What Is Chemotherapy?
The term chemotherapy (pronounced: kee-mo-
ther
-uh-pee), which is sometimes shortened to chemo, refers to the use
of medications to treat cancer.
Cancer
is a disease that occurs when cells in the body develop abnormally
and grow in an uncontrolled way. Cancer cells tend to divide
rapidly. Chemotherapy works by interfering with the way cells
divide, thereby preventing the cancer from spreading - and
sometimes even curing the disease by helping to get rid of all the
cancer cells in the body.
How Is Chemo Given?
A pediatric oncologist (pronounced: on-
kah
-luh-jist), a doctor who treats cancer in children and teens, will
work with other health care professionals to decide on the type of
chemotherapy treatment that will work best for each individual
cancer patient.
There are many different ways that teens are given chemo
medications, including:
-
Intravenously (IV).
A needle is inserted into a vein and the medicine flows from an
IV bag or bottle into the bloodstream. Chemo can also be
delivered intravenously through a catheter, a thin flexible tube
that is placed in a large vein in the body.
-
Orally.
The person getting treatment swallows a pill, capsule, or liquid
form of chemo medication.
-
By injection.
Using a needle or syringe, the drugs are injected into a muscle
or under the skin.
-
Intrathecally.
A needle is inserted into the fluid-filled space surrounding the
spinal cord and the chemo drugs are injected into the spinal
fluid.
Combination Therapy
Chemotherapy may be used alone to treat cancer, or it may be
used in combination with other cancer treatments, such as
radiation
therapy
(pronounced: ray-dee-
ay
-shun
ther
-uh-pee) or surgery. Radiation therapy directs high-energy X-rays
at a person's body to kill cancer cells and shrink tumors.
Surgery helps to remove larger tumors, making the job of the
chemotherapy easier. The kind of therapy a person receives is based
on the type of cancer that person has and whether it has spread to
areas outside where it started.
Most cancers in teens are treated with more than one
chemotherapy drug; doctors refer to this as
combination chemotherapy
. For a lot of people, combination therapy improves the chances
that their cancer will be cured - the cancer has less chance of
building up a resistance to a combination of chemotherapy drugs
than it does to just one drug. (Resistance means that the body no
longer reacts to that medication.) Another important strategy in
treating cancer is giving a person repeated courses of
chemotherapy. This helps prevent the cancer cells from
regrowing.
People who feel nervous about receiving chemo can ask about
touring the hospital or clinic before treatment begins to help them
feel more at ease. People who are being treated for cancer can also
join a support group for teens and families coping with cancer.
When and Where Is Chemo Given?
A person can receive chemotherapy treatments at a hospital,
cancer treatment center, doctor's office, or at home. Most
teens receive their chemo treatments at a clinic or hospital and go
home after chemo. Sometimes, though, people who are getting chemo
treatments may need to stay in the hospital so doctors can
watch for side effects.
Some people receive chemotherapy every day; others receive it
every week or every month. Doctors use the word "cycles"
to describe chemotherapy treatments because the treatment periods
are mixed in with periods of rest.
What Are the Common Side Effects?
While chemotherapy works to treat cancer, normal cells - like
hair cells, which also divide rapidly - can be affected, too. This
can cause problems, which are known as
side effects
. Side effects are usually temporary and are different from person
to person, depending on the person's age, the type of
treatment, and where the cancer is located.
Some of the side effects of chemotherapy are:
-
Fatigue.
It's quite common for people who are having chemotherapy to
feel very tired. Some people feel extremely tired all of a sudden
and may be exhausted even after sleeping or resting.
-
Discomfort and pain.
Some people may feel a little discomfort when the catheter or IV
needle is put in the skin. Chemo treatments may also cause nerve
problems and burning, numbness, tingling, or shooting pain in the
fingers and toes. Certain types of chemo medications also cause
mouth pain, headaches, muscle pains, and stomach pains.
-
Skin changes.
People who are receiving chemo treatments may find their skin
becomes red, sensitive, or irritated. People who receive
radiation therapy before having chemotherapy may notice that
involved skin may turn red, blister, and peel once chemo begins.
This is known as "radiation recall."
-
Hair loss and scalp problems.
Some people who get chemo lose their hair. It may become thinner
and then fall out completely or in clumps. People who are
receiving chemo may lose hair all over their bodies, including
the head, face, arms and legs, underarms, and pubic area. Most
people who lose their hair during chemotherapy find that it grows
back once treatment has ended, usually within 3 months.
-
Mouth, gum, and throat sores.
Chemotherapy may cause sores in the mouth, gums, and throat, or
cause a person's gums to become irritated and bleed. A doctor
may prescribe a mouth rinse or other products to reduce pain,
dryness, and irritation. People who are receiving chemotherapy
treatments should get regular dental checkups and follow their
dentist's advice on how to brush their teeth during
chemotherapy.
-
Stomach problems.
People receiving chemotherapy may feel sick, not feel like
eating, or throw up during the course of their treatment. They
may also have loose bowel movements or become constipated.
-
Central nervous system problems.
Chemotherapy may also cause temporary confusion and depression in
some people.
-
Kidney and bladder problems.
Some chemo drugs can irritate or damage the bladder or
kidneys.
