Chemotherapy refers to the use of chemical substances to treat cancer. These drugs are designed to target and destroy cancer cells or stop them from growing and dividing. Although chemotherapy primarily aims to target cancer cells, it can also affect normal, rapidly dividing cells, leading to potential side effects.

Types of Chemotherapy

1. Systemic Chemotherapy: This is administered either orally (by mouth) or through injections into the bloodstream. It travels throughout the body to reach cancer cells in various locations.
2. Regional Chemotherapy: This type is delivered directly to a specific area of the body, such as a tumor site, to minimize the impact on healthy tissues.

How Does Chemotherapy Work?

Chemotherapy drugs work by targeting cells that grow and divide quickly, a key characteristic of cancer cells. The drugs interfere with the cell cycle, preventing cancer cells from replicating and spreading. However, because some normal cells also divide rapidly, they can also be affected by the treatment.

Goals of Chemotherapy Treatment

When chemotherapy is recommended for cancer treatment, understanding its goals is crucial in making informed decisions. There are three primary objectives for using chemotherapy:

1. Cure

The ultimate goal of chemotherapy, if possible, is to cure the cancer. This means that the cancer is completely eradicated, and there is no return. However, doctors rarely use the term “cure” , instead, they may describe the treatment as having “curative intent.” Achieving a cure can be challenging and may take years to confirm if the cancer is truly gone.

2. Control

When a cure is not feasible, the aim of chemotherapy shifts to controlling the cancer. This involves shrinking tumors or preventing the cancer’s growth and spread. In many cases, the cancer may not be entirely eradicated but managed as a chronic condition.

3. Palliation

Chemotherapy can also be used for palliation, which focuses on relieving symptoms and improving quality of life rather than curing the disease. This is particularly relevant in advanced stages of cancer where control is unlikely. Palliation aims to ease symptoms such as pain or pressure caused by tumors. Although palliative chemotherapy does not aim to cure or control the cancer, it helps in making the patient more comfortable and alleviates discomfort.

How is Chemotherapy Used to Treat Cancer?

Chemotherapy can be used in several ways depending on the type and stage of cancer:

1. Neoadjuvant Therapy: Given before surgery to shrink tumors, making them easier to remove.
2. Adjuvant Therapy: Administered after surgery to kill any remaining cancer cells and reduce the risk of recurrence.
3. Primary Therapy: Used as the main treatment for cancers that are not operable or for which surgery is not a viable option.
4. Palliative Therapy: Focuses on relieving symptoms and improving quality of life in advanced cancer cases.

The approach to chemotherapy can be customized based on individual patient needs and cancer characteristics.

How Chemotherapy is Administered

Chemotherapy can be given through various methods, depending on the type of cancer and the treatment plan. Here’s a summary of the common ways chemotherapy is administered:

1. Oral: Chemotherapy drugs are taken by mouth in the form of pills, capsules, or liquids.
2. Intravenous (IV): Chemotherapy is delivered directly into a vein through a thin needle. This is the most common method and often involves placing a needle in the hand or lower arm. In some cases, IV chemotherapy is administered through catheters or ports, and may use a pump.
3. Injection: Chemotherapy is given by a shot into a muscle (e.g., arm, thigh, or hip) or just under the skin (e.g., arm, leg, or abdomen).
4. Intrathecal: The drug is injected into the space between the layers of tissue surrounding the brain and spinal cord.
5. Intraperitoneal (IP): Chemotherapy is delivered directly into the peritoneal cavity, the area containing abdominal organs like the intestines, stomach, and liver.
6. Intra-arterial (IA): The drug is injected directly into the artery that supplies blood to the cancerous area.
7. Topical: Chemotherapy is applied as a cream directly onto the skin.

Among these methods, intravenous (IV) administration is the most frequently used, involving the insertion of a needle into a vein at the beginning of each treatment session, with the needle being removed afterward. IV chemotherapy can also be administered through specialized devices like catheters or ports, sometimes with the assistance of a pump.

Managing Chemotherapy Side Effects

Chemotherapy can cause a variety of side effects, but many of them can be managed with appropriate care and medications. Here are some common side effects and strategies for managing them:

1. Nausea and Vomiting: Anti-nausea medications can help control these symptoms. Eating small, frequent meals and staying hydrated may also provide relief.
2. Hair Loss: This is a common side effect but is usually temporary. Consider using wigs, scarves, or hats if desired.
3. Fatigue: Ensure adequate rest and balance activity with rest periods. A nutritious diet and light exercise can also help improve energy levels.
4. Appetite Changes: If appetite changes occur, try consuming small, nutritious meals throughout the day. Consulting a dietitian can provide additional support.
5. Increased Risk of Infection: Chemotherapy can weaken the immune system. Practice good hygiene, avoid large crowds, and consult your doctor if symptoms of infection arise.
6. Mouth Sores: Rinsing the mouth with a saltwater solution and avoiding spicy or acidic foods can reduce discomfort.

Preparing for Chemotherapy

1. Consult Your Healthcare Team: Discuss the treatment plan, including the types of drugs, schedule, and potential side effects.
2. Undergo Required Tests: Your healthcare team may conduct tests such as blood work or imaging to ensure you are ready for treatment.
3. Prepare Your Home: Arrange your living space to accommodate your needs during treatment, including a comfortable resting area and easy access to necessary supplies.
4. Arrange Support: Ensure you have a support system, such as family, friends, or a caregiver, who can assist with daily tasks and attend appointments with you.

Chemotherapy Safety at Home: Key Points

• Wear gloves and avoid direct contact while handling the medications
• Do not touch medications with bare hands.
• Follow storage instructions and maintain recommended temperature.
• Cleaning and disposal following the guidelines provide by the medical team
• Keep good Personal hygiene and wash hands frequently with soap and water, especially after handling medications or body fluids.
• Handle patients body fluids carefully: Use disposable pads and wash contaminated items separately.
• For children and pregnant or breastfeeding Women: Avoid contact with chemotherapy drugs and body fluids that may contain chemotherapy. Ensure they do not handle medications or come into contact with potentially contaminated fluids.

Caregiving and Support

If you are a caregiver for someone undergoing chemotherapy, your role is crucial in providing emotional and practical support:

1. Emotional Support: Offer empathy, encouragement, and a listening. Emotional support can significantly impact the patient’s well-being.
2. Monitor Symptoms: Keep track of side effects or changes in the patient’s condition and communicate these to the healthcare team.
3. Assist with Daily Activities: Help with tasks such as meal preparation, transportation to appointments, and household chores.
4. Promote Rest and Comfort: Ensure the patient has a comfortable and restful environment.
5. Stay Informed: Educate yourself about chemotherapy and its effects to better understand and support the patient.