Chemotherapy: Treating Cancer, Uses, Side Effects

Choose the content to read

• Chemotherapy: Treat, Fight Cancers
• What diseases can chemotherapy treat?
• How is chemotherapy drug used?
• What is the chemotherapy procedure?
• What is self-care during chemotherapy?
• How long does chemotherapy take?
• What is the chemotherapy side effect?
• Chemotherapy at MedPark Hospital
• FAQ

Chemotherapy: Treat, Fight Cancers

Chemotherapy is a cancer treatment method using anti-cancer drugs containing chemicals to kill all cancer cells in the body while preventing cancer cells from dividing, growing, spreading, and eventually dying. Chemotherapy eliminates cancer cells, reduces the number of cancer cells, and prevents cancer from recurring. Chemotherapy can be used in conjunction with radiotherapy, targeted therapy, or surgery to speed up the elimination of cancer cells. Currently, chemotherapy drugs have developed to be many times more effective in treatment than ever before, while also reducing the side effects of previous chemotherapy drugs, such as nausea, vomiting, dizziness, and hair loss. Individuals who discover they have cancer should consult, discuss, and consider a variety of treatment options with an expert oncologist as soon as possible. Cancer is curable if detected early and treated promptly.

Goals of chemotherapy treatment

1. Cure: To be completely cured of cancer is the primary goal of chemotherapy treatment. Chemotherapy aims to prevent cancer from reoccurring and allows patients to live a quality life.
2. Control: To be able to control the disease, destroy cancer cells, prevent cancer cells from spreading to other bodily organs, and shrink cancer cells, as well as increase the patient's survival rate and quality of life.
3. Palliation: for stage 3–4 cancer patients whose cancer has spread throughout the body. Chemotherapy relieves pain, prevents cancer from spreading to other organs, and supports patients to live their lives as best as they can.

What diseases can chemotherapy treat?

Chemotherapy is primarily used to treat cancers, including:

1. Primary cancer: Early-stage cancer that has not yet spread to other bodily organs.
2. Metastatic cancer: Cancers in stages 3-4 that have spread to other parts of the body.

How is chemotherapy drug used?

Oncologists use chemotherapy drugs to treat cancer as follows:

1. Induction chemotherapy is used solely as the primary treatment for some cancers that respond well to chemotherapy drugs, such as testicular cancer, small cell lung, or Hodgkin's lymphoma.
2. Neoadjuvant chemotherapy is used to treat local cancer before other cancer treatments such as surgery or radiotherapy in order to shrink the lesion, tumor, or cancer to the smallest possible size, control the disease, reduce symptoms, and lower the risk of cancer spreading to nearby organs.
3. Adjuvant chemotherapy is used after local cancer treatment, such as surgery or radiotherapy, to eliminate any remaining cancer cells and prevent them from recurring. Adjuvant chemotherapy is used to treat colon cancer or metastatic breast cancer in lymph nodes that have not spread to other organs.
4. Local chemotherapy is used specifically only for the organ that has lesions, tumors, or cancer to kill cancer cells while also relieving symptoms related to cancer, such as intraperitoneal chemotherapy to treat ovarian cancer or gastrointestinal cancer, intra-cerebrospinal fluid chemotherapy to treat cancer that has spread to the spinal fluid, or through the pleural space to treat small-cell lung cancer.

How is chemotherapy delivered?

Chemotherapy can be administered using a variety of methods. The oncologist will determine the best method of administering chemotherapy, tailoring it to each individual in order to achieve the most effective treatment outcomes. Chemotherapy can be administered using the following methods:

1. Intravenous Chemotherapy (IV chemotherapy): Intravenous chemotherapy involves giving chemotherapy drugs through a peripheral vein or a port (implanted port). A port is a catheter tube that is inserted under the skin to help bring fluids, nutrients, and chemotherapy drugs through the body instead of giving it through a peripheral vein.
2. Oral Chemotherapy involves taking chemotherapy drugs orally, in the form of tablets, or capsules to treat breast cancer or colon cancer, etc. 
3. Intra-arterial chemotherapy Intra-arterial chemotherapy involves intravenously injecting chemotherapy drugs into the organ that directly feeds the tumor. Intra-arterial chemotherapy is used to treat liver cancer, cancer that has spread to the liver using the Transarterial Chemoembolization (TACE) method, and retinoblastoma in children.
4. Intraperitoneal chemotherapy (IP chemotherapy) is the injection of chemotherapy into the abdomen or peritoneum at a temperature higher than normal body temperature (HIPEC: Hyperthermic intraperitoneal chemotherapy) to treat cancer that has spread to the peritoneum. Intraperitoneal chemotherapy can treat cancers such as ovarian cancer, colon cancer, liver cancer, or stomach cancer.
5. Topical chemotherapy is the application of external chemotherapy to the skin to treat certain types of cancer, including skin cancer. Dermatologic surgeons may recommend topical chemotherapy to treat cancer on the skin's outermost layer, in combination with Mohs surgery to eliminate skin cancer.

