We know that chemotherapy is a cancer treatment in which medications are used to kill cancer cells. There are different types of chemotherapy medication but all of them work in a similar way. Chemotherapy can stop the cancer cell reproducing and it can prevent them from growing and spreading in the body. This is one of the most common and most powerful forms of cancer treatment. Chemotherapy can help you to rid of cancer but on the other hand, it can cause side effects [1]. Chemotherapy can be carried out in many different ways which depend on your circumstances. Before the chemotherapy begins, your doctor will test you to check your general health and to be sure that the chemotherapy is suitable for you.
When chemotherapy is used?
This type of therapy can be used if cancer has spread or if there is a risk that it will. Chemotherapy can be used to:
- Relieve symptoms if a cure is not possible (palliative chemotherapy)
- Decrease the risk of cancer coming back after you had radiotherapy or surgery (adjuvant chemotherapy)
- Make other treatments more effective, for example, it can be combined with radiotherapy (chemotherapy) or used before surgery (neoadjuvant chemotherapy)
- Try to cure cancer completely (curative chemotherapy)
The effectiveness of chemotherapy can vary a lot from one person to another [2]. If you are diagnosed with cancer, then you should talk to your doctor about the chances of treatment being successful for you.
Types of chemotherapy
It is known that chemotherapy can be given in several ways. Your doctor will recommend the best type of chemotherapy for you. Here are the most common types of chemotherapy:
- Chemotherapy tablets (known as oral chemotherapy) which is usually involving taking a course of medication at home, with regular check-ups in hospital [3,4]
- Chemotherapy is given into a vein (it is known as intravenous chemotherapy) which is usually done in the hospital and it is involving medicine being given through a tube in a vein in your hand, arm or chest
You can be treated with one type of chemotherapy medicine or a combination of different types. Usually, you will have several treatment sessions, which will typically be spread over the course of a few months.
Side effects of chemotherapy
Chemotherapy can cause unpleasant side effects but many of them can be treated or prevented and most of them will pass when your treatment stops. It is difficult to know what kind of side effects you will get from the chemotherapy. Below are given some of the most common side effects caused by chemotherapy:
Feeling sick and vomiting There are many people who are using chemotherapy and they have periods where they feel sick or vomit. Your doctor can give you anti-sickness medication to reduce or prevent this. This is available as skin patch; suppositories which are capsules that you put into your bottom; injections or a drip into a vein; tablets or capsules. If you have noticed that your medicine does not help you or it causes you too many side effects then tell your care team. Your doctor will find what works better for you.
Tiredness or fatigue is one of the most common side effects of chemotherapy. There are many people with chemotherapy who feel tired a lot of the time or they tire very easily during daily tasks. You can get a lot of rest to prevent it. You should avoid doing tasks or activities which you do not feel up to. You can do light exercises, like yoga and walking if you are able to do it. These exercises will boost your energy levels but you should be careful not to push yourself too hard. If you suddenly feel very tired and out of breath, then you should talk with your doctor because this can be a sign of anemia. [5]
Hair loss This is a very common side effect of chemotherapy but it does not happen to all people who have chemotherapy. You should ask your care team if the hair loss is likely to be a side effect of medicines which you are taking. If you lose hair, then this usually starts within a few weeks of your first treatment session. If you lose a lot of hair, then this typically happens in a month or two. Most commonly, people are losing hair from the head but you can also lose hair from other parts of your body, such as the face, legs, and arms. Almost, always the hair loss is temporary. Your hair should start growing again after you have finished with the chemotherapy. There are some cases when the hair which grows back has a slightly different color or it can be curlier or straighter than it is used to be. The hair loss can be upsetting. You should talk with your care team if the hair loss is difficult for you to cope with. Your care team will understand you and it will help you to discuss the options which you have. [6]
Anemia It is known that the chemotherapy can lower the amounts of red blood cells which can carry oxygen around the body. If your red blood cell count drops too low, then you will develop anemia. The most common symptoms of anemia are a pale complexion; noticeable heartbeats; shortness of breath; tiredness and lack of energy. If you have any of the mentioned symptoms, then you should talk to your doctor because he or she will help you to increase the number of red blood cells. [7]
Infections It is known that chemotherapy can reduce your body’s ability to fight against infections. This is increasing your chances to get infections which can make you seriously ill.
