Chemotherapy is the use of drugs to kill bacteria, viruses, fungi, and cancer cells. Most commonly, the term is used to refer to cancer-killing drugs. This article focuses on cancer chemotherapy.
Cancer chemotherapy; Cancer drug therapy; Cytotoxic chemotherapy
Chemotherapy drugs can be given by mouth or injection. Because the medicines travel through the bloodstream to the entire body, the majority of administered chemotherapy is considered a body-wide (systemic) treatment.
Chemotherapy may be used to:
Cure the cancer
Keep the cancer from spreading
Ease symptoms (when the cancer cannot be cured)
HOW CHEMOTHERAPY IS GIVEN
Depending on the type of cancer and where it is found, chemotherapy may be given in a number of different ways, including:
Injections or shots into the muscles (intramuscular, or IM) or under the skin (subcutaneous, or SC)
Into a vein (intravenous, or IV)
Into an artery (intra-arterial)
Pills taken by mouth (PO)
Shots into the fluid around the spinal cord or brain (intrathecal, or IT)
Different chemotherapy drugs may be given at the same time in combination or after each other in sequence. Patients may receive radiation therapy before, after, or while they are getting chemotherapy.
Chemotherapy is most often given in cycles. These cycles may last one day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months and is given in order for the body and blood counts to recover before the next dose.
Often, the chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home, even when the chemotherapy is given into the veins. Patients and their family members will receive special training if this is planned.
When chemotherapy is given over a longer period of time, a thin catheter can be placed into a large vein near the heart. The catheter is placed during a minor surgical procedure. This is called a central line (there are many types, including ports) or a percutaneously inserted central catheter (PICC).
SIDE EFFECTS OF CHEMOTHERAPY
Traditional chemotherapy medicines work best on cells that divide often to make new cells. This is typical of most cancer cells.
However, some normal cells -- including those found in the bone marrow, hair, and the lining of the gastrointestinal tract -- also divide very quickly. Chemotherapy can also damage or kill these healthy cells.
When this damage occurs, there can be side effects. Some people who receive chemotherapy:
Side effects of chemotherapy depend on many things, including the type of cancer, and which drugs are being used. Each patient reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells more specifically may cause fewer side effects.
Your doctor and nurse will explain what you can do at home to prevent or treat side effects, such as:
Being careful with pets and other animals to avoid catching infections from them
Eating enough calories and protein to keep your weight up
Preventing bleeding, and what to do if bleeding occurs
Practicing safe eating and drinking habits, including being careful when eating out, knowing how to cook and store foods safely, and making sure your water is safe
Washing your hands often with soap and water
You will need to have follow-up visits with your doctor and nurse during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans, will be done to:
Monitor how well the chemotherapy is working
Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body
Perry MC. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 182.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.