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Chemotherapy 101: An Overview


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Following is a general overview of chemotherapy.  Articles linked at the end provide additional information about each subject. 

Chemotherapy In General

Chemotherapy is the use of chemicals to kill cancer cells or prevent them from dividing. There have been significant advances in chemotherapy and even more significant advances in our ability to manage the side effects of chemotherapy. There are also more medications to eliminate or reduce side effects.

Chemotherapy (commonly called "Chemo") is the use of drugs to cure cancer OR to control cancer if it cannot be cured OR to relieve pain from a cancer that cannot be cured or controlled ("Palliative" care). Chemotherapy can be used to shrink a tumor to make it possible to do surgery, or to make the odds of a positive surgical result better; after surgery to kill any cells remaining in the body or to relieve symptoms of advanced cancer. 

When used in combination with another therapy, chemotherapy is known as "adjuvant therapy." When used to relieve symptoms, it is known as "Palliative chemotherapy."

Chemotherapy works by attacking reproducing cells and either killing them or preventing them from dividing. A treatment plan can include several types of drugs which use different routes to be more effective against disease. 

Chemotherapy can be given on a systemic basis that reaches all areas of the body through the bloodstream. It can also be given on a "regional" basis which means that drugs are injected directly into an artery that leads to a part of the body containing the tumor. 

The treatment schedule is determined by the drug(s) used and dose. It is important to keep to the schedule. The schedule, drug and dosage may be modified by your doctors as they monitor your response.

Which chemotherapy to use depends on the following factors:  

  • The type of cancer and stage (which includes whether it has spread and, if so, how far).
  • How and where chemo is given.
  • For how long chemo is given.
  • How often chemo is given. 
  • Your general health status, including other diseases if you have more than one.
  • Patient preference. For example, the side effects you are willing to tolerate.

Methods For Giving Chemotherapy

Chemotherapy can be given:

  • Orally (generally in pills) 
  • Through an I.V. (intravenous) drip (a needle sat the end of a flexible tube which is attached to a bag or bottle hanging on a pole)
  • Through a Central Venous Catheter (CVC) (a port embedded in your skin).

Steps To Take Before Agreeing To Chemotherapy

If a chemotherapy is recommended:

  • Ask every question of concern to you. For a list of suggested questions, click here
  • Learn the appropriate medical terms. The correct words will make discussions with your medical team more precise and faster.
  • Get a second opinion before starting treatment. A second opinion is when you have an opinion from one doctor about a diagnosis or proposed treatment, and you want an opinion from another medical professional. Insurance, including Medicare, generally pays for second opinions. Second opinions are common when it comes to cancer diagnosis and treatment. Your doctor should not mind if you ask for a second opinion. In fact, some insurance companies require you to get one. NOTE: If you have health insurance, check the provisions of your policy to determine when second opinions are covered and the correct procedure to use. For example, with managed care policies, you generally have to get the insurance company's approval before proceeding. 

Always ask your doctor and nurse any questions you have about your chemo. A general knowledge of the words used with respect to chemo will help make discussions with medical providers more accurate and faster, leaving more time to raise any questions or concerns you may have.

What To Do Once You Agree To Chemotherapy Treatment: 

  • You will be asked to sign a Consent Form. Ask to see the form well before the date your chemo is supposed to start so you have time to review it. It may provide information you didn't ask about or it may contradict what you think about the particular chemotherapy. (For information about medical consent forms, click here.)
  • If you could lose your hair, plan ahead. For instance, start shopping for a wig or other head covering.(For information about hair loss and how to deal with it, click here.)
  • If other side effects such as nausea and fatigue commonly accompany the chemo, get a prescription now "just in case." Learn what other steps you can take to decrease or eliminate the side effect.
  • If you want to have children, take steps now to bank sperm and eggs. 
  • Think through the effect on work during and after treatment. Negotiate for the necessary accommodations or time off.
  • See your dentist (to clear up any oral infections before starting chemo)

What To Do During Chemotherapy

Chemotherapy is not painful. IV medicines should not hurt after the first needle stick to put in the catheter. 

  • Follow the protocol including when you are supposed to take the drug and when you are supposed to visit a doctor.
  • Know when to call the doctor (for instance, if you spike a fever over ___ degrees),
  • Chemotherapy's attack on healthy cells can cause a variety of side effects ranging from nausea and vomiting to hair loss to so-called "chemo brain" to fatigue. There are drugs and other steps that can be taken to lessen the effect of side effects or eliminate them all together. How long the side effects continue after treatment depends on the treatment and your body.
  • Use family, friends and caregivers for support.
  • If you haven't already, ask your doctor whether the side effects from the chemo are likely to continue after treatment ends. If so, for how long?

If your cancer returns, chemotherapy may be used again.

If it does, you may be given different drugs, including to relieve symptoms or to slow the cancer's growth or spread. Side effects may be different, depending on the drug, the dose, and how it is given. 

Cutting Ege Drugs 

If drugs approved by the FDA are not available for use for your situation, cutting edge drugs may be available through clinical trials. Drugs may also be available outside the U.S. which are not approved or subject to controlled studies here.

Payment For Chemotherapy

Chemotherapy can be very expensive. 

Chemotherapy is generally paid for by health insurance (including Medicare and Medicaid).  If an insurer balks at paying, appeal - and keep appealing!  Many pharmaceutical companies will handle the discussions with the insurer for you. If you are uninsured, there are alternative means for payment.
Emotional Support While Undergoing Chemothearpy

Emotional support is valuable before, during and after treatment. Consider joining a support group. At least make contact with another person going through what you are or who has recently going through it..

Open and honest talks between you, your family, and your cancer care team is the best way to understand what is happening to you, your body, and your cancer - and to get needed support.


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