Chemotherapy is a powerful form of drug treatment that utilizes strong chemicals to target and destroy fast-growing cells within the body. It’s most commonly known for its role in cancer treatment because cancer cells are characterized by their rapid and uncontrolled growth, multiplying at a significantly higher rate than most normal cells.
There’s a wide range of chemotherapy drugs available, and they can be used individually or in combination, depending on the type of cancer and the treatment strategy. While chemotherapy is a vital tool in combating many cancers, it’s important to understand that it also comes with the potential for side effects. These side effects can vary in severity, from mild and manageable to more serious complications.
Why is Chemotherapy Used?
Chemotherapy is a cornerstone of cancer treatment, employed in various scenarios to effectively manage and combat the disease. Here are the primary ways chemotherapy is used in cancer care:
Curing Cancer
In some cases, chemotherapy can be used as the primary or sole treatment with the goal of completely eradicating cancer from the body. This is known as curative chemotherapy and is often employed for cancers that are highly responsive to these drugs.
Adjuvant Therapy: Targeting Hidden Cancer Cells After Primary Treatment
Even after successful primary treatments like surgery or radiation therapy, microscopic cancer cells might still linger in the body. Adjuvant chemotherapy is administered after these initial treatments to eliminate any remaining cancer cells, reducing the risk of cancer recurrence.
Neoadjuvant Therapy: Preparing for Other Treatments
Neoadjuvant chemotherapy is given before other primary cancer treatments, such as surgery or radiation. Its purpose is to shrink tumors, making subsequent treatments more effective or even possible. For example, reducing the size of a tumor through chemotherapy can make it surgically removable or more responsive to radiation.
Palliative Chemotherapy: Relieving Symptoms and Improving Quality of Life
When a cancer is advanced or incurable, palliative chemotherapy can be used to alleviate symptoms and improve a patient’s quality of life. By reducing the size of tumors and slowing cancer growth, palliative chemotherapy can help manage pain, discomfort, and other cancer-related symptoms.
Chemotherapy Beyond Cancer Treatment
While primarily used for cancer, certain chemotherapy drugs are also effective in treating other medical conditions:
Bone Marrow Diseases and Stem Cell Transplants
Conditions affecting the bone marrow and blood cells, such as leukemia and lymphoma, can be treated with bone marrow or stem cell transplants. High-dose chemotherapy is a crucial part of this process, used to destroy the diseased bone marrow before the transplant of healthy stem cells.
Immune System Disorders
Lower doses of certain chemotherapy drugs can be used to manage overactive immune systems in autoimmune diseases like lupus and rheumatoid arthritis. These drugs help to suppress the immune system and reduce inflammation associated with these conditions.
Understanding the Risks and Side Effects of Chemotherapy
It’s crucial to be aware of the potential side effects associated with chemotherapy. Each chemotherapy drug has a unique profile of side effects, and not everyone experiences every possible side effect. It’s essential to discuss the specific drugs you will receive and their potential side effects with your doctor.
Common Side Effects During Chemotherapy Treatment
Many side effects can occur during the course of chemotherapy treatment. These are often temporary and can be managed or treated. Common side effects include:
- Nausea and Vomiting: Chemotherapy can trigger nausea and vomiting. Medications are available to help prevent and manage these symptoms.
- Diarrhea: Changes in bowel function, including diarrhea, can occur. Dietary adjustments and medications can help manage this.
- Hair Loss (Alopecia): Many chemotherapy drugs cause hair loss, which is usually temporary and hair typically regrows after treatment ends.
- Loss of Appetite (Anorexia): Chemotherapy can affect appetite and taste. Nutritional support and strategies to manage appetite loss are important.
- Fatigue: Feeling tired and weak is a common side effect. Balancing rest and gentle activity can help manage fatigue.
- Fever: Chemotherapy can weaken the immune system, increasing the risk of fever and infection.
- Mouth Sores (Mucositis): Painful mouth sores can develop. Good oral hygiene and specific mouthwashes can help.
- Pain: Pain can occur as a side effect of some chemotherapy drugs. Pain management strategies are available.
- Constipation: Some chemotherapy drugs can cause constipation. Dietary changes and laxatives can help.
- Easy Bruising and Bleeding: Chemotherapy can affect blood cell production, leading to easy bruising and bleeding.
Most of these immediate side effects gradually subside once chemotherapy treatment is completed.
Long-Term and Late-Developing Side Effects
Some chemotherapy drugs can cause side effects that may not appear until months or even years after treatment has finished. These late effects vary depending on the specific drugs used and can include:
- Lung Tissue Damage: Some chemotherapy drugs can cause lung damage, potentially leading to breathing problems.
- Heart Problems: Certain chemotherapy drugs can weaken the heart muscle or cause other heart-related issues.
- Infertility: Chemotherapy can affect fertility in both men and women.
- Kidney Problems: Some drugs can cause kidney damage or impair kidney function.
- Nerve Damage (Peripheral Neuropathy): Numbness, tingling, or pain in the hands and feet can occur due to nerve damage.
- Risk of Second Cancer: In rare cases, some chemotherapy drugs can slightly increase the risk of developing a different type of cancer later in life.
