Chemotherapy

What is chemotherapy?

Chemotherapy is a common treatment for cancer. Chemotherapy destroys cancer cells so that they can no longer divide or grow.  

In a healthy person, human cells grow, divide, and die in a controlled manner. If you are diagnosed with cancer, it means your cell reproduction is no longer under control. 

Chemotherapy drugs stop the uncontrollable reproduction and division of cancer cells. Different cancer drugs work differently.  

Some cancer drugs target specific parts of cancer cells. Other drugs stop the continuous division of cells across your body.  

Your doctor (oncologist) may administer chemotherapy treatment as a single dose. He or she may also prescribe several chemotherapy drugs to treat cancerous cells.   

Chemotherapy can also be used alongside other cancer treatments, such as radiation therapy or surgery.

Why is chemotherapy important?

Chemotherapy treatment can be used in one of the following ways:

• As the only form of cancer treatment- Your healthcare provider can elect to use chemotherapy alone as a treatment for cancer without relying on any other treatment

• As an adjuvant therapy- Your healthcare provider may recommend surgery to remove cancerous cells and later use chemotherapy to destroy any remaining cancer cells.

• As a neo-adjuvant therapy- Your oncologist may rely on chemotherapy to shrink a large tumor. It allows for the use of surgery, radiation, or other forms of treatment.

• To relieve cancer symptoms- When chemotherapy kills cancerous cells, this eases the signs and symptoms associated with the disease. This is palliative chemotherapy.

Types of cancer treated by chemotherapy

Chemotherapy is effective in treating various forms of cancer. These include:

Primary cancer

This is cancer that grows in the area where it started and has not spread to other parts of the body.

Metastatic cancer

This is cancer that has spread from one organ or region to other organs or parts of the body.

Chemotherapy drugs are also effective in treating other conditions like:

Immune system disorders – People with diseases like rheumatoid arthritis and lupus present with an overactive immune system.

Chemotherapy drugs, if administered at a lower dose, have proven useful in controlling the immune system in people with such conditions.

Bone marrow disease – Patients suffering from bone marrow disease usually need to undergo a bone marrow transplant.

Chemotherapy drugs are effective in preparing you for such kind of treatment.

The choice of chemotherapy is determined by:

• The extent to which the cancer has advanced

• Where the cancer is located

• Patient’s treatment goals and preferences

• Past treatments for cancer

• Patient’s overall health

• Age

• Body weight

• Any preexisting medical conditions

Explore with your oncologists the various treatment alternatives available to you and make the right decision.

Types of chemotherapy  

The main types of chemotherapy include: 

Anti-tumor antibiotics – These drugs work by interfering with reproduction.  

Alkylating agents – These drugs target the cell’s DNA. They kill cells at various phases of their life cycle. 

Plant alkaloids – These work by hindering cell growth and division. 

Antimetabolites – These chemotherapy drugs imitate proteins necessary for the survival of cells. Once the cells consume antimetabolites, they starve.  

Your doctor can use chemotherapy alongside other medication, such as immunotherapy and monoclonal antibodies. 

Your oncologist will recommend the most suitable combination of chemotherapy for your condition.  

How do I prepare for thermotherapy treatment?

Your oncologist will order various blood tests to determine your overall health. The results of such tests will also enable your oncologist to decide if you can handle the side effects of chemotherapy.

Your oncologist will order a complete blood count. The test involves checking your red blood cells, platelet, and white blood cell count.

In case of low counts, your doctor may suggest postponing chemotherapy until you reach acceptable levels.

You should also be actively involved in preparing for chemotherapy treatment. Be informed about the treatment.

This will enable you to prepare effectively for the likely side effects and benefits that come with this type of treatment.

Your doctor will assist with useful resources like support groups and online sources to increase your knowledge of the treatment.

Plan for the likely side effects of chemotherapy. For instance, in case chemotherapy may cause hair loss, make arrangements to acquire a wig.

In case chemotherapy results in skin sensitivity or changes, your doctor can recommend skin care products with mild ingredients.

Arrange an appointment with your dentist before chemotherapy as the treatment can interfere with your taste buds or cause mouth sores.

Your dentist ensures you do not have any infection and that your teeth are healthy before commencing with chemotherapy.

Make sure your health insurance caters to chemotherapy treatment as it will take a heavy burden off your shoulders.

Inform your employer of your chemotherapy treatment.

You may have to take time off for this treatment. Liaise with your oncologist to establish if the treatment shall interfere with your work.

Plan for your treatment by establishing a treatment routine. With the help of your oncologist.

In case the treatment takes long, you may consider carrying a book to read during the sessions. Alternatively, you can carry a packed lunch.

If chemotherapy is to be administered intravenously, you will have a device or catheter surgically inserted beforehand.

The catheter is implanted in your chest where a large vein is located. This device will assist with administering the chemotherapy drugs.

Work closely with your chemotherapy nurses or oncologist on how best to prepare for your first treatment.

You will need to be fully rested for your first sessions. Consider having a light meal to counter nausea brought about by chemotherapy drugs.

Consider tagging your spouse, friend, or family member along for chemotherapy. You might feel sleepy after the chemotherapy treatment and it can affect your driving.

During treatment

Work closely with your oncologist to establish the most suitable form of treatment that works for you.

