Chemotherapy for Cancer Treatment
- Adjuvant therapy—This is chemotherapy that is given after surgery, either alone or with radiation (or another type of therapy), and that is designed to kill cells that have metastasized.
- Neoadjuvant chemotherapy—This is used prior to surgery to shrink a tumor, usually in conjunction with radiotherapy.
- Primary therapy—This form is used alone when leukemia or lymphoma is present. The therapy is also used alone in the management of other cancers when no hope for cure is present, and chemotherapy is given to control symptoms.
- Induction chemotherapy—This is used as the first of many therapies. For instance, in the management of some lung cancers , chemotherapy may be given first (induction) followed by either surgery or radiation therapy. In stomach cancer (either before or after surgery), chemotherapy may be given first followed by radiation therapy.
- Combination chemotherapy—This involves the use of two or more chemotherapeutic agents, allowing for each medication to enhance the action of the other or for the two to work synergistically.
- G0 phase—Also known as the resting phase, at this stage, the cell has not started to divide. This step can last a few hours, a few days, a few years, or a lifetime. When the cell is signaled to reproduce, it moves to the next phase, G1 phase.
- G1 phase—The cell readies to divide by manufacturing proteins necessary for reproduction. This phase lasts about 18 to 30 hours.
- S phase—The cell’s complement of genes made of DNA is copied so that when the cell divides, the new cell will have a copy of the genetic information. This phase lasts from 18 to 20 hours.
- G2 phase—Further protein synthesis occurs; this phase lasts from 2 to 10 hours.
- M phase—The cell splits into two new cells; this phase lasts about 30 to 60 minutes.
- Cure—The goal is to cure the cancer so that is disappears (is killed off) and does not return.
- Control—If cure is not possible, chemotherapy aims to control the growth and spread of the cancer.
- Palliation—If cure and control are not possible, chemotherapy is given to relieve symptoms caused by the cancer.
Cell Cycle Phase-specific
Cell Cycle Phase-nonspecific
- Vinca plant alkaloids
- Miscellaneous agents such as asparaginase and dacarbazine
- Alkylating agents
- Antitumor antibiotics
- Hormone and steroid drugs
- Miscellaneous agents such as procarbazine
- Orally—The drug is given in pill, capsule, or liquid form and swallowed.
By injection—The drug is given using a needle or syringe in one of several ways:
- Intramuscularly (IM)—into the muscle
- Subcutaneously (SQ or SC)—under the skin and into the fat tissue
- Intralesionally (IL)—directly into the cancerous area of the skin
- Topically—The drug is applied to the surface of the skin.
- Blood cells
- Hair follicle cells
- Skin cells
- Reproductive and digestive tract cells
- Plan time to rest throughout the day.
- Take several short naps or breaks, rather than one long one.
- Try easier or shorter versions of activities you enjoy.
- Take short walks or do light exercise (with your doctor’s approval).
- Allow others to help you with daily responsibilities.
- Eat healthfully and avoid caffeine and alcohol .
- Focus on maintaining as normal a lifestyle as is possible; continue to do what you enjoy doing, but listen to your body (if you feel tired, rest).
|Melphalan (in high doses)||Plicamycin|
|Streptozocin||Methotrexate (in high doses)|
|Cytarabine (in high doses)||Carboplatin|
|Etoposide (in high doses)||Doxorubicin|
- Prior experience with motion sickness
- Previous bad experiences with nausea and vomiting
- Being young
- Heavy alcohol intake
- Women of menstrual age
- Drink liquids at least one hour before or after meals, instead of with your meal.
- Eat and drink slowly.
- Eat several small meals throughout the day, instead of one, two, or three larger meals.
- Breathe deeply and slowly when you feel nauseated.
- Avoid sweet, fried, greasy, or fatty foods.
- Rest, but do not lie flat for at least two hours after a meal.
- Try ginger tablets or ginger ale; ginger has been reported to reduce feelings of nausea.
- Practice relaxation exercises .
- Wear loose-fitting clothes.
- Lorazepam (Ativan)
- Prochlorperazine (Compazine)
- Metoclopramide (Octamide, Reglan)
- Dexamethasone (Dexamethasone, Hydrocortisone, Prednisone)
- Ondansetron (Zofran)
- Granisetron (Kytril)
- Use a mild shampoo.
- Use a soft hair brush.
- Use low heat when drying your hair.
- Have your hair cut short—a shorter style will make your hair look fuller and thicker.
- Use a sunscreen, sun block, hat, or scarf to protect your scalp from the sun.
