Chemotherapy: An Introduction
Chemotherapy
Chemotherapy is a type of drug treatment that kills cancer cells, controls their growth or relieves disease-related symptoms. It may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. Chemotherapy usually works best for cancers that are aggressive and rapidly spreading.
Chemotherapy can be used as a stand-alone treatment for specific cancers or stages of disease. It can also be given with other treatments, like targeted therapy and radiation therapy.
What diseases does chemotherapy treat?
Chemotherapy is mainly used to treat cancer, but it can also be used for other conditions. Some of the most common cancers treated with chemotherapy include:
- Blood cancers (leukemia, lymphoma, multiple myeloma)
- Breast cancer
- Colorectal cancer
- Lung cancer
- Ovarian and cervical cancer
- Prostate cancer
Doctors may also use low doses of chemotherapy for autoimmune diseases like lupus and rheumatoid arthritis in order to suppress an overactive immune system.
Who gets chemotherapy?
You may need chemotherapy if:
- You have cancer that is growing or spreading and needs to be controlled.
- Your doctor wants to shrink a tumor before surgery or radiation (called neoadjuvant chemotherapy).
- You need chemotherapy after surgery or radiation to kill any remaining cancer cells (called adjuvant chemotherapy).
- You have a type of cancer that responds well to chemotherapy, such as leukemia or lymphoma.
- Your cancer has spread (metastasized) and needs to be managed with systemic treatment. For very advanced cancers, chemotherapy is usually given indefinitely.
Your care team will consider factors like your overall health, cancer type, and stage before recommending chemotherapy.
What happens during a chemotherapy procedure?
The treatment is usually given in cycles, with rest periods in between to allow your body to recover. You may need chemotherapy weekly, every few weeks, or monthly, depending on your treatment plan. During your sessions, you¡¯ll be monitored for side effects, and your care team will help manage any symptoms.
Chemotherapy is administered in several ways:
- Intravenous (IV) is the most common method. A needle is inserted into a vein and attached with tubing to a plastic bag holding the drug.
Some IV chemotherapy requires a catheter, a tube that connects directly to a large vein and is left in place throughout treatment. Patients may choose to have a catheter inserted to avoid frequent needle sticks. Patients with a catheter may have an IV connection device called a port implanted under the skin.
- Oral chemotherapy drugs are taken by mouth, either in pill or liquid form.
- Injections are administered into the muscle, under the skin, or directly into a tumor, depending on the type or location of the cancer.
- Intrathecal chemotherapy is delivered directly into the cerebrospinal fluid, a liquid that surrounds and protects the brain and spinal cord. It is typically delivered with an injection between two vertebrae. Intrathecal chemotherapy is used to treat patients with evidence of cancer in the cerebrospinal fluid. It is also used as a preventive treatment for patients with cancers that have a high risk of spreading to the central nervous system, such as leukemia and lymphoma.
- Isolated limb perfusion is a way to deliver chemotherapy directly to tumors in the arm or leg. The blood supply of the affected limb is isolated from the rest of the body. Heated chemotherapy drugs are then pumped into the treatment area through tubes inserted into tiny incisions. Isolated limb perfusion is used to treat advanced or metastatic melanoma and some sarcomas.
- Hepatic arterial infusion is a method of delivering chemotherapy directly to tumors in the liver. It is typically used to treat cancers that have metastasized, or spread, to this organ. A tiny pump is surgically inserted under the skin and connected to the hepatic artery, which supplies blood to the liver.
- Topical chemotherapy delivers the drug as a cream applied to the skin. It is used to treat skin cancer.
What are the side effects of chemotherapy?
Chemotherapy affects both cancer cells and healthy cells, which can lead to side effects.
