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What Is Chemotherapy?


Chemotherapy is the use of drugs to treat cancer. The drugs often are called "anticancer" drugs.

How Does Chemotherapy Work?
Normal cells grow and die in a controlled way. But cancer occurs when cells become abnormal and keep dividing and forming more cells without control or order. Anticancer drugs destroy cancer cells by stopping them from growing or multiplying at one or more points in their life cycle. Because some drugs work better together than alone, chemotherapy often may consist of more than one drug. This is called combination chemotherapy.

Other types of drugs may be used to treat your cancer. These may include certain drugs that can block the effect of hormones. Doctors also may use biological therapy to boost the body's natural defenses against cancer.

What Can Chemotherapy Achieve?
Depending on the type of cancer and its stage of development, chemotherapy can be used:
  • To cure cancer.
  • To keep the cancer from spreading.
  • To slow the cancer's growth.
  • To kill cancer cells that may have spread to other parts of the body. from the original tumor. To relieve symptoms that may be caused by the cancer.
  • Chemotherapy also can help people live more comfortably; this is known as palliative care.


Will Chemotherapy Be My Only Treatment for Cancer?
Sometimes chemotherapy is the only therapy a patient receives. More often, however, chemotherapy is used in addition to surgery and/or radiation therapy; when it is used for this purpose, it is called adjuvant therapy. There are several reasons why chemotherapy may be given in addition to other treatment methods. For instance, chemotherapy may be used to shrink a tumor before surgery or radiation therapy. It also may be used after surgery and/or radiation therapy to help destroy any cancer cells that may remain.

Which Drugs Will I Get?
Your doctor decides which drug or drugs will work best for you. The decision depends on what kind of cancer you have, where it is, the extent of its growth, how it is affecting your normal body functions, and your general health.

Your doctor also may suggest that you join a clinical trial for chemotherapy, or you may want to bring up this option with your doctor. Clinical trials are carefully designed research studies that test promising new cancer treatments. Patients who take part in research may be the first to benefit from improved treatment methods. These patients also can make an important contribution to medical care because the results of the studies may help many people. Patients participate in clinical trials only if they choose to and are free to withdraw at any time.

How Will I Get Chemotherapy?
Depending on the type of cancer you have and the drug or drugs you are getting, your chemotherapy may be given in one or more of the following ways:
  • Into a vein (intravenously, or IV). You will get the drug through a thin needle inserted into a vein, usually on your hand or lower arm. Another way to get IV chemotherapy is by means of a catheter, a thin tube that is placed into a large vein in your body and remains there as long as it is needed. This type of catheter is known as a central venous catheter. Sometimes, a central venous catheter is attached to a port, a small plastic or metal container placed surgically under the skin.
  • By mouth (orally,or PO) in pill, capsule, or liquid form. You will swallow the drug, just as you do many other medications.
  • Into a muscle (intramuscularly, or IM), under the skin (subcutaneously, or SQ or SC), or directly into a cancerous area in the skin (intralesionally, or IL). You will get an injection with a needle.
  • Topically. The medication will be applied onto the skin.
  • Chemotherapy also may be delivered to specific areas of the body using a catheter (or a catheter plus a port). Catheters may be placed directly into the spinal fluid, abdominal cavity, bladder, or liver. Your doctor or nurse may use specific terms when talking about certain types of catheters. For example, an intrathecal (IT) catheter is used to deliver drugs into the spinal fluid. Intracavitary (IC) catheters can be placed in the abdomen, pelvis, or chest.
  • Two kinds of pumps - external and internal - may be used to control the rate of delivery of chemotherapy. External pumps remain outside the body. Some are portable and allow a person to move around while the pump is in use. Other external pumps are not portable and may restrict activity. Internal pumps are placed surgically inside the body, usually right under the skin. They contain a small reservoir (storage area) that delivers the drugs into the catheter. Internal pumps allow people to go about most of their daily activities.


How Will I Know If My Chemotherapy Is Working?
Your doctor and nurse will use several methods to measure how well your treatments are working. You will have frequent physical exams, blood tests, scans, and x-rays. Don't hesitate to ask the doctor about the test results and what they show about your progress.

While tests and exams can tell a lot about how chemotherapy is working, side effects tell very little. (Side effects-such as nausea or hair loss-occur because chemotherapy harms some normal cells as well as cancer cells.) Sometimes people think that if they don't have side effects, the drugs aren't working, or that, if they do have side effects, the drugs are working well. But side effects vary so much from person to person, and from drug to drug, that having them or not having them usually isn't a sign of whether the treatment is effective.
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