-
Blood problems.
Having chemo may cause certain blood problems:
Anemia.
Having chemo can affect the red blood cells, which are made in
the bone marrow and carry oxygen to the rest of the body. This
can cause anemia, a low number of red cells in a person's
blood.
Bleeding problems.
Some types of chemo drugs may also cause problems with platelets,
which are needed to help blood clot. Platelet problems can make
it easy for a person to bleed and become bruised. Blood
transfusions are sometimes given to help remedy these problems.
Increased risk of infection.
In addition to red blood cell and platelet problems, people who
get chemo may have lowered numbers of white blood cells. These
cells are part of the immune system and help the body to fight
infections. As a result, people getting chemotherapy are more
vulnerable to infection. Because of their suppressed immune
systems, it's important for these people to avoid crowds and
to stay away from people they know who have infections like colds
or the flu. This doesn't mean that teens getting chemo need
to hide in their rooms, though. Doctors encourage people who are
getting chemo to maintain contact with friends. And, although
they usually ask patients to check in before going to a place
where there will be lots of people, doctors usually give teens
the go-ahead to attend social functions. One way to prevent
infection is frequent
hand washing
.
Long-Term Side Effects
Because chemotherapy can cause long-term side effects (known as
late effects
), it is critical that people who have had cancer continue to get
routine medical care even after their cancer has been cured.
Depending on their treatment, people who have had cancer should get
regular heart and lung exams, as well as blood tests for thyroid
function.
It's important for anyone who's receiving chemotherapy
treatments to tell nurses or doctors about side effects so they can
help treat the problem. Doctors who treat people using chemotherapy
aren't just working to cure cancer, they also want their
patients to be as comfortable as possible while they're having
chemotherapy.
Getting Support
Chemotherapy can be frightening to think about. If you're
one of the many people whose cancer is being treated with
chemotherapy, your doctors, nurses, and other members of the cancer
treatment team are there to reassure you before, during, and after
chemotherapy.
You can also look for support from friends and family. Your
friends make you feel good when you're healthy - so surrounding
yourself with friends when you're sick is sure to be a
pick-me-up. Phone and email are great ways to keep in touch, even
if you're having a bad day. If you're afraid that your
friends will feel weird or embarrassed, talk to a parent or nurse
about some ideas on how to cope.
How Can I Help Myself Feel Better During Chemotherapy?
In addition to dealing with the many emotions you'll feel,
you have to manage the physical stuff, too. Try these tips for
chilling out more comfortably during treatment:
-
Sleep long, sleep often.
Your body needs plenty of rest to recover from chemotherapy.
Scale back on strenuous stuff, and make time to get a good
night's sleep every night.
-
Focus on good nutrition.
If you have nausea, vomiting, and diarrhea, your appetite's
probably in the toilet, too. Try to stick to foods high in
nutrients and eat a balanced diet to prevent weight loss and stay
healthy. Several small meals may be easier to eat than fewer
larger ones, and eating every few hours can prevent you from
feeling too hungry. Skip fatty, greasy, fried, or spicy foods -
things that may make you feel nauseated - and eat bland foods
like crackers, toast, and popsicles that may be easier for your
stomach to handle.
-
Ask your doc about anti-nausea medication.
If you feel sick to your stomach a lot, there
are medications that can help relieve nausea.
-
Get your doctor's OK before taking other
medications.
"Other medications" includes herbal medicines or
over-the-counter drugs. The same goes for immunizations, such as
the flu shot.
-
Drink up.
You may not feel like drinking, but clear broth, juices, and
sports drinks can replace fluids lost through vomiting and
diarrhea. Room-temperature beverages may be easier to drink than
hot or cold liquids.
-
Get on a medication schedule.
If you're taking pain medication, getting on a schedule helps
prevent you from missing doses - waiting until you feel pain can
make it harder to control. If your pain persists or worsens at
any time, talk to your doctor.
-
Protect your scalp.
To protect your head from sun exposure and irritation, wear soft
hats and scarves. Until your hair grows back, you may feel more
comfortable wearing hats, scarves, or wigs to school or other
events. Use only mild shampoos and hair products.
-
Practice infection protection.
Wash your hands before eating, after using the bathroom, and
after touching animals. If friends or family members have
infections such as colds, the flu, or chickenpox, they should
skip visiting until they're feeling better. It's also a
good idea to avoid crowds. And don't worry about missing
school. Home tutors can keep patients on track with their
schoolwork at a manageable pace.
-
Try to prevent bleeding.
If you have blood-clotting problems, blow your nose and brush
your teeth very gently to avoid bleeding.
Once you've finished chemo, it's still important to
visit the doctor for follow-up appointments. During these checkups,
the doctor will want to know how you're feeling and whether
you're experiencing any side effects. He or she will also check
to see whether there are any signs of the cancer coming back.
Undergoing treatment for cancer can be time-consuming, scary,
and sometimes painful. But for teens who beat cancer, there may be
a silver lining - cancer survivors are often tougher, have a
greater appreciation of what life has to offer, and possess the
courage and perseverance it takes to follow their dreams.
Reviewed by:
Donna Patton, MD
Date reviewed: February 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.