FAQ



GOALS OF CHEMOTHERAPY

Chemotherapy is the use of medication (chemicals) to treat disease. More specifically, chemotherapy typically refers to the destruction of cancer cells.
Total remission :
to cure the patient completely. In some cases chemotherapy alone can get rid of the cancer completely.

Combination therapy : chemotherapy can help other therapies, such as radiotherapy or surgery have more effective results. In some cases it is given before surgery (Neoadjuvant therapy) to reduce the size of the tumor to make tumor more amenable to surgery.

Delay/Prevent recurrence (Adjuvant ) : chemotherapy, when used to prevent the return of a cancer, is most often used after a tumor is removed surgically.

Slow down cancer progression (Palliative) : used mainly to slow down the progress of cancer in its advanced stages, where a cure is unlikely.

 

AGE AND CHEMOTHERAPY



There is no bar to taking chemotherapy at any age. However doctors may modify doses or suggest the appropriate line of treatment after complete assessment of the patient.

HOW LONG IS A COURSE OF CHEMOTHERAPY?

 

A protocol plan is drawn up which specifies when treatment sessions will occur and for how long.
Courses of chemotherapy may vary

• One day treatment followed by three weeks of rest
• One day treatment followed by weekly therapy
• And many other protocols depending on the disease and patient status


BLOOD TESTS BEFORE AND DURING CHEMOTHERAPY TREATMENT

 

• To ensure that the patients are tolerating chemo well and have minimal sideeffects
• Judge response of tumor to treatment.

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TWO WAYS OF GIVING CHEMOTHERAPY


SDepending on the type of cancer, chemotherapy may be administered orally or intravenously (directly into the vein).

• Oral chemotherapy in the form of tablets
• Intravenous chemotherapy (straight into the vein) which may be given through.

• A cannula : a thin tube is inserted through the skin into the vein - usually it enters the body via the back of the hand or the lower arm.

• A drip (intravenous infusion) : in order to dilute the medication it may be injected into a bag. The solution in the bag will pass through a tube into the patients arm and into a vein (intravenous infusion). A cannula will be used. The solution will enter the vein slowly.

• A peripherally inserted central catheter (PICC) line : a long, thin, flexible tube that is inserted into a peripheral vein, usually in the upper arm and makes its way into a large vein in the chest near the heart. It is similar to a central line but has a different point of entry.

• A portacath (implantable port) : a thin, soft, flexible plastic tube goes into a vein. It has a port (opening) just under the skin of the chest or arm. The port has a thin rubber disc which special needles can pass medicines into, or take blood from.

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WHAT ARE THE SIDE EFFECTS OF CHEMOTHERAPY?

 

The severity of side effects is variable, differing from patient to patient.
Below is a list of the most commonly reported side effects:

• Nausea and vomiting : Over half of all patients receiving chemotherapy will experience nausea and vomiting. Doctors will usually prescribe anti-emetics for this.

• Alopecia (Hair loss) : Some chemotherapy medications cause hair loss while others don't. If hair does start to fall out this will usually happen a few weeks after treatment starts.
The hair loss is NOT permanent - it will grow back soon after treatment if finished.

• Fatigue : Most patients receiving chemotherapy will experience some degree of fatigue.

• Neutropenia (low white blood cells) - Susceptibility to infections

When receiving chemotherapy the immune system will be weakened because the white blood cell count will go down. Consequently, patients become more susceptible to infections.
Some patients will be prescribed antibiotics or injections to improve cell count which may reduce their risk of developing infections.

The following precautions will help reduce the risk of infections:

• Personal hygiene - the cleaner you are, the fewer bacteria there will be around which can infect you.
Regularly wash your hands with warm water and soap, have a bath/shower at least once a day
• Preparing food - make sure your food is free of food borne pathogens (organisms, such as bacteria that can make you ill)
Thoroughly cook animal sourced proteins before eating them. Wash your dishes thoroughly and always use a clean plate and cutlery - keep the kitchen clean.
• Infected people - stay away from people who are ill. This may include those who just have a fever.
• Skin wounds - If you graze or cut your skin, clean the area well with warm water, dry it, and cover it with a sterile dressing.
Patients receiving chemotherapy who develop an infection need immediate treatment. This may mean being hospitalized and receiving antibiotics via an intravenous drip.
• Thrombocytopenia (low blood platelet count) - Blood clotting problems.
• Anemia (low red blood-cell count)
• Low hemoglobin may result in severe fatigue.

Erythropoietin (EPO) is a drug that makes the body produces more red blood cells.
The following foods are rich in iron, which helps red blood cells carry more oxygen. Dark green leafy vegetables, beans, meat, nuts, prunes, raisins, and apricots.
• Mucositis (inflammation of the mucous membrane)

Oral Mucositis (in the mouth) - patients more commonly experience symptoms in their mouth.

If symptoms do appear, they will usually do so about 7 to 10 days after treatment starts. The inside of the mouth may feel like sunburn; Ulcers often appear on the lining of the mouth, the tongue, and sometimes around the lips. The severity of symptoms is closely linked to the strength of the chemotherapy dose.

As better drugs are appearing, mucositis is becoming less common. Symptoms clear up a few weeks after treatment is completed.
• Loss of appetite

The severity of appetite and consequent weight loss may vary.
It is important to keep trying to eat well and take in plenty of fluids. Smaller and more frequent meals are easier to get down than the typical three meal-a-day regime.
• Nails and skin
Chemotherapy can sometimes cause dry and sore skin, flaky and brittle nails. The skin may become more sensitiveto sunlight.

• Fertility

Depending on the type of medication administered, fertility may be variably affected, but it returns after treatment is over.

• Bowel movement problems (diarrhea or constipation)
Depending on the type of medication administered, fertility may be variably affected, but it returns after treatment is over.


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