There are various ways of administering chemotherapy treatment:

• Pills – Certain chemotherapy drugs come as capsules or pills

• Infusions – This is the most common form of administering chemotherapy drugs. Infusions are administered intravenously

• Creams – Chemotherapy creams or gels are popular with certain forms of skin cancer as they have proven effective in treating such cancers

• Shots – This involves administering chemotherapy drugs using an injection

Certain forms of cancer may not be effectively treated using systemic chemotherapy. For such types of cancer, your oncologist may recommend the following treatments:

Intracavitary chemotherapy: This type of chemotherapy is directed at a specific body cavity like the belly or bladder.

Intra-arterial chemotherapy – This chemotherapy is directed at the one artery that the tumor relies on for blood supply

Intrathecal chemotherapy – This drug is directed at the region between your spinal cord and brain.

Chemotherapy treatment can be administered in your doctor’s office, at home, or in an infusion center.

Duration of chemotherapy

How long your chemotherapy treatment lasts will depend on the form of chemotherapy treatment being administered.

A session may be of only a few minutes. Other sessions last several hours.

Some patients require continuous infusion. It might take several days.

It can start at the hospital and be completed at home. Most cancer patients require several rounds of chemotherapy.

A session can take between a few days and several weeks. You will be given time off so that your body can recover after the treatment.

Once your oncologist has established you can withstand another round of chemotherapy, they will initiate it in a similar pattern to the first one.

A patient can receive chemotherapy treatment daily, once per week, or on a monthly basis.

Benefits of chemotherapy treatment 

Chemotherapy treatment holds back cancer or shrinks it as this will alleviate the symptoms. 

Chemotherapy promotes in shrinkage of cancer cells. It allows for other treatments to remove cancer, such as surgery. 

Chemotherapy treatment following surgery minimizes the chance of your cancer coming back. 

It’s reassuring to undergo regular tests and checkups with your oncologist.    

Side effects

Chemotherapy treatment may manifest in mild or severe side effects, depending on the form and scope of treatment.

For some people, the side effects are multiple and severe. Others experience fewer side effects.

Some of the adverse side effects of chemotherapy include:

• Fatigue – You will experience fatigue from time to time. It happens especially after engaging in certain tasks. Liaise with your oncologist to identify the activities to engage in and when you need to rest to ease fatigue.

• Nausea and vomiting – Your oncologist will recommend antiemetic medication to relieve this side effect.

• Infections – Chemotherapy reduces the white blood cells in your body. It can lead to weakened immune systems. It means you are highly predisposed to infections.

Your doctor can recommend antibiotics to minimize the risk of infection. You can also do the following to reduce this risk:

• Wash your hands with soap and water

• If you have any wound, make sure it remains clean

• In case of an infection, have it treated as soon as possible

• Keep off individuals who may have an infection

Anemia – Chemotherapy causes a decrease in red blood cells. Nearly 70% of individuals who have received chemotherapy treatment are anemic.

Anemia causes shortness of breath and tiredness. You are also likely to experience heart palpitations.

You need to consume foods rich in iron to increase your red blood cell levels. Examples of such foods include nuts, green leafy vegetables, and beans.

If you experience severe symptoms because of anemia, your oncologist can recommend a blood transfusion.

Hair loss- You will probably experience hair loss after chemotherapy treatment. These drugs target hair cells and other fast-growing cells.

Cooling caps can prevent hair loss by maintaining a cool scalp. Chemotherapy may also lead to sore and dry skin. It can also affect the color and strength of your nails. Use sunblocks to avoid direct contact with sunlight.

Bleeding- Chemotherapy interferes with blood clotting caused by a reduction in platelet count. You are likely to bleed excessively from a small cut. You could also get bruised easily.

Exercise a lot of caution when partaking in activities like shaving or cooking to avoid getting injured. In case of a low platelet count, your doctor may recommend a blood transfusion.

Fertility – Certain thermotherapy drugs may reduce your fertility. Usually, fertility resumes once the treatment is completed.

You may consider freezing embryos or sperm if you intend to have children in the future.

Pregnancy – Make sure you are not pregnant when undergoing chemotherapy treatment. This is because such medication can adversely affect the pregnancy.

Mucositis – This is a condition that is characterized by an inflamed or swollen mucous membrane. If you have a swollen mouth, this is called oral mucositis.

Symptoms differ based on the dosage. If you are thinking of having children in the future, it is important to control mucositis to avoid bleeding or infection. Your oncologist will prescribe medication for this.

Cognitive problems – Chemotherapy can interfere with your cognitive functions, including the ability to organize or reason.

Some individuals present with depression and mood swings following chemotherapy treatment.

How long do chemotherapy side effects last?

You will experience easing of side effects as soon as you stop the treatment.

Other side effects will manifest for months after you stop treatment. Examples of the long-term effects of chemotherapy include:

• Early menopause

• Infertility

• Cognitive problems

• Cardio problems

• Nerve damage

You may require cancer rehabilitation to manage such long-term effects of chemotherapy.

Cost of chemotherapy in India

The cost of chemotherapy treatment in India ranges between Rs. 3,000 and Rs. 50,000.

This variation in cost is reliant on various factors. They include:

• Age of the patient

• Admission fee

• The room where you are admitted

• Oncologist fee

• Patient’s overall health

• Type of hospital

• Diagnostic and lab tests like ECG, X-ray

• Type of chemotherapy

• Whether there were any complications after chemotherapy

• The site of treatment

By factoring in the above factor, the cost of chemotherapy in India may be as low as USD 55 or as high as USD 800 for an individual session.

A similar procedure in the United States will set you back between USD 20,000 and USD 60,000.

The table below summarizes the cost of chemotherapy treatment in selected cities across India:

References

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