Chemotherapy

Chemotherapy is the use of drugs/medications to treat cancer. These drugs are also known as "cytotoxic" drugs - meaning poisonous to cells. There are many different anti-cancer drugs in use. Some have been in use for many years, while others have only recently been developed. You will be prescribed drugs that are known to be effective in the treatment of your particular type of cancer.

• Why is Chemotherapy Used

  Chemotherapy is used for one of the following reasons:
  
  Cure: Some cancers can be cured by chemotherapy, either alone or in combination with other treatments. The aim is to destroy all cancer cells.
  
  Control: Many cancers can be controlled with chemotherapy by shrinking the tumour (cancer) and preventing it from spreading.
  
  Relief of symptoms: Sometimes it isn't possible to cure or control a cancer completely. However, chemotherapy can be used to help relieve distressing symptoms. For example, chemotherapy might be used to shrink a tumour to relieve pain.
  
  Your doctor will explain what your chemotherapy is expected to do for you.

• Use of Chemotherapy - Combined Treatments

  Chemotherapy can be used to help other treatments - such as surgery or radiotherapy - to be more effective. This is called adjuvant chemotherapy.
  
  When given before other treatments, chemotherapy can be used to make the cancer smaller. This assists the main treatment such as surgery or radiotherapy.
  
  When given in combination with radiotherapy, chemotherapy boosts the effect of the radiation so that more cancer cells are destroyed.
  
  When given after other treatments chemotherapy is used to try to destroy any remaining cancer cells which may cause problems later on.

• Research into Chemotherapy Treatments

  Active research is being done to develop better drugs to treat cancer, better use of current drugs, and ways to reduce the side effects of current treatments.
  
  You may be asked to be involved in research programs/trials as part of your treatment. If you wish to take part, you will be fully informed about the research trial and be asked to give your written consent before commencing any treatment.

• How is Chemotherapy Given?

  Chemotherapy can be given as a single drug or as a combination of two or more drugs. Chemotherapy drugs may be given in a variety of ways, but most commonly they are given by injection into a vein or through a catheter. They can also be given in tablet or liquid form and occasionally by injection into a muscle, artery or via the spinal fluid. The method of treatment you have will depend on your cancer and the drugs that have been found most effective in treating your type of cancer.

• How Does it Work?

  Chemotherapy drugs enter your bloodstream and travel around your body. They have most effect on rapidly dividing cells, such as cancer cells. The drugs enter and attack cancer cells in different parts of the body. Some anti-cancer drugs also affect your body's normal cells, causing side effects.
  
  Chemotherapy may take several weeks to work and will usually be given on set days over a period of time, ranging from one week to several months. During your course of chemotherapy your doctor may do further tests such as scans, blood tests and x-rays, to see how the cancer cells are being affected.

• Will it Hurt?

  Chemotherapy is not usually painful. Most patients find the most uncomfortable part is the insertion of the needle into a vein to start the intravenous drip. If you are having ongoing treatment, the doctor may discuss with you having an infus-a-port.

• Side Effects - General

  Although chemotherapy drugs can be very effective in destroying cancer cells, they may also cause unwanted side effects.Some normal body cells most commonly affected by chemotherapy drugs are those in your gastro-intestinal tract, bone marrow, hair and reproductive systems (see glossary). As a result, these parts of the body are the ones most often affected by side effects. Most side effects are temporary and will go away in time.
  
  Side effects vary from person to person and from treatment to treatment. The good news is that you may in fact have no side effects at all. If you do suffer from any side effects, there are many treatments available to help reduce and manage your reactions. It is very important to remember that the type and severity of side effects has nothing to do with the success of your treatment.
  
  Before your treatment begins, your doctor and nurse will discuss the potential side effects of your specific treatment and how they may be managed.

• Possible Side Effects - Specific

  • Nausea and vomiting - if nausea (feeling sick) and vomiting occurs it may begin a few hours after treatment and in some cases can last for several days. There are now very effective anti-sickness drugs to prevent or reduce nausea and vomiting. If your nausea/vomiting is out of control, or continues for more than 12 hours, you should contact your doctor.
  • Fatigue/tiredness - most people undergoing chemotherapy feel very tired at some stage during their treatment, and the degree of fatigue varies. You may need to take things slowly until you get your energy back. This can be frustrating - especially if you are usually an active person - but it is important to listen to your body and get plenty of rest. Your doctor, nurse or OT can all provide you with advice about how to best manage tiredness and fatigue.
  • Anaemia - chemotherapy can interfere with the production of red blood cells. These cells carry oxygen around the body. If your red cell count is low you may feel weak, tired and look pale. You may occasionally require a blood transfusion to increase your red cell counts to help you feel better.
  • Bowel changes - chemotherapy may cause constipation or diarrhoea. It is important that you report any changes in your bowel movements to your doctor, who will advise you how to best manage these problems. Dieticians are available to provide nutritional advice that may assist in managing any bowel changes.
  • Hair loss - this will depend on the type of chemotherapy you are having, and may occur some time after your first dose. The hair on your head may be lost completely. You may also experience thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and your hair will usually return to normal once your treatment is finished. In the meantime, hats and wigs and other headgear are available from a number of sources. Ask your nurse for details.
  • Skin care - it is very important to protect your skin while you are having chemotherapy. Scratches and cuts can easily become infected so you may need to take extra care to avoid, or look after any injuries. Some chemotherapy drugs can also make the effect of the sun stronger on your skin, so remember to "Slip, Slop, Slap!" - it is very important to wear a hat, stay in the shade and use a sunscreen.
  • Mouth ulcers - soreness of the mouth and/or mouth ulcers can occur with some chemotherapy treatment. It is important to keep your mouth clean and moist and brush your teeth and gums after meals and at bedtime using fluoride toothpaste and a soft toothbrush. If your mouth becomes sore or you notice any ulcers in your mouth, tell your doctor or nurse.
  • Infection - your bone marrow is your body's "factory" for producing blood cells. Your blood is made up of red and white cells and platelets. White blood cells are produced to protect you from infection. Chemotherapy can temporarily reduce your body's ability to produce white blood cells, meaning that you're less able to fight infection. If your white cell count is low, you may need to avoid people who have infections such as the "flu". Some common signs of infection you need to watch for include fever or chills, sores that are red or not healing as usual, a severe cough or sore throat, and a temperature over 38C. You should contact your doctor immediately if you have any of these symptoms.
  • Bleeding and bruising - chemotherapy drugs can also interfere with your platelet production. Platelets help your blood to clot when you injure yourself. If your platelets are low you are more likely to have problems with bleeding and bruising. You should contact your doctor immediately if you experience any unusual or ongoing bleeding or bruising.

  
  This is some general information to help get you on the road to understanding what chemotherapy is all about. Your doctor or treating nurse will be happy to talk about your specific treatment and answer any questions you may have.