Sore mouth There are some cases when chemotherapy can lead to mouth sore and irritated mouth. This condition is known as mucositis. The symptoms of the sore mouth include bad breath; a reduced sense of taste; a dry mouth; discomfort when eating, drinking and talking; mouth ulcers, which can become infected; the inside of your mouth feeling sore.
Bruising and bleeding It is known that chemotherapy can reduce the number of cells called platelets in your blood. Platelets can help to stop severe bleeding when you cur or injure yourself. If you have a low number of platelets, then you have bleeding gums; severe nosebleeds; skin that bruises easily.
Skin and nail changes There are some chemotherapy medicines which can cause temporary changes to your skin. Your skin can become itchy; red and sore; more sensitive to sunlight; slightly discolored; dry. You should talk to your doctor if you have noticed problems with your skin. They can tell you which creams are good for you and how to protect your skin from the sun.
Loss of appetite If you are having chemotherapy, then you can lose your appetite. You should try to drink plenty of fluids and eat what you can because they can improve your appetite.
Memory and concentration problems There are some problems that have problems with their short – term memory, concentration and attention span during chemotherapy. You can notice that the routine tasks need more time to be finished than normal. It is not known why this happens but the symptoms usually improve when the chemotherapy is finished. You can use things, like mobile phones, calendars, post-it notes, and lists as reminders because they can help you. Also, getting enough rest, eating well and doing some mental exercises can be useful.
Sex and fertility issues Many people have lost interest in sex during chemotherapy. Usually, this is temporary and your sex drive will gradually return after your treatment has finished. Also, some chemotherapy medicines can reduce fertility in men and women. Often this is temporary but in some cases, it can be permanent. Before you start your chemotherapy, you should talk to your doctor if your fertility would be affected. If you are having a risk of infertility, then you should talk about the best options for you.
Emotional issues When you have chemotherapy, then it can be a frustrating, stressful and traumatic experience. It is natural to feel anxious and to wonder if the chemotherapy will be successful. Also, stress and anxiety can increase your risk of getting depression. If you are struggling to cope emotionally, then talk with your doctor about possible treatment strategies. [8]
Sleep problems There are some people who have problems with sleeping caused by chemotherapy, such as difficulty falling asleep or wake up in the middle of the night and they cannot go back to sleep. This condition is known as insomnia.
Diarrhea and constipation You can have constipation or diarrhea a few days after you begin chemotherapy. Your doctor can recommend suitable medications for you and diet changes which will help you.
References:
[1] Du XL, Jones DV, Zhang D. Effectiveness of adjuvant chemotherapy for node-positive operable breast cancer in older women. Journals Of Gerontology Series A-Biological Sciences And Medical Sciences. 2005;60(9):1137–44.
[2] Safdie FM, Dorff T, Quinn D, et al. Fasting and cancer treatment in humans: A case series report. Aging (Albany NY). 2009;1(12):988–1007.
[3] Weingart SN, Mattsson T, Zhu J, et al. Improving electronic oral chemotherapy prescription: Can we build a safer system? Journal of Oncology Practice. 2012;8(6):e168–e173.
[4] Journal of Oncology, Navigation & Survivorship. Oral chemotherapy: Patient education and nursing intervention. 2016;7(6).
[5] Karthikeyan G, Jumnani D, Prabhu R, et al. Prevalence of fatigue among cancer patients receiving various anticancer therapies and its impact on quality of life: A cross-sectional study. Indian Journal of Palliative Care. 2012;18(3):165–75.
[6] Muth CC. Chemotherapy and hair loss. JAMA. 2017;317(6):656.
[7] Bryer E, Henry D. Chemotherapy-induced anemia: etiology, pathophysiology, and implications for contemporary practice. International Journal of Clinical Transfusion Medicine. 2018;6:21-31.
[8] Marusak H. Understanding the psychological effects of childhood cancer. Scientific American. 2018.
