Alternative Names antineoplastic medications, anti-cancer medications
Definition Cancer is a complex disease. In order to treat it effectively, one or more therapies are often used. They can be used separately or in combination. The most common therapies are surgery, radiation therapy, and chemotherapy. Surgery and radiation therapy are local treatments. This means they are directed at and treat a specific area affected by cancer. Chemotherapy refers to medications that can kill or control cancer. These medications are delivered to all parts of the body in the bloodstream. For this reason, chemotherapy is considered a systemic treatment, or one that affects the entire body.
There are many kinds of chemotherapy. The choice of medications will depend on the type of cancer, the extent of the cancer, and the potential side effects of the medication. The goal of chemotherapy can be to cure the cancer, to control its growth, or to relieve the symptoms or pain caused by the cancer. Each medication used for chemotherapy will have side effects specific for that medication. Most of the time, chemotherapy is given as an outpatient procedure in a clinic or a doctor's office. People generally do not need to stay overnight in the hospital to receive chemotherapy.
Who is a candidate for the procedure? A person is likely to receive chemotherapy if:
the cancer is sensitive to chemotherapy. Leukaemia, lymphoma, breast cancer, bowel cancer and other cancers respond to this form of treatment.
a person is able to tolerate the expected side effects
How is the procedure performed? Most of these medications are given directly into a vein. This method gets the medications into the bloodstream quickly. Some medications are given by mouth. These medications are absorbed from the stomach into the blood stream. Combinations of different medications are often used to provide the most effective treatment.
What happens right after the procedure? Before chemotherapy medications are administered, the person will receive medications that help prevent or lessen side effects. After the procedure, additional medications are given if needed. Also, the individual will be sent home with instructions on how to manage expected side effects. The person will be told how to reach the doctor to report problems.
What happens later at home? Side effects can usually be well managed. Medications are often given after the person returns home to prevent or manage these problems. A person treated with chemotherapy will need to remain in close contact with the doctors and nurses administering the medication.
What are the potential complications after the procedure? Complications vary depending on the type of medications used. There are hundreds of medications used for chemotherapy. Each medication will have a specific set of side effects. Many individuals experience only mild problems related to the therapy. Most side effects are temporary and resolve when treatment ends. Few medications cause permanent problems.
In general, chemotherapy tends to also effect normal body tissues like the bone marrow and hair. These similar tissues are very active. Active tissue, normal, and cancerous tissues are sensitive to chemotherapy. Normal tissue is usually able to completely recover from the effects of chemotherapy. Cancerous tissue is usually not able to recover. The following are common problems experienced by people undergoing chemotherapy. However, not all medications used for chemotherapy will cause these problems.
Bone marrow suppression. The bone marrow is very active, producing components of the blood continuously. Most of the time, chemotherapy causes a temporary decrease in the number of normal blood cells. Low numbers of white blood cells make a person more vulnerable to infections. Low numbers of red cells make a person tire easily. Low number of platelets may cause the person to bleed more easily. The blood count, or FBC, will be monitored closely. Special medications can be given that speed the recovery of the bone marrow, but are usually not required. There are no special foods or supplements that will help the bone marrow recover more quickly. People on chemotherapy should avoid infections and report fevers promptly. Most people do not have problems from low blood counts. Blood counts generally recover without incident in time for the next treatment.
Hair loss. Not all chemotherapy causes hair loss. The person may only experience thinning of the hair on the head. Rarely does chemotherapy cause a person to lose all body hair. Usually only the hair on the head is involved. When hair loss occurs, it is temporary. There is no proven method of preventing hair loss. The effects of hair loss can be disturbing for men and women even it is temporary. Many times, hair growth will resume before the end of planned treatment.
Nausea. Not all chemotherapy causes nausea, vomiting, or other stomach upset. This can be a significant side effect of some chemotherapy. Medications now available can usually prevent this side effect at the time of drug administration. Other medications can be offered to help with nausea when the person is at home. Modifying the diet by avoiding strong smelling or spicy foods may be helpful. Food that can be tolerated will be different for each person. There is no "right" or "wrong" food.
Fatigue. Many people undergoing chemotherapy experience fatigue. Fatigue may have many causes. The emotional toll of having cancer and undergoing therapy can contribute to the loss of energy. Treatment for cancer such as radiation, surgery, or chemotherapy can place demands on the person's energy reserve. Low numbers of red blood cells also makes the person feel weak. There is no proven method for treating fatigue. Many times, encouraging activity can actually improve energy. Excessive napping or resting may actually make fatigue worse. After chemotherapy has been completed, fatigue usually resolves. If the fatigue is from anaemia, medications can be offered to improve the number of red blood cells without transfusions.
Other side effects. Each medication used for chemotherapy will have specific side effects. It is important for the person receiving these medications to know what might occur. The person should expect to receive clear instructions for managing side effects. If there are any questions, the person should ask the doctor or nurse to clarify instructions. Knowing what to expect and how to handle problems will help the person through the cancer treatment experience.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