How many types of chemotherapy drugs?

There are over 100 different types of chemotherapy drugs, each with a unique mechanism for inhibiting cell division. The most common types of chemotherapy include:

1. Alkylating agents are a type of chemotherapy drug that binds to cancer cell's DNA, preventing them from multiplying and eventually dying. Alkylating agents are effective in treating a variety of cancers, including lung cancer and leukemia, lymphoma, breast cancer, and ovarian cancer, whether administered via intravenous injection or oral tablets.
2. Antimetabolites are a type of chemotherapy drug that inhibits the activity of enzymes that synthesize DNA or RNA, causing cancer cells to stop growing and die. Antimetabolite groups can be used to treat a variety of cancers, including cervical, breast, ovarian, and pancreatic cancer, stomach cancer, and large-cell lung cancer.
3. Topoisomerase inhibitors are a type of chemotherapy drug that inhibits the activity of enzymes. Topoisomerase I, leading DNA damage, fails to replicate DNA strands, and eventually dies. Topoisomerase inhibitors are frequently used in combination with other drugs to treat cancers such as small-cell lung cancer, breast cancer, ovarian cancer, and testicular cancer.

What is the preparation for chemotherapy?

Preparation before chemotherapy administration is very crucial for allowing individuals to cope with treatment and reducing side effects associated with chemotherapy. Preparation for chemotherapy includes:

• Eat nutritious foods from all 5 food groups and emphasize eating protein to prevent low blood counts while receiving chemotherapy. 
• Drink plenty of water.
• Get enough sleep, exercise appropriately, keep your mind relaxed and stress-free.
• Refrain from smoking, drinking alcohol, herbal medicine, or any type of narcotic.
• Schedule oral and dental health checkups (for those receiving chemotherapy and radiation therapy to the head and neck).
• Those with underlying diseases or taking personal medications, *Notify the doctor in advance.
• Balance your life between work, exercise, and relaxation.

What is the chemotherapy procedure?

Individuals whose oncologist is considering intravenous chemotherapy (IV chemotherapy) will have chemotherapy administered directly into a vein or artery via a syringe or catheter. In each treatment cycle, the oncologist will determine the dosage administration, whether chemotherapy is given alone or in combination with other types of drugs, in order to achieve synergistic or antagonistic effects to help reduce the side effects of some chemotherapy drugs, including considering the most appropriate duration of chemotherapy for each patient.

What is self-care during chemotherapy?

• Most chemotherapy drugs cause nausea and vomiting. To prevent side effects that may occur, the doctor will administer antinausea drugs to prevent nausea and vomiting for 30 minutes before receiving chemotherapy.
• All chemotherapy drugs can cause allergic reactions, including chest tightness, heart palpitations, palpitations, headache, dizziness, or shortness of breath. Those who experience the symptoms should notify the doctor or nurse immediately.
• Some chemotherapy drugs are highly irritating to tissues. Those who experience an abnormal burning sensation while receiving chemotherapy should notify the doctor and nurse right away.
• Doctors and nurses may provide ice for cryotherapy during chemotherapy to prevent potential oral mucositis side effects.

How to take care of yourself after chemotherapy?

• Those who experience a high fever or infection should see a doctor right away.
• After receiving chemotherapy for about 2-3 days, there may be symptoms such as nausea, vomiting, and indigestibility; the doctor will prescribe at-home medications to alleviate symptoms.
• If the injection site is sore or painful, apply a cold or warm compress every 4-6 hours for 15 minutes at a time, depending on the type of chemotherapy drug used. If there is pain, swelling, redness, burning, or secretions from the injection site, see the doctor right away.
• During the first week after receiving chemotherapy, there may be symptoms of fatigue and lack of energy. However, the symptoms will gradually improve.
• The majority of patients who receive chemotherapy may experience hair loss. The scalp may hurt at first, but cutting hair short can make it more comfortable and easier to care for. However, after the chemotherapy sessions are completed, hair will grow normally.
• If there is pain or burning in the mouth, change the toothbrush to a soft-bristled one and rinse your mouth frequently with clean water to help maintain oral hygiene and reduce infection. Do not use mouthwash that contains alcohol as it may irritate the mouth further.
• The color of fingernails and toenails may darken, and the skin may become more sensitive to sunlight.
• Consume clean, cooked foods from all five food groups, with an emphasis on protein-rich foods like meat, eggs, nuts, and milk.
• Exercise as needed, not excessively or insufficiently, and get enough sleep.
• Refrain from smoking, drinking alcohol, using narcotic drugs, and taking herbal medications.

How long does chemotherapy take?

The duration of chemotherapy varies from patient to patient, depending on the type of cancer and the reason for treatment. The average duration of chemotherapy is approximately 3-6 months. The length of each cycle may differ depending on the treatment regimen and type of cancer. The doctor may consider administering chemotherapy every 2 or 3 weeks. The duration of each chemotherapy round varies depending on the chemotherapy drug. Some types may take approximately 30 minutes to administer, while others may require continuous administration in the hospital 24 hours a day.

