Chemotherapy

What is Chemotherapy?

Chemotherapy is a type of cancer treatment that uses medicines to destroy cancer cells or stop them from growing and spreading. Unlike surgery or radiation therapy, which target a specific area, chemotherapy works throughout the body. This makes it useful when cancer has spread to other organs.

Chemotherapy can be used on its own, but it is often combined with surgery, radiation therapy or targeted therapy, depending on the type and stage of the cancer. Your care team will recommend a plan suited to you and explain what to expect at each stage.

How Chemotherapy Works

Chemotherapy medicines are given in different ways, most commonly through an intravenous (IV) infusion or as tablets taken by mouth. Once in the bloodstream, they circulate through the body and can reach cancer cells wherever they are.

Chemotherapy acts on cells that divide quickly, which is a feature of cancer cells. Some healthy cells also divide quickly, such as those in the hair, mouth, intestines and bone marrow, and this is why chemotherapy can cause side effects.

Goals of Chemotherapy

The purpose of chemotherapy differs from patient to patient. Your doctor will explain the aim of your treatment.

• Before Surgery or Radiation (Neoadjuvant): Chemotherapy is given to shrink a tumour so that surgery or radiation therapy can be more effective.
• After Surgery or Radiation (Adjuvant): Chemotherapy is given to destroy any cancer cells that may remain after other treatments.
• To Remove the Cancer: In some patients, the aim of treatment is to eliminate the cancer. Whether this is possible depends on the type and stage of the cancer.
• To Control Advanced Cancer: In advanced cancer, chemotherapy may be used to control the disease, relieve symptoms and improve quality of life.

How Chemotherapy Is Given

• Intravenous (IV) infusion: The medicine is delivered into a vein, usually over a period of time.
• Oral tablets: Some chemotherapy medicines are taken by mouth, at home or as directed by your doctor.
• Treatment cycles: Chemotherapy is usually given in cycles, with rest periods in between to allow your body to recover. Your doctor will explain your schedule.
• Combined treatment: Chemotherapy may be given together with, or before or after, surgery, radiation therapy or targeted therapy.

Possible Side Effects

Because chemotherapy affects fast-growing cells, side effects can occur. They vary from person to person and depend on the medicines used. Many are temporary and can be managed with supportive care.

• Hair: Hair thinning or hair loss.
• Mouth: Mouth sores or a sore mouth.
• Digestive System: Nausea, vomiting, diarrhoea or constipation.
• Bone Marrow: Low blood counts, which may cause tiredness, a higher risk of infection, or bruising and bleeding.
• General: Fatigue.

Preparing for Chemotherapy

• Review your treatment plan: Your doctor will explain the medicines, the schedule and what to expect, and will answer your questions.
• Have your tests done: Blood tests and other checks help your team confirm that chemotherapy is suitable for you and monitor you during treatment.
• Share your medical history: Tell your doctor about your other medical conditions, and about all the medicines and supplements you take.
• Plan ahead: Arrange transport and support from family or friends, particularly for treatment days, and plan to rest as needed.

Looking After Yourself During Treatment

• Eat well and stay hydrated: Small, regular meals and plenty of fluids can help if you feel nauseous or have a poor appetite. A dietitian can advise on your nutrition.
• Rest when you need to: Tiredness is common, so balance rest with gentle activity as you are able.
• Protect yourself from infection: Wash your hands often and avoid close contact with people who are unwell.
• Look after your mouth: Brush gently and rinse your mouth as advised by your care team.
• Seek support: Speak to your care team if you feel anxious or low. Support is available.

Your care team can provide supportive treatment, such as medicines to prevent or relieve nausea, and will monitor your blood counts with regular blood tests. Please tell your team about any side effects you experience, so that they can help you manage them.