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Chemotherapy

    About the Treatment

    Chemotherapy is a treatment procedure that involves the use of drugs that possess powerful chemicals to kill fast-growing cells especially cancer cells which divide at a

    faster rate than normal cells in the body. Chemotherapy drugs stop these cells to grow by altering their morphology. Thus stopping or slowing down their growth. In turn curing or controlling cancer. While stopping these faster-growing cells, these drugs also act on the normally faster-growing cells of the body e.g. bone marrow cells, intestine lining, etc. which becomes the side effects of these drugs.

    Types of Chemotherapy

    • Induction Chemotherapy: only one drug is used to cure cancer.
    • Combination Chemotherapy: Combination of drugs is used to cure cancer. All drugs have a different mode of action and different target areas.
    • Neoadjuvant chemotherapy: when the cancer is in one part of the body and part can be removed by surgery e.g. breast cancer. Before the surgery this chemotherapy is given to shrink the cancer.
    • Adjuvant chemotherapy: it is given after the local treatment e.g. surgery to kill the cancer cells which has spread to the other parts or to check reoccurrence.
    • Maintenance chemotherapy: it is given to prolong the re-occurrence of the cancer.
    • Palliative chemotherapy: It is given to control the effects of cancer on the body, to increase the life expectancy.
    • Combined modality chemotherapy: Chemotherapy given with other types of cancer treatment such as radiotherapy, surgery etc.

    Indications

    • Cancer
    • Bone marrow diseases
    • Immune system disorders like rheumatoid arthritis and lupus.

  • A series of tests and procedures to assess your health status is done.
  • To determine the right chemotherapy dose, height and weight are measured.
  • If any infection is detected, then treatment is given to cure the infection.
  • The patient signs an informed consent form.

Chemotherapy is given in cycles (cycle is session of chemotherapy repeated after a definite period) depending on

  • Drug and dose used for treatment
  • Goal of treatment
  • Method of treatment
  • Type of the patient
  • Type of the cancer
  • Stage of cancer
  • The response of the patient to first cycle.

 

Chemotherapy can be given through different means like:

  • Intravenous (IV) - Through vein. Various devices like winged infusion device, peripheral cannula, midline catheter, a peripherally inserted central catheter (PICC), central venous catheter, Hickman line and implantable port are surgically inserted into the vein to give multiple cycles over a period.
  • Intra-arterial (IA) - Through the artery
  • Intraperitoneal (IP) - Into the peritoneal cavity i.e. abdominal cavity.
  • Intrathecal – In Cerebrospinal fluid (CSF) through spinal cord in case the cancer is in central nervous system or brain.
  • Intramuscular (IM) – injection given in a muscle in your arm, thigh, or hip.
  • Topically – Applied on to the skin as a cream or gel.
  • Orally – As pills, capsules, or liquids.

  • IV line is removed.
  • If you have a port, it will remain until you finish all your treatments.
  • Vitals are monitored again.
  • Chemotherapy weakens your immune system, so precautions should be taken.
  • Drinking lots of fluids after chemotherapy will flush out the drugs through your body.

  • Anemia
  • Fatigue
  • Nausea and vomiting
  • Hair loss
  • Immunosuppression
  • Myelosuppression
  • Typhlitis
  • Gastrointestinal distress
  • Secondary neoplasm
  • Infertility
  • Teratogenicity
  • Peripheral neuropathy
  • Cognitive impairment
  • Tumor lysis syndrome
  • Organ damage
  • Red skin (erythema)
  • Dry skin
  • Damaged fingernails
  • Dry mouth (xerostomia)
  • Water retention

Dr. Randhir Sud

Dr. Randhir Sud

Chairman - Institute of Digestive & Hepatobiliary Sciences

Medanta The Medicity, Gurgaon

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Dr. Avnish Seth

Dr. Avnish Seth

Director & Head

Fortis Memorial Research Institute, Gurgaon

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Dr. Hitendra K Garg

Dr. Hitendra K Garg

Consultant

Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi

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