
What can be done to prevent infections and boost health whilst on chemotherapy?
- Get enough sleep
- Keep active as much as your body will allow
- Eat a well-balanced diet
- Avoid raw and undercooked meats and wash fruits and vegetables
- Wash hands frequently and well and use an antibacterial hand sanitiser
- Avoid contact with people who are sick
- Avoid big crowds if possible
- Wash daily and use lotion to maintain your skins barrier
- Pay particular attention to the area surrounding previous drip sites
- Clean teeth gently with a soft toothbrush
- Avoid handling animal waste
- Speak with your doctor before getting any vaccinations
- Speak with your doctor about any additional supplements that you are taking. Some health products can interfere with the way chemotherapy works or in some cases, worsen the side effects of chemotherapy.