Q: What does chemotherapy do?
A: Chemotherapy is the use of drugs to treat cancer throughout the body. The effects of chemotherapy are systemic, because the drugs are transported via the blood stream to most parts of the body. Like normal cells, cancer cells grow and divide through the same life cycle. The difference is that cancer cells are uncontrolled and grow in an abnormal fashion. Chemotherapy drugs destroy cancer cells by stopping their growth so they can't divide and multiply at one or more points in their life cycle. Cancer cells that are actively dividing are the most sensitive to chemotherapy.
Q: How is chemotherapy given?
A: Chemotherapy may be given in several ways. The route of administration selected by your doctor will depend on the type of chemotherapy drug or drugs you will receive, how good your veins may be, or whether you are able to comply with an oral chemotherapy regimen. The most frequently used ways of giving chemotherapy are oral and intravenously, either via a peripheral vein or a central vein.
Chemotherapy may be given oral (by mouth) in a pill, capsule or liquid form. Compliance is very important with prescribed oral agents. Intravenous (through a vein) administration is the most common route. Chemotherapy is administered either into a peripheral vein using a small needle or a special catheter placed into a large central vein by a doctor and kept in place for as long as necessary.
Other less common routes include intramuscular (IM), subcutaneous (SQ), or topically, where medication can be applied onto the skin. Chemotherapy may also be administered to a specific area of the body. A catheter may be placed into the abdomen, spinal fluid, bladder or liver and chemotherapy given specifically to that area.
Q: How long will my chemotherapy take?
A: The duration of time over which chemotherapy is given varies. It depends on the kind of cancer you have, the chemotherapy medications that the doctor decides to use, how your body responds to them and the goal of the treatment. You may need to come for treatment every day, every week, once a month or a variation of this. This may continue anywhere from several months to a year or longer.
The actual length of time each treatment will take depends on the type of chemotherapy you receive. Some chemotherapy drugs can take as little as 10 minutes to administer while others can take up to 8 hours. The longer treatment times also include other medications that are given along with the chemotherapy to prevent and decrease potential side effects. Some chemotherapy can even be given continuously over 24 hours for 1 to 5 days.
Q: Can I drive myself to get my treatment?
A: Most patients are able to drive themselves to their treatments. It is always a good idea, however, to have someone bring you to your first treatment to see how you tolerate it. If you tolerate the first treatment without any problems and you feel up to driving yourself, there shouldn't be any reason that you can't drive. Some patients like to have someone with them for support even if they physically feel well.
Q: Will I lose my hair with chemotherapy?
A: Hair loss, or alopecia, is the effect of chemotherapy on the cells responsible for hair growth. Not all chemotherapy drugs cause hair loss, but it is a common side effect of the drugs used frequently to treat cancer. Scalp hair is the most commonly affected area, but hair loss can occur on all parts of the body including the face, pubic area, arms and legs.
When hair loss occurs, hair can either fall out gradually and become thinner or it may be more complete, falling out in clumps. Typically, hair loss is noticed two to three weeks after a chemotherapy dose is given. During this time, the scalp may feel tender. Hair loss from chemotherapy is nearly always temporary and reversible. Regrowth of hair is noted approximately three months after chemotherapy is completed.
Discuss with your doctor or nurse the type and degree of hair loss to be expected. Remember it will vary depending on your treatment plan. Information is available on how to care for your scalp and hair and resources to purchase a wig or alternative head coverings.
Q: Can I continue to exercise while on chemotherapy?
A: Yes, you can continue to exercise while on chemotherapy, but you may need to decrease the length of time and intensity of your workout. For example, if your workout includes 30 minutes on the stairmaster at level 6, you may need to decrease your workout to only 15-20 minutes at a lower level. Because chemotherapy affects your blood count, you may notice a decrease in your red blood count (hemoglobin - the oxygen-carrying cell) which may cause you to fatigue easier and more quickly.
It is still important to continue to exercise to maintain your endurance and energy level, and it is a great way to relieve stress. Remember to always check with your health care provider prior to starting an exercise program and to review any restrictions that you may have with your particular treatment regimen.
Q: Can I continue to work during chemotherapy?
A: This question comes up with almost all of our patients. The answer is so variable, because it depends on the combination of chemotherapy drugs that you are receiving. Many patients are able to continue working but some find that they need to adjust their work schedule based on how they feel. In general, most patients find that they are more fatigued while undergoing chemotherapy treatments.
We often tell patients that while they may be able to keep their current work schedule, they will notice increasing fatigue at the end of the day and the need to go to bed about an hour earlier than they are used to. On the positive side, we had one young woman who not only worked full time, but also trained for the Chicago Triathlon during her chemotherapy treatments. Everyone handles the experience differently.
Q: Can I have sex during chemotherapy treatments?
A: Sexuality is very important to everyday life. Patients receiving chemotherapy can continue sexual relations with their partners during and after treatment. There may be specific recommendations which need to be followed based on your specific case. Do not be afraid to discuss issues regarding sex and sexuality with your doctor or other health care provider.
Chemotherapy can either temporarily or permanently alter sexual and reproductive function. These alterations can include temporary or permanent sterility, irregularity or cessation of menses, alterations in libido and fetal development. Speak to your doctor regarding these possible effects.
Since chemotherapy may have undesired effects on fetal development, it is recommended that an effective means of birth control be used during treatment to avoid birth defects. Discuss suggested methods of contraception and other questions and concerns with your doctor or health care provider. Referrals to sexual counselors can be arranged if needed.