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Chemotherapy (Drug Therapy for Cancer)

What is chemotherapy?

Chemotherapy is the use of medicines to control, slow, or cure medical problems. The term chemotherapy is most often used to refer to the medicines given to slow or stop the growth of cancer cells. A problem with these medicines is that some of them also damage healthy cells.

The goals of chemotherapy are:

  • To cure the cancer with the fewest or least harmful side effects.
  • To control the cancer. This is done by keeping the cancer from spreading, slowing the cancer's growth, and killing cancer cells that may have spread to other parts of the body.
  • To relieve symptoms that the cancer may cause. Relieving symptoms such as pain can help people who have cancer to live more comfortably. Controlling the size of the cancer can prevent problems or symptoms caused by pressure from the tumor on nearby organs.

What are the different types of drug therapy for cancer?

Chemotherapy uses many drugs. In general they fall into 3 categories:

  • antimitotic drugs
  • hormones and hormone inhibitors
  • biological therapy.

Most of the chemotherapy drugs are antimitotics. This means that they stop cancer cell growth by stopping cells from dividing into more cells. There are many ways that scientists have found to do this, so there are now many different kinds of these drugs. They include names you may have heard: Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), and 5FU (5-fluorouracil.

Treatment related to hormones plays an important role in chemotherapy. This is especially true if you have breast or prostate cancer. Hormones that occur naturally in the body may help these cancers grow. For example, the female hormone estrogen makes some breast cancers grow. The male hormone testosterone makes some prostate cancers grow. Hormone inhibitors are used to stop the hormones from helping the tumor grow.

One commonly used hormone inhibitor is tamoxifen, which blocks female hormones in breast cancer. Hormones, such as cortisone (Prednisone), are also used to treat some tumors or their side effects.

Biological therapy, or immunotherapy, is the name for a group of cancer drugs that help the immune system work better and fight cancer. Interferon is one example of these drugs. Another example of biological therapy is the use of antibodies. The goal is to find or create antibodies that can attach to cancer cells. The antibodies can keep the cancer cells from multiplying, or they may destroy the cells. Antibodies can also be used to help cancer medicine attach only to the cancer cells. This type of therapy is also called biotherapy or biological response modifier therapy (BRM).

How is it used?

Chemotherapy may be used alone or combined with other treatments, such as surgery or radiation. The treatment depends on what type of tumor you have, where the tumor is, and how much it has spread. The medicine may be given on many different schedules: daily, weekly, or monthly. The schedules are based on what research has found to work best for each type of cancer. The medicine may be given by mouth, by shot, or into a tube put in a vein (IV, or intravenous). If given by shot, it can be injected into a muscle or it may be given into the spinal cord area.

IV medicine may be given over a few minutes or a few hours. You may be able to give some treatments to yourself at home. Portable pumps are available for chemotherapy treatments that go into the vein. The pump makes sure the prescribed dose of medicine is given over the correct period of time. You may receive some medicines at your healthcare provider's office and then go home wearing a pump at your waist (like a fanny pack) for a prescribed number of hours or a couple of days.

What side effects should I expect?

Common side effects of the antimitotics are tiredness, nausea, and hair loss. Other side effects depend on the drug, the dose, and your health. Examples of other possible side effects of these drugs are:

  • sores in your mouth
  • weight loss
  • rash or swelling where the medicine is injected
  • lowered blood counts that make you anemic or more likely to get an infection.

An otherwise healthy person receiving chemotherapy may not have a lot of side effects. Someone who has several other serious medical problems in addition to cancer may have a more difficult time.

Symptoms of menopause are a common side effect for women taking tamoxifen. Men taking finasteride may have a lowered sex drive.

Biological therapy often causes flulike symptoms, such as fever, aches, chills, nausea, and loss of appetite.

Your healthcare provider will be watching closely for any side effects and will help you manage them. Be sure to let your provider know if you are having side effects. If the side effects get severe, your treatment may need to be changed. Sometimes you may need to stay at the hospital until your side effects are under control.

What are clinical trials?

Ask your healthcare provider about clinical trials. These are studies being done to test new treatments, new medicines, and new combinations of medicines. Ask your provider where the closest clinical trials are and how you can learn more about them. Making an appointment to learn about a clinical trial does not mean you have to take part in the trial. After you learn about the study, you can decide if you want to join it.

How should I take care of myself during treatment?

  • First, follow your healthcare provider's instructions for your treatment. Always ask questions to make sure you understand the directions. It is often helpful to have a friend or family member go with you to help you remember what is said at visits with your provider. You may want to take notes.
  • Be sure to tell your provider about all medicines, vitamins, supplements, and any alternative or complementary therapies you are using. Some of these might interact with your chemotherapy and cause more side effects.
  • Several healthcare providers may be giving you care- for example, your family healthcare provider, a cancer specialist (oncologist), a radiation oncologist (a doctor who specializes in the use of radiation for treatment), and a surgeon. Help your providers communicate with each other. Always take a list of your current medicines and cancer drugs with you to ALL of your healthcare provider visits. Review the list with your provider and ask for the list to be included with your medical chart. Also share your test results by carrying copies of the results with you.
  • If you have diabetes, always take your blood sugar log to all of your appointments.
  • Ask if there are specific instructions about what to eat and drink and what to avoid.
  • Ask if you will need pain medicine and how to take it. If your cancer or your treatment is causing pain, it is usually best to take the pain medicine either on a regular basis or just when the pain is starting. There is usually no need to wait until you have a lot of pain.
  • If you are losing weight because you have no appetite, ask about an appetite stimulant. You need good nutrition to help fight the cancer.
  • Let family members and friends help you. Give them specific suggestions for what they can do to help and make your life easier. They want to help. They can help cook, clean, mow the lawn, drive you to your appointments, and let other friends know not to visit for awhile until you are feeling better. (They could make a sign for you: "No visitors today, please.")
  • Save your energy for important things and people you enjoy.
  • Laughter is the best medicine. Humor helps the immune system work. Read funny books or watch funny movies--whatever makes you laugh.

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Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File canc3519.htm Release 13/2010

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