Chemotherapy - what you need to know

cancer chemotherapy

Chemotherapy has long been used as a method of treating cancer, and the name will be familiar to most. But what exactly does the treatment consist of, and how will it affect you? Here's what you need to know.

What is chemotherapy?
The word itself literally means drug treatment and there are more than 100 different types currently available. If it is deemed a suitable treatment, what type is used depends on the type of cancer, the affected area of the body, what the cancer cells look like, whether it has spread and the general health of the patient. It can be used on its own or in combination with other treatments such as radiotherapy, surgery, hormone therapy or biological therapy.

How does it work?
Simply put, chemotherapy is designed to kill cells that are in the process of splitting into two. Cancer cells divide much more frequently than normal cells, eventually developing into a mass, or tumour. Because they divide more often than healthy cells, they are more likely to be successfully targeted by chemo. Some drugs work by killing the cell or damaging the genes inside the nucleus of the dividing cells, while others interrupt the chemical processes that allow the cells to divide. Success rates depend on the type of cancer, but where it does not cure completely, it can shrink the cancer, help to relieve the symptoms, or control it by putting it into remission.

What to expect
In order to do their job, chemotherapy drugs must be absorbed into the bloodstream and carried throughout the body. How they are administered depends on the type of cancer, the affected area of the body and the type of drugs prescribed. The most common courses of treatment involve injecting the drugs into a vein through a drip, taking them as oral tablets, or an infusion pump.

However, in some cases drugs are injected into a muscle, an artery, subcutaneous fat, fluid around the spine or brain, a body cavity such as the bladder or abdominal cavity, between the membranes that cover the lungs, or even directly into the tumour itself. It may be the case that a combination of two or more of the above methods is used to give the drug the best chance of treating the disease.

How will it affect me?
The affects of chemotherapy on your general health and wellbeing depend largely on the type of treatment and the dosage. For many patients taking oral chemo medication, there is little change, and some are able to continue working part time or between treatments. However, it is common to feel tired and that means resting if possible is a good idea. Some find their appetite is reduced, have trouble sleeping, both of which can contribute to a feeling of exhaustion.

Many chemotherapy drugs also affect the digestive system, and nausea or vomiting are quite common side effects, though these can usually be controlled with anti-sickness medication. Some drugs can result in a sore mouth or mouth ulcers, and a temporary change in sense of taste is not uncommon. Others irritate the lining of the bowel, leading to diarrhoea, but again, this usually occurs only in the first few days of treatment and can be controlled with medicines.

Low blood cell count
Chemotherapy drugs can also affect both the white and red blood cell counts, as well as the platelets that help blood to clot. A reduced white cell count will put a patient more at risk of developing infections, so it is important to see a doctor if you develop a high temperature or flu-like symptoms. If the red blood cells are low, you find yourself feeling tired or breathless, while a lack of platelets will mean you bruise very easily.

Skin and hair
Some drugs, though not all, cause the hair to fall out, but this is a temporary symptom and the hair usually begins to grow back a few weeks after the treatment ends. Dry, sensitive skin is often reported, and some patients find they experience pins and needles or numbness, usually caused by damage to nerves, most often in the hands and feet.

Kidney, liver, heart and lungs
Changes to the way the kidneys, liver, heart or lungs work is not uncommon in chemotherapy patients, but in most cases the effects are temporary and everything returns to normal at the end of treatment. However, in some instances the effects are permanent, so it is worth asking your doctor about the likelihood of this happening. There is sometimes an increased risk of developing blood clots too, so if you feel breathless or notice a swelling in your leg, it is wise to visit the hospital.

Chemotherapy can affect your libido, typically because you will feel tired during the course of treatment. It can also affect fertility though, and if you are planning to start a family in the future, it is worth speaking to your doctor about the treatment and what effects it may have. In some cases infertility is caused but is temporary - it really depends on the type of drug, your age and other health-related factors. Your doctor may be able to suggest a treatment that has a lower risk of causing infertility, or there are other options such as freezing fertilised eggs or sperm for the future.

The symptoms of chemotherapy, both physical and emotional, vary greatly but you should never be afraid to ask questions of your specialist consultant or healthcare team. Alternatively, you can contact Cancer Research UK on 0808 800 4040, where a team of cancer information nurses are on hand for further advice and support.

Have you had a course of chemotherapy? What advice would you give to others undergoing treatment? Leave your comments below...
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