What is Chemotherapy ?

Chemotherapy is the use of drugs in cancer treatment. Besides surgery and radiotherapy, chemotherapy is one of the three main modalities of treatment in cancer. In the multimodality treatment of cancer, chemotherapy is used in more than three fourths of the patients at some stage or the other. The medical branch dealing with chemotherapy is called Medical Oncology and the oncologist giving chemotherapy is known as Medical Oncologist.

Chemotherapy Drugs

There are about 100 chemotherapy drugs belonging to various groups. The common ones are adriamycin, taxol, cyclophosphamide, cisplatinum, methotrexate, 5 flurouracil. Mitomycin, bleomycin,  etoposide etc. They are usually given as intravenous injections in the veins but few drugs can be given orally too.

Indications of chemotherapy

Chemotherapy is used in various settings; it can be used as the following:-
•    Primary Chemotherapy  - where chemotherapy is used as the main mode of treatment as in leukemia, lymphoma and cases which are inoperable or patient is unwilling for surgery
•    Preoperative Chemotherapy – here chemotherapy is used before surgery to make the cancer operable or to decrease the extent of surgery and to preserve the affected organ
•    Post operative- here chemotherapy is used after surgery to prevent local and distant recurrence
•    Salvage – here chemotherapy is used for recurrence
•    Palliative- chemotherapy may also be used to decrease pain and other symptoms in advanced cancers
•    Chemoprevention- chemotherapy is also used in certain cases to prevent cancer in high risk patients or to prevent second cancer in cancer patients

Duration of Chemotherapy

There are various schedules of chemotherapy. It is usually given in cycles repeated every 3 weeks. Normally a patient receives six cycles. Some drugs are given over few hours while others may be given continuously for two to five day. Some regimes have a weekly schedule of chemotherapy and few drugs specially those being taken orally are given daily.

Actions of chemotherapy

Chemotherapy prevents cell division and leads to cell death. Maximum effect is on the cancer cells, however normal cells are affected too. The most commonly affected normal cells are of the bone marrow, blood and the intestines.

Preparation For Chemotherapy

Before chemotherapy the following blood tests should be done, hemoglobin, blood count, platelet, electrolyte, liver and kidney function tests. If the blood counts are high or low, then chemotherapy should be postponed. Patient should drink a lot of water and have light meals before chemotherapy.

Side Effects of chemotherapy

•    Vomiting and nausea
•    Loose motions
•    Fever
•    Low blood counts
•    Loss of hair
•    Bone marrow suppression
•    Stopping of periods
•    Blackening of skin and nails

Precautions during chemotherapy

•    To drink adequate fluids
•    To avoid heavy meals
•    To avoid eating raw vegetables or fruits
•    To avoid infections
•    To avoid going in crowded areas soon after chemotherapy

Ports and catheters

In patients who need chemotherapy for long durations and frequently or in those where veins are not found easily, chemotherapy can be given through special catheters or ports which are placed in a central big vein .The drugs are injected directly into the catheter which are outside the body or the       port which are placed under the skin. These prevent frequent injection of drugs in the veins.

Chemotherapy is being used extensively these days in the treatment of cancer patients with good results.

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