Whenever we hear about cancer and its treatment the first thing that comes to mind is chemotherapy. Chemotherapy, often known as chemo, is the most common treatment used for various types of cancer. This article delves into what chemotherapy is, how it works, what benefits and side effects one would experience, how one could prepare to undergo chemotherapy and the overall process of chemotherapy in a given duration.
Your body's cells typically develop and degrade in a controlled manner. Cancer cells divide in an uncontrolled manner affecting the body. Chemotherapy is one of the methods to eradicate cancer cells using effective drugs. Chemotherapy kills cancer cells by interacting with their DNA and protein synthesis leading to their inhibition of growth and preventing them from spreading.1,2
Chemotherapy can be used to treat cancer in a variety of ways, known as the intent of treatment. Based on this doctors generally divide chemotherapy into:3,4
- Chemotherapy with the intent to cure: Chemotherapy for cancer treatment seeks to totally eradicate all cancer cells from the body
- Adjuvant chemotherapy: The main goal of adjuvant chemotherapy is to combat any undetectable cancer cells that may remain in the body after surgery. This type of supportive therapy aims to stop recurrences
- Neoadjuvant chemotherapy: It is used when a tumour is too large to be surgically removed. Neoadjuvant chemotherapy frequently causes the tumour to shrink to the point where it can be surgically removed or eliminated using less invasive procedures.
- Palliative chemotherapy: When it is no longer possible to eradicate all tumour cells, chemotherapy is referred to as palliative care. Chemotherapy can then aid in the relief of certain symptoms, and the slowing or temporary halting of the disease's progression
Chemotherapy is used for primary cancers (tumours occurring first) and secondary tumours (metastatic tumours, ie. cancer spreading to other parts of the body). The type of chemotherapy one receives, completely depends on the size, location and how advanced the tumour is along with the overall health of the patient. Also, the type and amount of drug used solely depends on the type of cancer ie. for lung cancer a drug called Pembrolizumab can be used and it will differ for breast cancer.4
Benefits of chemotherapy
For many years, chemotherapy has been a successful and dependable cancer treatment. Chemotherapy can totally eradicate cancer from your body, or lessen your symptoms and improve your quality of life. Additionally, chemotherapy can improve the effectiveness of other treatments like surgery or radiation therapy and reduce the chances of cancer recurrence.4
Chemotherapy is also used in the treatment of other illnesses, like lupus and rheumatoid arthritis. It was observed that lower chemotherapy doses helped manage a hyperactive immune system. In addition patients with certain blood cancers or immune disorders like sickle cell anaemia often undergo bone marrow transplant, tend to receive chemotherapy to prepare them for receiving new bone marrow by killing the diseased cells in their bone marrow.5
Side effects of chemotherapy
Chemotherapy aims to target rapidly growing cancer cells. This indicates that while chemotherapy treatments kill cancer cells, they may also harm healthy cells in your body, perhaps resulting in adverse side effects. Examples of cells that develop and proliferate quickly include blood cells, skin, hair, and digestive tract cells.3
Some common side effects of chemotherapy are:2,3,4
- Tiredness and exhaustion
- Constipation and diarrhoea
- Bleeding and bruising
- Hair loss, sore or dry skin
- Dry mouth and bad breath
- Chances of recurrent infection of lung and mouth
- Loss of appetite
- Nausea and vomiting
- Difficulty falling asleep or disturbed sleep
The side effects of chemotherapy might vary based on the type of treatment, the type of cancer, and the duration of treatment. Furthermore, the majority of the adverse effects of chemotherapy are temporary, and not all of them are harmful. Following treatment, blood flow typically returns to normal, and hair frequently grows back.
Chemotherapy side effects, particularly in young patients, might occasionally last after the course of treatment. Chemotherapy may damage sperm or eggs, causing fertility issues, heart and nerve damage or kidney problems in certain cases. Hence the potential adverse effects of chemotherapy and whether they last permanently or just manifest during treatment will all depend on the chemotherapy treatment plan and the individual’s overall health.3
To manage these symptoms talk with your doctor/oncologist, as they will prescribe medications to keep your side effects at bay.
How should I prepare for chemotherapy
Depending on the type of cancer you have been diagnosed with and your overall health the oncologist will come up with a personalised chemotherapy treatment plan. Enquire with your oncologist about the chemotherapy medications you'll be taking, as well as any advantages and possible side effects it could cause. Find out about support groups, and other resources that are available from your healthcare provider, so that you can learn as much as you can about your treatment and become more equipped to adjust to life with chemotherapy.
Some ways you can prepare yourself for chemotherapy while you wait are:4,6
- Get a support system in place: The duration from the cancer diagnosis to the start of chemo is physically and emotionally draining. It is important to have support, this could include family members, friends, or support groups who can help you through the process. Having someone to talk to about your experiences and feelings can help you feel less isolated and overwhelmed. Practically speaking, your support system can also help with tasks such as transportation to appointments, meal preparation, and taking care of household chores. It's important to reach out for help and support when needed and not to try to go through this experience alone.