What is the chemotherapy side effect?

Chemotherapy drugs target rapidly growing cells in the body's various organs, including normal and cancerous cells. As a result, chemotherapy has adverse effects on normal cells as well. Rapidly growing body cells include blood, skin, hair follicles, digestive tract cells, and oral mucosal epithelium. This causes normal cells to experience side effects during chemotherapy more than cells in other body parts. 

Side effects of chemotherapy include fatigue, tiredness, nausea, vomiting, loss of appetite, and hair loss.

Chemotherapy side effects that require immediate medical attention include a body temperature higher than 37.5 degrees Celsius or lower than 36 degrees Celsius, muscle aches, difficulty breathing, mouth sores, diarrhea, sore throat when swallowing, swollen pain, bruising, redness, or secretion from the needle puncture wound.  

Can chemotherapy cure cancer?

Chemotherapy is regarded as one of the most effective cancer treatment methods available, as many types of cancer cells are sensitive to chemotherapy drugs when administered. These drugs aim to kill cancer cells in the body as quickly as possible while also preventing cancer cells from multiplying indefinitely and eventually dying. Therefore, many cancer patients can be completely cured of cancer using chemotherapy.

Chemotherapy at MedPark Hospital

Light of Day Oncology Center at MedPark Hospital, Bangkok, Thailand, is led by a team of expert oncologists and hematologists in collaboration with a multidisciplinary medical team to provide holistic treatment for all types of cancer, including complicated cancer or inherited blood disorders, from start to finish, using international gold standards JCI integrates a variety of treatment methods, including chemotherapy, immunotherapy, targeted therapy, radiotherapy, stem cell and bone marrow transplants, or surgery, using state-of-the-art medical equipment and technology, as well as experienced clinical caregivers who are ready to provide consistent post-treatment follow-up care. The ultimate goal of the treatment is for our patient to be completely cured of cancer, reduce complications, and prevent cancer from recurring, enabling the patient to have good physical health and a high quality of life.

FAQ

• Does chemotherapy hurt?
  Chemotherapy can cause neuropathic pain, which is caused by peripheral and central nerve damage and results in numbness, burning, tingling, or sharp pain, particularly in the hands and feet.
• What are oral chemotherapy side effects?
  Like intravenous chemotherapy, oral chemotherapy can cause side effects such as:
  • Exhausted, tired
  • Skin, palms, and soles are darker.
  • Nausea, vomiting.
  • Flu-like symptoms.
  • Dry mouth, dry throat

Those experiencing side effects from oral chemotherapy should seek medical attention right away.

• Is chemotherapy causing every patient’s hair loss?
  All chemotherapy drugs do not cause hair loss. In fact, only certain chemotherapy drugs can cause hair loss or thinning. Currently, doctors use a technique to prevent chemo drugs from reaching the hair cells by having patients wear a cooling scalp (cooling cap) covering their heads to keep the scalp cool. This technique shrinks blood vessels and prevents the drug from reaching the scalp, resulting in less hair loss.
• Does chemotherapy require hospitalization?
  Administering chemotherapy can be either outpatient or require hospitalization to observe symptoms and potential side effects, for example, high concentrations of chemotherapy that may cause nausea and vomiting, as well as chemotherapy drugs combined or not combined with a bone marrow transplant (stem cell transplantation). In addition, some cancer treatments may necessitate ongoing chemotherapy for several days in order to achieve the best possible treatment outcomes. Therefore, the patient is advised to stay in the hospital to closely monitor their symptoms, at the doctor's discretion.
• What stage of cancer requires chemotherapy?
  Chemotherapy can be used to treat cancer at any stage, from stage 1 to stage 4. The oncologist will decide whether to administer chemotherapy based on the stage of cancer progression, whether it is early-stage or advanced-stage, considering the type and location of the cancer as well as the patient's overall health. For example, doctors may consider administering chemotherapy to a patient diagnosed with blood cancer, testicular cancer, or Hodgkin's lymphoma to prevent the cancer from progressing to the next stage, such as stage 1 endometrial cancer (stage IA), in which the cancer is still confined to the uterus. Giving chemotherapy at this stage can help prevent cancer from progressing to stages 2, 3, and 4 (stage IV) when it has spread to other organs such as the bladder lining, intestines, or lymph nodes.
• What is the duration of the chemotherapy treatment?
  Chemotherapy typically lasts 3-6 months, depending on your response, cancer type, and stage. The oncologist may plan to administer chemotherapy in cycles of 1–5 days each, with 2 days off, for a total of 7 days (7-day rule chemotherapy), or continuously for 1–5 days per session and rest for 3–4 weeks to allow the white blood cells and the body to recover and be ready for the next session. In addition, the oncologist may decide to discontinue chemotherapy when the body has responded well to the treatment and the cancer cells have been inhibited from dividing.