- Avoid perming, dying, or relaxing your hair.
- Keep your head covered in the winter to prevent heat loss.
- White blood cells: 6 hours
- Red blood cells: 120 days
- Platelets: 10 days
- Shaking chills
- Sore throat
- Shortness of breath
- A new cough
- Nasal congestion
- Burning sensation during urination
- Redness, swelling, and warmth at site of an injury
- Wash your hands often during the day—always before you eat, after going to the bathroom, and after touching animals.
- Stay away from people who have illnesses that you can catch, like a cold , the flu , or chicken pox .
- Try to avoid crowds.
- Stay away from children who have recently received "live virus" vaccines, like chickenpox or oral polio .
- Maintain good mouth care.
- Do not eat raw fish, seafood, meat, or eggs.
- Clean cuts and scrapes right away and daily until healed.
- Feeling faint
- Shortness of breath
- Feeling as if your heart is "pounding" or beating very fast (heart palpitations)
- Chest pain
- Nausea and vomiting
- Get plenty of rest. Sleep more at night and take naps during the day.
- Limit your activities.
- Ask for help when you need it.
- Eat a well-balanced diet.
- When sitting, get up slowly. When lying down, sit first and then stand.
- Easy bruising
- Heavy or longer menstrual periods
- Bleeding longer than usual after minor cuts or scrapes
- Bleeding gums or nose bleeds
- Developing large bruises (ecchymoses) and multiple small bruises (petechiae)
- Eat small, frequent meals throughout the course of the day, rather than one, two, or three large meals.
- Avoid drinking fluids with meals to prevent from feeling full.
- Eat foods high in protein, such as eggs, peanut butter, nuts, dairy products, tuna, and beans.
- Make eating more pleasurable; eat with friends in a relaxing environment.
- Breakfast may be the most tolerable meal of the day; try to include at least one-third of your calories in this meal.
- Monitor and record your weight weekly; tell your doctor of any changes.
- Stiff neck
- Nausea and vomiting
- Lethargy or sleepiness
- See your dentist at least several weeks before you start chemotherapy. You may need to have your teeth cleaned and to take care of any problems such as cavities, gum abscesses, gum disease, or poorly fitting dentures. Talk with your doctor before undergoing any dental procedure.
- Ask your dentist to show you the best ways to brush and floss your teeth during chemotherapy.
- Brush your teeth and gums after every meal. Use a soft toothbrush and a gentle touch; brushing too hard can damage soft mouth tissues.
- Rinse with warm salt water after meals and before bedtime.
- Rinse your toothbrush well after each use and store it in a dry place.
- Avoid mouthwashes that contain any amount of alcohol.
- If you develop sores in your mouth, tell your healthcare provider. You may need medicine to treat the sores.
- Ask your doctor to prescribe or recommend a medicine to ease the pain; there are some medications you can apply directly to the sores.
- Eat foods cold or at room temperature. Hot or warm foods can irritate a tender mouth and throat.
- Eat soft, soothing foods, such as ice cream, milkshakes, baby food, soft fruits (bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese, macaroni and cheese, and puddings.
- Puree cooked foods in the blender to make them smoother and easier to eat.
- Avoid irritating, acidic foods and juices, such as tomato and citrus juice; spicy or salty foods; and rough or coarse foods such as raw vegetables, granola, popcorn, and toast.
- Your age when treated
- Dose and duration of the chemotherapy
- Which chemotherapy drugs are given
- Temporary or permanent damage to the ovaries
- Disruption or stoppage of the menstrual cycle
- Symptoms of early menopause , such as hot flashes, vaginal dryness, and tightness during intercourse
- Irritation and dryness of the lining of the vagina
- Vaginal infections
- Decrease in sexual desire
- Difficulty getting and maintaining an erection
- Damage to sperm—Talk with your doctor about freezing sperm prior to treatment.
Chemotherapy and you: a guide to self-help during cancer treatment. National Cancer Institute website. Available at: http://www.cancer.gov . Accessed November 25, 2002.
Chemotherapy: what it is, how it helps. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed November 25, 2002.
DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001:289-306.
Otto SE. Oncology Nursing. 4th ed. St. Louis, MO: Mosby, Inc; 2001:638-683.
Understanding chemotherapy: a guide for patients and families. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed November 25, 2002.
What are the side effects of chemotherapy? American Cancer Society website. Available at: http://www.cancer.org/ . Accessed November 25, 2002.
- Reviewer: Igor Puzanov, MD
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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