- Find a comfortable way to deal with side effects: Before the start of treatment, take measures to manage possible side effects. For instance, if you know that hair loss is possible, get yourself a head scarf or a wig to your liking. Select skin care products with the help of a dermatologist if skin changes and sun sensitivity are potential side effects. You can take many such steps to prepare yourself mentally and physically.
- Visit your dentist: Mouth sores and altered taste buds are typical side effects of chemotherapy. Avoid dealing with dental issues on top of other chemo-related issues, it is advised to make sure your mouth is free of infections, cavities and that your teeth are in good shape before the treatment begins. Ask your dentist to prescribe mouth sore gels and anti-bacterial mouthwash to maintain your oral health.
- Come up with a treatment routine: It's important to consult with your oncologist to gain a full understanding of what will happen during your first chemotherapy session. This includes information on the duration of treatment and what to expect during treatment. For example, if your treatment is for hours, you may want to plan for meals and entertainment, such as bringing a book or music to pass the time. To help manage side effects like nausea, try to eat a small snack one hour before the treatment.
What should I expect during and after chemotherapy
What takes place during chemotherapy:4,6
- Administration: Chemotherapy can be given in various forms such as an injection, a pill, or through a vein (intravenous). Chemotherapy is sometimes administered via a port to avoid repeated needle insertion and to reduce infections. Your nurse can place the IV for each treatment without having to locate a vein with a port. If you require a port, you will need to have a quick procedure before your initial chemotherapy visit to implant the port
- Side effects: During chemotherapy, you may experience side effects such as fatigue, nausea, vomiting and changes in appetite
- Monitoring: Your vital signs such as blood pressure and oxygen levels will be checked during each chemotherapy session and your nurse will monitor you for any adverse reactions
What takes place after chemotherapy:4,6
- Recovery time: The recovery time after chemotherapy varies from person to person. You may feel tired and weak for a few days to a few weeks after treatment and it is advised to take some time off. Regularly check for any side effects or other issues during this period and contact your doctor when required
- Return to normal activities: Gradually, you should be able to return to your normal activities, but it's important to listen to your body and rest when you need to
- Long-term side effects: Some side effects of chemotherapy may persist long after treatment, such as changes in fertility, hearing or vision problems, or a higher risk of infections. Your doctor can provide more information on the potential long-term effects of your specific chemotherapy regimen
It's important to follow your doctor's instructions and to report any concerning symptoms or side effects after chemotherapy.
How long is the chemotherapy treatment
The duration of chemotherapy treatment varies, depending on several factors, including the type and stage of cancer, the type of chemotherapy drugs being used, and the individual's response to treatment. Each chemotherapy treatment session is referred to as a cycle and some people may receive chemotherapy for just a few cycles, while others may receive treatment for several months.4
In general, chemotherapy is given in cycles that consist of a treatment period followed by a rest period, during which the body has a chance to recover from the effects of the drugs. The length of each cycle, the number of cycles, and the length of the rest periods can vary depending on the individual and the specific chemotherapy regimen.6
It's important to follow your doctor's instructions and schedule for chemotherapy treatment, as missing or delaying treatments can impact the effectiveness of the treatment.
Chemotherapy (chemo) is a type of cancer treatment that uses powerful drugs to kill cancerous cells. It is often used in combination with other treatments such as radiation therapy or surgery. The length of chemotherapy treatment varies depending on the type and stage of cancer, the type of chemotherapy drugs being used, and the individual's response to treatment. Before starting chemotherapy, it is important to have tests and procedures to ensure the body is ready for treatment and to make arrangements for any side effects or other needs. After chemotherapy, recovery time can vary and side effects may persist long after treatment. It is important to reach out for support to maintain your mental and emotional health during the treatment and recovery phase along with regularly reporting your symptoms to your doctor for a speedy recovery.
- Behranvand N, Nasri F, Zolfaghari Emameh R, Khani P, Hosseini A, Garssen J, Falak R. Chemotherapy: a double-edged sword in cancer treatment. Cancer Immunology, Immunotherapy. 2022 Mar;71(3):507-26.
- Amjad MT, Chidharla A, Kasi A. Cancer chemotherapy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: http://www.ncbi.nlm.nih.gov/books/NBK564367/
- How does chemotherapy work? [Internet]. Institute for Quality and Efficiency in Health Care (IQWiG); 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279427/
- Chemotherapy: types & how they work [Internet]. Cleveland Clinic. [cited 2023 Feb 9]. Available from: https://my.clevelandclinic.org/health/treatments/16859-chemotherapy
- Klöß S, Dehmel S, Braun A, Parnham MJ, Köhl U, Schiffmann S. From cancer to immune-mediated diseases and tolerance induction: Lessons learned from immune oncology and classical anti-cancer treatment. Frontiers in Immunology. 2020 Jul 8;11:1423.
- What to expect when having chemotherapy [Internet]. Cancer.Net. 2012. Available from: https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/what-expect-when-having-chemotherapy