What is Chemotherapy?

Chemotherapy is the use of medications or chemicals with cancer-fighting abilities. This why chemotherapy is often called an anti-cancer agent.

It all begins with normal cells versus cancer cells. Normal, healthy cells divide and grow in a patterned, controlled behavior. As they divide, replicas are produced. Cancer cells, on the other hand, grow out of control.

There is no apparent pattern at all. When in contact with a normal cell, the cancer cell takes over and copies itself many times over. In this way, the body becomes overburdened with cancer cells. Chemotherapy destroys cancer cells with drugs.

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How does Chemotherapy Work?

Chemotherapy drugs interfere with the cancer cells' ability to grow or multiply. Different groups of drugs act on cells in different ways. Identification of the type of disease is important because certain chemotherapies work best for certain diseases. For example, a patient treated for acute myelogenous leukemia is treated with different agents than one treated with Hodgkin's disease. Even patients diagnosed with the same disease may be treated with different agents, depending on what is known to be most effective for the particular circumstances.

Chemotherapy can damage normal cells as well as cancer cells. Those normal cells most effected are ones which divide rapidly. These include the hair follicles, cells in the gastrointestinal (GI) tract, and bone marrow. Consequently, side effects can occur including: hair loss, mouth sores, difficulty in swallowing, nausea, vomiting, constipation, diarrhea, infection, anemia, and increase risk of bleeding. These side effects will be discussed in greater detail later.

How is Chemotherapy Given?

Chemotherapy can be given in different ways. The five most common methods are:

• intravenous (IV)
• oral (PO)
• intramuscular (IM)
• intrathecal (IT)
• intraperitoneal (IP)

The intravenous route or IV is a very common way of giving medicine directly into a vein. A small plastic needle is inserted into one of the veins in the lower arm. There is some discomfort during insertion because a needle stick is required to get into the vein. After that, the administration of the medication is usually painless.

Chemotherapy flows from the IV bag/bottle, through the needle and catheter into the bloodstream. Sometimes a syringe is used to "push" the chemotherapy through the tubing.

The oral method takes the form of either a pill, capsule or liquid taken by mouth. This is the easiest and most convenient method and can usually be done at home. Under certain special circumstances, chemotherapy given by other routes may also be administered at home.

Intramuscular means that the chemotherapy is given by way of an injection into the muscle. There is a slight sting as the needle is placed into the muscle of the arm, thigh or buttocks. Although, this procedure only lasts a few seconds, the effect of the intramuscular chemotherapy may last much longer. This is because the chemotherapy may be absorbed slowly through the muscular tissues and into the bloodstream.

Certain forms of cancer have a tendency to spread to the nervous system. To treat cancer that spreads to the spinal cord or brain, doctors may perform a spinal tap and inject chemotherapy into the spinal fluid. This is known as the intrathecal method of administration.

Permanent and Temporary Catheters - For some patients, IV insertions can eventually damage the veins in the arm. Some patients have small veins and some have very few accessible veins. Frequent IV insertions and too small or too few veins may prompt the doctor to recommend a permanent type of IV catheter. Permanent catheters allow patients to go home and receive chemotherapy without needing other IV's placed. Along with receiving chemotherapy and IV fluids through this catheter, patients can receive blood products and even have their blood drawn without painful needle sticks.

Information on Radiation Therapy

Radiation therapy is the use of high level radiation to destroy cancer cells. Both tumor cells and healthy cells may be affected by this radiation. The radiation injures the cancer cells so they can no longer continue to divide or multiply. With each treatment, more of the cells die and the tumor shrinks. The dead cells are broken down, carried away by the blood and excreted by the body. Most of the healthy cells are able to recover from this injury. However, the damage to the healthy cells is the reason for the side effects of radiation therapy. Radiation has its greatest effect on tissues that divide rapidly.

The dose of radiation is determined by the size, extent, type and grade of tumor along with its response to radiation therapy. Complex calculations are done to determine the dose and timing of radiation in treatment planning. Often, the treatment is given over several different angles in order to deliver the maximum amount of radiation to the tumor and the minimum amount to normal tissues.

Some things to remember about radiation therapy:

• The side effects that occur during radiation therapy are manageable. Your doctors and nurses will help you with these.
• The radiation passes through your body and does not remain in you. You are not radioactive.
• Only the body part in the field of radiation is affected.
• Normal cells exposed to radiation begin to repair themselves hours after exposure.