It’s important to discuss the potential for long-term and late-developing side effects with your doctor and understand any signs or symptoms to watch out for.
Preparing for Chemotherapy Treatment
Preparation for chemotherapy treatment is tailored to the specific drugs you will receive and how they will be administered. Your doctor will provide detailed instructions, but general preparation steps may include:
- Surgical Device Insertion for Intravenous Chemotherapy: If chemotherapy will be given intravenously, a catheter, port, or pump may be surgically implanted into a large vein, often in the chest, for easier and more comfortable drug administration.
- Pre-Chemotherapy Tests and Procedures: Blood tests to assess kidney and liver function, and heart tests to check heart health, are often performed to ensure your body is ready for chemotherapy. Adjustments to treatment plans may be made based on these results.
- Dental Check-up: A dentist may need to check for and treat any existing dental infections before chemotherapy begins, as chemotherapy can weaken the immune system and increase infection risk.
- Planning for Side Effects: Discuss potential side effects with your doctor and plan accordingly. This may include considering fertility preservation options if infertility is a risk or planning for head coverings if hair loss is expected.
- Arranging for Support at Home and Work: While many people continue working during chemotherapy, it’s wise to assess your needs for help at home or work, especially after treatments.
- Preparing for the First Treatment Session: Ask your healthcare team for specific instructions on how to prepare for your first chemotherapy session. Being well-rested and having a light meal beforehand can be helpful. Arranging transportation for your first session is also recommended, as you may experience unexpected side effects that could make driving difficult.
What to Expect During Chemotherapy
Determining the Chemotherapy Drug Regimen
Your oncologist will carefully select the chemotherapy drugs based on several critical factors:
- Type of Cancer: Different cancers respond to different chemotherapy drugs.
- Stage of Cancer: The extent and spread of the cancer influence drug selection.
- Overall Health: Your general health and any pre-existing conditions are considered.
- Previous Cancer Treatments: Prior treatments can impact drug choices.
- Your Goals and Preferences: Your treatment goals and preferences are also taken into account.
Open communication with your doctor is essential to decide on the most appropriate treatment plan for you.
Methods of Chemotherapy Administration
Chemotherapy drugs can be administered in various ways:
- Intravenous (IV) Infusions: The most common method, where drugs are delivered directly into a vein through a needle or device.
- Oral Chemotherapy: Some drugs are available as pills or capsules to be taken by mouth.
- Injections (Shots): Chemotherapy drugs can be injected intramuscularly or subcutaneously.
- Topical Creams or Gels: For certain skin cancers, chemotherapy creams or gels can be applied directly to the skin.
- Regional Chemotherapy: Drugs are delivered directly to a specific area of the body, such as:
- Intraperitoneal Chemotherapy: Into the abdominal cavity.
- Intrapleural Chemotherapy: Into the chest cavity.
- Intrathecal Chemotherapy: Into the central nervous system.
- Intravesical Chemotherapy: Into the bladder, via the urethra.
- Direct Delivery to the Cancer Site: Chemotherapy can be delivered directly to the tumor or the surgical site after tumor removal, using methods like chemotherapy wafers or direct injection into arteries feeding the tumor.
Chemotherapy Treatment Schedule and Location
The frequency of chemotherapy treatments depends on the drugs used, cancer characteristics, and your body’s recovery rate. Schedules vary, and treatment can be continuous or cyclical, with periods of treatment alternating with rest periods for recovery.
Chemotherapy treatments can be administered in different settings:
- Outpatient Chemotherapy Units: Most treatments are given in specialized outpatient clinics.
- Doctor’s Offices: Some treatments can be administered in a doctor’s office.
- Hospitals: Inpatient hospital stays may be required for certain treatments.
- At Home: Oral chemotherapy allows for treatment at home.
Understanding Chemotherapy Results
You will have regular appointments with your oncologist during chemotherapy to monitor your progress and manage any side effects. Scans and other tests may be used to assess how your cancer is responding to treatment, and adjustments to your treatment plan may be made as needed.
Clinical Trials and Chemotherapy Advancements
Participating in clinical trials can offer access to the latest advancements in chemotherapy and cancer treatment. Clinical trials are research studies that explore new ways to prevent, detect, treat, or manage cancer and other conditions.
Explore Mayo Clinic studies of tests and procedures.
By Mayo Clinic Staff
Chemotherapy care at Mayo Clinic
March 13, 2024
References
- Chemotherapy and you: Support for people with cancer. National Cancer Institute. https://www.cancer.gov/publications/patient-education/chemo-and-you. Accessed Oct. 1, 2019.
- Niederhuber JE, et al., eds. Cancer pharmacology. In: Abeloff’s Clinical Oncology. 6th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Sept. 26, 2019.
- What to expect when having chemotherapy. Cancer.Net. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/what-expect-when-having-chemotherapy. Accessed Oct. 1, 2019.
- Cyclophosphamide (Cytoxan). American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Cyclophosphamide-Cytoxan. Accessed Oct. 1, 2019.
- Warner KJ. Allscripts EPSi. Mayo Clinic. Nov. 25, 2019.
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