Short-term side effects include:
- Fatigue
- Nausea and vomiting
- Hair loss
- Mouth sores
- Loss of appetite
- Increased risk of infections (due to low white blood cell counts)
Long-term side effects (which may appear months or years later) include:
- Nerve damage (tingling or numbness)
- Heart or lung problems
- Fertility issues
- Increased risk of a second cancer
The side effects of chemotherapy depend on the specific drug or drugs that a patient receives. The duration and severity of chemotherapy side effects differ from patient to patient. Most are temporary and will disappear once treatment has ended.
What are chemo curls? Understanding post-chemo hair changes
Many patients are surprised to find that their hair looks different when it grows back after chemotherapy. Hair that was once straight may come back curly, a phenomenon sometimes called ¡°chemo curls.¡± Changes in hair texture or even color are common after treatment, but they¡¯re usually temporary.
We talked to breast medical oncologist , to understand why this happens and what you can expect during hair regrowth after chemotherapy.
How chemotherapy affects hair growth
Chemotherapy works by targeting cells that divide rapidly. While this approach is effective at killing cancer cells, it also affects healthy cells, including those in the hair follicles.?
Damage to the follicles can temporarily disrupt your hair¡¯s normal growth process, leading to changes in texture or color.
¡°Chemo can linger in the hair follicles and alter the way hair grows,¡± says Iheme. ¡°That¡¯s why patients sometimes notice their hair coming back curlier, finer or even in a different color.¡±
Hair growth depends on a process called hair shaft synthesis. When chemotherapy disrupts this process, it can cause new hair to grow differently than before. Texture changes are one of the most common side effects, but you might also notice that your hair feels thinner, more fragile or grows in uneven patches at first.
As chemotherapy leaves your body and the hair follicles recover, in most cases, hair should eventually return to its original texture and color.
Chemotherapy may cause your hair color to change?
Along with texture, patients sometimes experience changes in hair color after chemotherapy. If you once had brunette hair, for instance, you may notice reddish or lighter hues when your hair regrows.
The exact reasons for these color changes are not fully understood. Iheme says that genetics, age and gender may all influence how hair grows back. ¡°We don't know the full biology behind it, but we do know that changes in hair color are possible after chemotherapy,¡± she says.
Fortunately, like texture changes, hair color changes are usually temporary. As your body heals, you may find that your hair gradually returns to its pre-treatment color.
Interestingly, while scalp hair may change color or texture, other body hair ¡ª such as eyebrows and eyelashes ¡ª typically regrows with little to no noticeable change.
IV vitamin therapy: Is it safe to use during chemo?
Sometimes, patients ask me about IV vitamin therapy after reading testimonials online from people who claim it has helped them feel better, or that it can ease the side effects of cancer treatments, such as nausea caused by chemotherapy.??
But is there any evidence to support these claims? And, is IV vitamin therapy safe??
Here, I¡¯ll answer some of the most frequently asked questions I hear about IV vitamin therapy.?
What is IV vitamin therapy?
IV vitamin therapy is when you receive a fluid solution containing certain vitamins intravenously, or through a vein, rather than by taking them by mouth in pill form as a dietary supplement or getting them from the foods you eat.?
What is the goal of IV vitamin therapy?
That depends on who you ask, and which IV vitamins you¡¯re talking about. People are drawn to IV vitamin therapy for different reasons.??
The one I¡¯m usually asked about is vitamin C. Some patients have heard that IV vitamin C therapy may improve their quality of life during cancer treatment. Others hope that IV vitamin C therapy may give them a chance to live longer after diagnosis or reduce their chances of a cancer recurrence.??
So, does IV vitamin therapy actually work?
IV vitamin therapies have been investigated for a long time. But at this point, most doctors in the field of cancer medicine have not seen enough convincing, high-quality evidence to broadly recommend the use of IV vitamin therapies alongside conventional cancer treatments.??
There is very strong evidence, though, showing that a whole-food, plant-based diet and regular exercise can help you feel better, live longer, reduce your overall cancer risk and risk of recurrence. So, we encourage our patients to make lifestyle changes to improve and protect their health first. We¡¯d rather you get your vitamins through the foods you eat than through an infusion.?
